Can Lack of Gut Bacteria Contribute to Acid Reflux?

Gut bacteria wihtin a person's microbiome

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Acid reflux, a common complaint you might recognise as a burning sensation in your chest, occurs when stomach acid backs up into your oesophagus. The condition can be episodic or chronic, in which case it is referred to as gastroesophageal reflux disease (GERD). Recent studies have begun exploring the intricate relationship between the microbes living in your gut and acid reflux, considering whether an imbalance in this internal ecosystem could be a contributing factor to the development of GERD symptoms.

Exploring the role of gut bacteria in acid reflux involves understanding how these microorganisms influence digestive health and potentially affect the functioning of the lower esophageal sphincter (LES), which acts as a barrier to prevent stomach acid from entering the oesophagus. As research unfolds, there is growing interest in whether modifications to gut flora can be a part of managing acid reflux, looking beyond traditional treatments that focus on reducing stomach acid production.

Key Takeaways

  • Acid reflux is characterised by stomach acid entering the oesophagus, causing discomfort.
  • Gut bacteria may influence the functioning of the LES, affecting acid reflux severity.
  • Exploring the gut microbiome’s role offers a potential avenue for managing GERD.

Understanding Acid Reflux

Acid reflux is a common digestive condition where stomach acid flows back into your oesophagus, causing discomfort. It’s important to recognise its symptoms, understand its causes, and know the role gut bacteria play in its development.

Definition and Symptoms

Acid reflux, often referred to as heartburn, is characterised by a burning sensation in the chest and a sour taste in the mouth. Symptoms include:

  • Heartburn: A burning discomfort behind the breastbone
  • Regurgitation: A sour or bitter-tasting acid backing up into your throat or mouth


The disorder stems from the malfunctioning of the lower esophageal sphincter (LES), which normally closes to prevent stomach contents from flowing back up. When the LES is weak or relaxes inappropriately, stomach acid can damage the lining of the oesophagus.

Gastroesophageal Reflux Disease (GERD)

When reflux symptoms occur frequently, it may indicate Gastroesophageal Reflux Disease (GERD), a chronic version of acid reflux. GERD is associated with a higher rate and proportion of acid reflux events and persistent symptoms.

Role of Gut Bacteria

Gut bacteria, or flora, are linked to intestinal health and may impact acid reflux. Changes in bacterial balance can affect digestion, and some studies suggest that probiotics might influence GERD-related symptoms.

Risk Factors and Causes

Several factors can increase the risk of acid reflux, including:

  • Obesity
  • Pregnancy
  • Smoking
  • Certain medications and foods

Lifestyle Factors

Your lifestyle plays a crucial role in managing reflux. Dietary habits, alcohol consumption, and coffee intake are common culprits. Addressing these through lifestyle changes can alleviate symptoms.

Common Misconceptions

One misconception is that only spicy foods trigger acid reflux. In reality, it can be caused by a variety of foods and lifestyle factors, including being overweight.

Related Health Conditions

Acid reflux can coexist with other conditions, such as asthma, allergies, irritable bowel syndrome, and Helicobacter pylori infection, all contributing to the complexity of symptoms.

Esophageal Complications

Chronic acid reflux can lead to complications such as oesophagitis, esophageal stricture, Barrett oesophagus, and increased risk of developing esophageal cancer.


The prevalence and demographics of acid reflux vary, with it being highly prevalent in Western populations, and factors such as age and obesity playing a significant role in its distribution.

Psychological Aspects

Acid reflux can also affect your psychological well-being, exacerbating conditions like anxiety and impacting your quality of life due to the chronic stress of managing the condition.

Diagnosing Acid Reflux

Recognising acid reflux involves understanding its symptoms, seeking a professional diagnosis, undergoing tests and examinations, and noting distinctive signs. Your awareness of these elements is crucial in addressing the condition effectively.

Typical Symptoms Presentation

If you’re noticing a persistent sour taste in your mouth or a burning sensation in your chest, known as heartburn, these might be tell-tale symptoms of acid reflux. Other symptoms include regurgitation, where you may taste food or a sour liquid at the back of your mouth, and symptoms affecting your throat such as a sore throat, bad breath, and hiccups. It’s important to monitor these symptoms, as they can indicate the frequency and severity of your reflux.

Professional Diagnosis

When over-the-counter pharmacy medicines fail to alleviate your symptoms, it’s time to consult your GP. They will review your symptoms, consider your medical history, and evaluate whether you should undergo further testing or if empirical treatment is appropriate.

Tests and Examinations

If your GP suspects that you have acid reflux, they may recommend several tests to confirm diagnosis:

  • Endoscopy: A gastroscopy can offer a close look at your oesophagus and identify any possible damage due to stomach acid.
  • Barium Meal: This test involves swallowing a barium solution, which can highlight abnormalities in an X-ray.
  • pH Monitoring: This examination measures the acidity in your oesophagus and determines acid reflux activity.

By undergoing these examinations, healthcare professionals can gather more accurate information about the health of your oesophagus and the presence of reflux.

Distinctive Signs

In addition to the typical symptoms, distinctive signs can include difficulty swallowing (dysphagia), unintended weight loss, and persistent, chronic coughing. Recognising these signs and discussion with your healthcare provider can help in formulating a specific diagnosis and treatment plan.

Treatment and Management

When addressing the possibility of gut bacteria imbalance causing acid reflux, a multifaceted approach to treatment and management is crucial. Tailoring this approach to individual needs often results in the most effective control of symptoms.

Initial Treatment Approaches

Your doctor may recommend initial treatments that include over-the-counter medications and lifestyle adjustments. These are aimed at reducing symptoms and creating an environment that may support a healthier gut flora balance.

  • Medications: You might start with antacids to neutralise stomach acid.
  • Lifestyle Changes: Implementing dietary changes, such as eating smaller meals, can be beneficial.

Medication Options

For ongoing management, several prescription medications may be used to reduce acid production and heal any damage to your oesophagus.

  • Proton Pump Inhibitors (PPIs): Drugs like omeprazole and lansoprazole reduce stomach acid.
  • H2-Receptor Antagonists: Medications such as famotidine can also decrease acid production but are typically not as strong as PPIs.

Surgical Interventions

Surgery may be an option if medications and lifestyle changes do not sufficiently control your acid reflux.

  • Hiatal Hernia Repair: Should you have a hiatus hernia contributing to your condition, surgery might be recommended to reconstruct the affected area.

Lifestyle and Dietary Adjustments

Modifications to your diet and lifestyle can have a substantial impact on managing acid reflux.

  • Weight Loss: For those overweight, reducing body weight can alleviate pressure on the stomach.
  • Food and Drink: Limiting foods that are known to trigger reflux, such as fatty or spicy dishes, is often advised.

Alternative and Complementary Therapies

In addition to conventional treatments, exploring alternative therapies might offer additional relief.

  • Probiotics: These may help balance your gut bacteria and are found in foods like yoghurt or available as supplements.
  • Relaxation Techniques: Activities such as yoga or meditation can decrease stress, which is sometimes linked to worsening acid reflux symptoms.

Frequently Asked Questions

These questions address common concerns about the connection between gut bacteria and acid reflux, offering specific insights into symptoms, dietary strategies, and probiotic use.

What symptoms are indicative of H. pylori-associated acid reflux?

If you’re experiencing persistent heartburn, regurgitation, and perhaps nausea, these may be signs of acid reflux associated with Helicobacter pylori infection. This bacterium can undermine your stomach’s mucosal lining, leading to an increased risk of reflux.

Which dietary changes may alleviate acid reflux symptoms in SIBO patients?

Patients with Small Intestinal Bacterial Overgrowth (SIBO) may find symptom relief by reducing their intake of fermentable carbohydrates, which can otherwise trigger bloating and increase pressure, potentially leading to acid reflux.

How can GERD and a leaky gut be reversed?

GERD and a leaky gut may be addressed by restoring the balance of gut flora and managing lifestyle factors. Strategies involve a tailored diet, possibly the use of supplements, and stress reduction techniques, all aimed to improve gut integrity and function.

What are the typical symptoms of GERD associated with small intestinal bacterial overgrowth?

The typical symptoms include chronic heartburn, abdominal pain, bloating, and gas. It’s thought that an overgrowth of bacteria in the small intestine might contribute to increased gastroesophageal reflux.

Which probiotics are considered most effective for the management of acid reflux?

Certain strains like Lactobacillus and Bifidobacterium have been noted for their potential in managing acid reflux by improving digestive health and decreasing pathogenic bacterial overgrowth.

In what ways can gut dysbiosis contribute to the development of acid reflux?

Gut dysbiosis can weaken the gastric barrier and increase intra-abdominal pressure, creating conditions that are conducive to acid reflux. This imbalance of bacteria can also impact gut motility and lead to the malabsorption of nutrients, further exacerbating reflux symptoms.

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