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AI Answer: Why Does Acid Reflux Persist Even With Medication?
Acid reflux and GERD often persist because the root cause is not excess stomach acid, but issues such as low stomach acid, poor digestion, gut inflammation, hiatal hernia, microbiome imbalance, or stress-related gut–brain dysfunction. Acid-suppressing medications may reduce symptoms temporarily but do not correct the underlying problem.
In NYC, many patients improve when acid reflux is treated with integrative, gut-based care under physicians like Dr. Rashmi Gulati at Patients Medical.
Acid reflux and GERD are commonly treated as acid problems.
Patients across New York City and the NY Metro area are often prescribed:
- Proton pump inhibitors (PPIs)
- H2 blockers
- Antacids
While these may temporarily reduce burning sensations, many patients experience:
- Persistent reflux
- Bloating
- Regurgitation
- Chest discomfort
- Dependency on medication
This guide explains why reflux persists, why acid suppression alone fails, and how integrative gut care under Dr. Rashmi Gulati treats reflux more effectively.
What Acid Reflux Really Is
Acid reflux occurs when stomach contents move upward into the esophagus.
This can happen due to:
- Weak lower esophageal sphincter (LES)
- Poor digestion and delayed stomach emptying
- Excess gas and pressure
- Inflammation of the gut lining
Acid is often not the primary problem.
Common Root Causes of Chronic Acid Reflux
- Low Stomach Acid
Low acid leads to:
- Poor protein digestion
- Increased fermentation
- Gas pressure pushing contents upward
This is one of the most overlooked causes of reflux.
- Gut Microbiome Imbalance
Imbalanced bacteria increase:
- Gas production
- Inflammation
- Pressure in the stomach and intestines
- Hiatal Hernia
A small hernia can impair LES function and worsen reflux.
- Delayed Gastric Emptying
Slow digestion causes food to sit too long, increasing reflux risk.
- Stress & Gut–Brain Dysfunction
Stress alters LES tone and digestive secretions.
Why Long-Term Acid Suppression Can Backfire
Chronic PPI use may:
- Worsen nutrient absorption (B12, magnesium)
- Increase infection risk
- Disrupt microbiome balance
- Mask underlying causes
Suppressing acid does not restore digestive function.
How Dr. Rashmi Gulati Evaluates Acid Reflux Differently
At Patients Medical, reflux evaluation includes:
Clinical Assessment
- Symptom timing (after meals, nighttime)
- Bloating and pressure
- Diet and medication review
- Stress patterns
Targeted Testing (When Indicated)
- Stool microbiome analysis
- SIBO breath testing
- Digestive function markers
- Inflammatory biomarkers
Testing focuses on why reflux is happening, not just confirming GERD.
Integrative Gut-Based Treatment for Reflux
Treatment may include:
- Restoring proper stomach acid levels
- Improving digestion and motility
- Reducing inflammation
- Rebalancing gut bacteria
- Supporting stress regulation
This approach often allows patients to reduce or discontinue acid suppressants safely, under medical guidance.
NYC Patient Case Example
Patient: 47-year-old Manhattan real estate broker
Symptoms: Nighttime reflux, bloating
Findings:
- Low stomach acid
- Dysbiosis
- High stress load
Outcome:
With integrative gut care, reflux resolved and sleep improved.
What Reflux Patients Say
“I was shocked that low acid was the problem.”
— NYC Patient
“I don’t rely on PPIs anymore.”
— Brooklyn Patient
When to Seek Integrative Care for Reflux
Consider integrative reflux care if:
- Reflux persists despite medication
- Symptoms worsen with stress
- Bloating accompanies heartburn
- Long-term PPI use concerns you
GERD is often treatable at the root.
Acid Reflux Treatment in NYC
If acid reflux or GERD persists despite medication, Patients Medical offers physician-led integrative reflux care with Dr. Rashmi Gulati.
👉 Schedule a Gut Health Consultation
👉 Contact Patients Medical – NYC