Heartburn & Reflux Conditions We Treat
Here are the conditions behind chronic heartburn, and how we investigate each one instead of guessing.
What conditions cause heartburn and reflux? In our Wilmington practice, the most common are GERD, acid reflux, H. pylori infection, hiatal hernia, eosinophilic esophagitis (EoE), and hidden food sensitivities. Underneath those diagnoses we often find low stomach acid, gut microbiome imbalances, and stress-driven changes in digestion. We test for each of these directly, then build your plan around what we actually find.
Why the diagnosis rarely explains the whole story
GERD and acid reflux describe what is happening. They do not explain why. The stomach is not a bucket that simply overflows. Reflux happens when the valve above the stomach, the lower esophageal sphincter, relaxes at the wrong time or loses its pressure. Something is driving that. Often several things at once.
In conventional care, the usual move is to suppress acid and move on. That calms the burn. It rarely changes the driver. When the medication is stopped, the symptoms return, because the reason the valve was misbehaving was never found. We have spent over 20 years in practice watching that pattern repeat, and it is why we built a testing-first approach for people who are tired of managing symptoms.
The conditions we investigate
GERD
Chronic reflux with a diagnosis attached. We look past the label to the drivers keeping the burn alive.
Acid Reflux
The symptom pattern behind heartburn and regurgitation, and the root causes that trigger it.
H. pylori
A stomach infection that changes acid production and digestion, often missed on standard testing.
Hiatal Hernia
A mechanical driver: part of the stomach sits above the diaphragm and weakens the reflux barrier.
Eosinophilic Esophagitis (EoE)
Immune-driven esophageal inflammation that mimics reflux and needs its own plan.
Food Sensitivities
Hidden immune reactions to everyday foods that keep the gut irritated and reflux active.
What these conditions share
Nearly all of them involve the same handful of upstream problems: stomach acid that is too low or too high, a gut microbiome out of balance, an immune system reacting to foods it should tolerate, and stress hormones that change gut motility and sphincter tone. That is why our 3-Step Root Cause Heartburn Protocol starts with testing instead of guessing. We use a comprehensive stool analysis, food sensitivity testing, and stress hormone mapping to see what is actually driving your symptoms.
Most test kits are collected at home and mailed to the lab. Results typically come back within 7 business days, and then we sit down with you for a dedicated results review. Telehealth is available anywhere in North Carolina, so distance is not a barrier. If you have been dismissed by conventional care, you can read more about our practice and our answers to common questions before you book anything.
Which condition is causing my heartburn?
Symptoms alone cannot tell you. GERD, H. pylori, food sensitivities, low stomach acid, and hiatal hernia produce overlapping patterns of burn, bloating, and regurgitation. That is why we start with testing instead of trial-and-error. In our Wilmington practice we see combinations more often than single causes, and your care plan is built around what the results show, not a guess.
Can these conditions cause symptoms other than heartburn?
Yes. Reflux drivers often show up as bloating, belching, a sour taste, chronic cough, hoarseness, sinus congestion, chest pressure after eating, or fatigue after meals. Many people never connect those symptoms to their digestion. When we map your full symptom picture alongside testing, patterns usually become clear that a single symptom description would hide.
Do I have to stop my medication to work with you?
No. We never ask you to stop medication on your own. While we investigate, taking your medication as prescribed is fine. When the time comes to reduce it, we build a gradual step-down plan with your prescribing doctor, based on your test results and how your symptoms respond. Safety and supervision come first, always.
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