Acid Reflux Doctor in Wilmington, NC

What causes acid reflux that keeps coming back? Reflux happens when the valve between the esophagus and stomach opens at the wrong time or loses pressure, letting acid move upward. In our Wilmington practice we test for the drivers behind that valve problem — H. pylori, food sensitivities, low stomach acid, gut microbiome imbalances, and stress hormone changes — instead of treating the burn alone.

What acid reflux is

Acid reflux, sometimes called gastroesophageal reflux, is the movement of stomach contents back up into the esophagus. When it becomes frequent or persistent, doctors label it GERD. The two terms get used interchangeably, and the mechanism is the same either way: something is allowing stomach contents past the lower esophageal sphincter, and the esophageal lining is getting irritated by contact it was never designed for.

The burn is the part you feel. Underneath it there is always a reason the reflux is happening, and that reason is usually digestive, immune, or stress-related. We built our whole approach around finding it.

How reflux produces heartburn

Your stomach makes acid strong enough to break down protein and control organisms in your food. The esophagus, right above it, has a lining that is sensitive to that acid. A muscular valve called the lower esophageal sphincter keeps the two compartments separate. When it relaxes inappropriately or weakens, acid splashes upward and you feel a burn behind the breastbone.

What makes the valve misfire? Gas and bloating raise pressure inside the abdomen and push upward. Undigested food from low stomach acid ferments and produces that gas. Stress hormones change how quickly the stomach empties and how the sphincter behaves. Certain foods trigger immune irritation in some people. Sometimes a structural issue, such as a hiatal hernia, is part of the picture. Each of those is a different route to the same burn, and each calls for a different plan.

Signs and symptoms

• Heartburn behind the breastbone, particularly after meals
• Regurgitation of sour liquid or food into the mouth
• Burping and bloating that build through the day
• A sour or bitter taste, especially in the morning
• Worsening symptoms after late or large meals
• Symptoms that flare when lying flat or bending over
• Hoarseness, throat clearing, or a chronic dry cough
• Sinus drainage or a sensation of something caught in the throat
• Disturbed sleep from nighttime burning
• Relief on medication, then a fast return when it is reduced

Root causes we look for

• H. pylori — a stomach organism that alters acid regulation and digestion. Read H. pylori causing heartburn.
• Food sensitivities — hidden IgG/IgE reactions to common foods that inflame the gut and drive pressure and symptoms. See food sensitivities causing reflux.
• Low stomach acid (hypochlorhydria) — poor digestion, fermentation, and pressure pushing back on the valve.
• SIBO and dysbiosis — bacterial overgrowth that turns every meal into gas and bloating.
• Adrenal stress dysregulation — cortisol rhythm problems that change motility, acid production, and sphincter tone.
• Hiatal hernia — a mechanical component we screen for when symptoms fit. Covered on our hiatal hernia page.
• PPI rebound — acid production that flares when suppressors are reduced without a plan.

How we test

Testing is where the guessing stops. Our kits are collected at home and mailed to the lab, with results typically within 7 business days and a dedicated results review afterward. For acid reflux we usually use:

• Comprehensive Stool Analysis — gut microbiome analysis covering H. pylori, bacterial overgrowth, parasites, and digestive markers including elastase and inflammation. See stool testing.
• Alletess 184 Food Sensitivity Panel — immune response (IgG/IgE) to 184 common foods to surface hidden sensitivities. This is not a standard allergy test.
• Adrenocortex Stress Profile / HU-Map — cortisol rhythms and stress hormones that affect acid production, motility, and the lower esophageal sphincter.
• H. pylori stool antigen and functional panels — noting that conventional breath tests can miss strains when biofilm is present, which is what we see clinically.

What your symptom pattern may point to

Pattern	Common driver	What we check
Burn plus heavy bloating after meals	Microbiome imbalance or SIBO	Comprehensive stool analysis
Reflux that flares with specific foods	Food sensitivities	Alletess 184 panel
Reflux with early fullness and undigested food	Low stomach acid	Digestive markers on stool testing
Symptoms that spike in stressful seasons	Stress hormone dysregulation	Adrenocortex / HU-Map
Burn worsened by lying down or bending	Mechanical driver such as hiatal hernia	Symptom review and referral for imaging when needed

How we address acid reflux

Your plan follows the 3-Step Root Cause Heartburn Protocol: a free discovery call, advanced testing, then your personalized plan. Once results are in, we typically remove the specific triggers your panel identified, support the gut lining and digestion, rebalance the microbiome where testing shows overgrowth, and address stress hormone rhythms when they are part of your case.

We practice functional medicine, so we do not prescribe. If you are on acid-suppressing medication, keep taking it as directed while we investigate. When your results and symptoms support it, we build a gradual step-down plan with your prescribing doctor. You can read more about our practice and how the process works before booking.

When to seek urgent care

Get emergency care for chest pain or pressure, especially with shortness of breath, sweating, or pain spreading to the arm or jaw, until the heart is ruled out. Seek prompt evaluation for difficulty swallowing, food that repeatedly sticks in the chest, black or tarry stools, vomiting blood, persistent vomiting, or unintended weight loss. These need conventional assessment first.