GERD Relief Protocols 7-8 / Build up Your LES and Get Those Digestive Enzymes Working Again

GERD Relief Protocols 7-8 / Build up Your LES and Get Those Digestive Enzymes Working Again

GERD Protocol #7 – Strengthen that LES!

The lower esophageal sphincter is a sphincter that connects the top of the stomach with the bottom of the esophagus. The LES first relaxes to allow food to enter the stomach. The LES then closes tightly after food enters the stomach to keep stomach acid and pepsin from traveling up the esophagus from the equalization of pressure. The LES can also relax to allow air to travel out of the stomach in the form of a burp. Finally, the LES will naturally relax to allow emesis. 1

The lower esophageal sphincter may become weakened over a period of time if you consistently ingest certain foods (peppermint, chocolate, tomatoes, or citrus juices,) 2 use anything that contains nicotine or caffeine, 3 take certain medications (SSRI antidepressants, anticholinergic medicines, Uniphyl, sedatives, and estrogen replacements,) 4 if you have vagus nerve damage, 5 if you are suffering from SIBO, have excessive LES pressure, 6 if you have a hiatal hernia, 7 or if you were born with a malfunctioning LES.

If your LES is weakened, excess gastrointestinal pressure can easily push gastric contents into the esophagus causing reflux symptoms. In addition, if the LES is weakened, reflux can easily occur during sleep because of the lack of LES pressure that would normally hold gastric contents in place. 8 Sleeping on your left side at night is more anatomically correct and can increase LES pressure causing it to remain closed and help relieve nighttime reflux. Strengthening the LES is hard because there are not many exercises that can be used to straighten the sphincter (research states that breathing exercises may help.) You can, however, take excess pressure off the LES and stomach physically by wearing loose clothing and by losing excess weight to help it strengthen. You can also limit foods that weaken the LES, treat SIBO, and finally attempt to switch medicines that do not weaken your LES. Some supplements can help by strengthening the LES, lower gastric pressure, and repair nerve damage. All of these suggestions should help your LES function better.

LES Protocol

  1. Hi my name is trevor im 23 and had a intestinal liver and pancreas transplant everything is going good except im constantly nauseated cant eat verry much at a time which makes it impossible to get the nutrition i need they did a scope and said my esophagus was verry inflamed and my sphincter didnt open and close like it should im takin 40 mg proteomics twice a day
    But it dont seem to be helping if i can keep food or drink down long enuff to get past the esophagus and sphincter i can usaly keep it down but i have bad heartburn and nausea till it moves through i would do anything to fix this problem any advise would be great can you please help me oh and i have a plurex tube i drain about 500 out of every day the doctors are hopeing it will just get better on its own and i also still have a colostomy and elyostomy bag till they reconnect my intestines in about 3 more months but if you can help me with my esophagus and sphincter that would be great thank you

    • I would try ginger, a Squatty Potty, and apple cider vinegar Urban Moonshine bitters to help improve digestion. Maybe try zinc carnosine for the nausea as well. As your doctor about the recommendations. Good luck!

  2. What do you recommend for a hiatal hernia?

    • It depends on the cause of your hernia. If you are overweight, loosing some weight and strengthening your abdominal muscles with a physical therapist may help. Getting a chiropractor to message the hernia back in place might help as well. Finally, make sure you have adequate stomach acid production and chew your food really well to prevent stomach bloating.

  3. I have a chronic cough and burping with no heartburn. I was prescribed Dexilant 60mg by Gastro. This does not help. Please advise

  4. Is the pH of Calcium citrate too acidic? I am curious to try the calcium citrate powder, but considering issues I have with reflux, and irritation in my larynx/throat, I am skeptical to try.

    Would something like calcium carbonate be better? Or is there something inherently valuable with the calcium bonded to citric acid?

    Thank you.

    • Calcium is a pretty basic mineral, so the addition to citric acid to form citrate should not make it acidic if at all. Calcium carbonate is absorbed less, so it may not work as well. It is possible, that citrate can feed certain organisms, and that is what creates irritation from increased endotoxin production.

  5. Hi John:
    I am a 64 yr. old female that has suffered with acid reflux for 20 years.
    The last 8 years I have had no relief – ppi’s and zantac do not work for me anymore. I have severe bloating and my nights are terrible – I have so much mucus in my throat and stomach that I bring it up all day. I have tried all of your suggestions above except the zinc carnosine which I will certainly buy and try.
    Would it be possible to get a copy of your fix your gut book – I am so tired of being ill, I don’t remember what it is to be well, it has been so long. I haven’t gotten any help from doctors. I promised myself that this year I would do anything to get better so your book may well help me with that. I would like to try your protocol.
    Thank you for listening. One thing that I noted to myself was I take 3mg of melatonin nightly for about 5 years and have so many hot flashes at night. Your article said that melatonin can cause hormone fluctuations. Thanks for that info. Keep up the good work in helping all us sick people.

    • Your problem is inflammation of the LES. This is a symptom of an underlying cause that the modern medical industry is absolutely stupid on and I can offer a product that will provide temporary relief long enough for you to experiment on a better solution. Use Black Caraway seed from

      This product is best explained here:

      Your problem explained:
      Ultimately your inflammation is a symptom as most acid reflux suffers (I myself included) have been through. Usually we take anti-acids and N2 blockers as a result of burping or the like and in the process make it worse by damaging a part of our system that then puts our body into an immune system defense mode that causes gastritous. Usually this inflammation prevents the production of acid as a reflux causing Hypochlorhydria and then when we don’t digest food and the vicious cycle leads to gullstones, malnutrition, and bacterial overgrowth. I’m suggesting you take Nigella Sativa because if you don’t have a Hiatal Hernia than the cause is that your LES needs to relax for temporary relief. A strong probiotic with this can help but you’ll need one with 430ish strains and a billion bacteria class which are in the 40$ range. You’ll have to choke out the H. Pylori the PPI put in your stomach before acid can start producing again. The Nigella Sative will relax the LES and help you produce more acid, but you will still be malnourished from the lack of acid so you’ll need an acid pill temporarily to kill the H. Pylori. Take a probiotic an hour before breakfast in the morning, then take an acid pill with your meal (you can read on proper dosaging of HCL w/Pepsin online). After you’ve eaten and taken an acid pill take 2 Nigella Sative pills with that meal. Then do the same thing with the acid and Nigella sative pills the following 2 meals, but limit the probiotic to once a day an hour before your meal for 2 or 3 days. Once the H. Pylori is out of your system and your biological eco system is restored you will need to find a solution to your gastritis by experimenting with a colon cleanse and if that doesn’t get rid of your acid reflux and relieve the pressure over your les, attempt your liver and gullbladder with himalaya liver care, and then if that doesn’t help dgl. There are a few other suggestions, but that is the best process I have found to out right cure acid reflux for non colon cancer/hiatal hernia patients. PPI’s are the Devil.

      Worst case scenario is you live the rest of your life on Nigella Sative oil or pills, but it’s rare to see people not outright cured once they find what is causing the stomach inflammation and pushing the les back in having it. Get well soon!

      • Note on a misspelling, you’ll need a probiotic with 30 to 40 strains not 430. My apologize for the typ-o. The refrigerated ones are always better and ultimately the more good bacteria cultures per serving the better.

      • This information is very interesting. Will it work too for people with hiatal hernia?


    • Mailed

  6. When it comes to strengthening the LES, does the use of calcium citrate have any health risks?
    How long are you supposed to use it for? Is it supposed to be used indefinitely?

  7. Hello,
    I am 35yrs young female dealing with gastrointestinal issues such as cramping, diarrhea, constipation, and pain as well as diagnosed with Antral Gastritis and all of this started in 2011 but diagnosed in 2015. I have seen doctor after doctor for help and a few gastroenterologist and none really cared to listen or do exams to check until my upper abd became swollen. I have only been told to take pantoprozole and antacids like pepcid and they don’t work. I am very stressed out and have become depressed dealing with this and thinking of the long term effect of what could happen if not treated. I have both left and right upper abdominal pain and fluttering in upper abdominal area below breast on top of rib cage, heartburn, belching, bloating, feeling of fullness after eating small meal, nausea, feeling of a knot in throat when I swallow, and sometimes feels like my throat is closing. The left side of my upper abd, right unerneath my breast/immediately below rib looks swollen and higher than the right side. I lost my job and I feel like I am running out of options, God and my kids(single parent) are my inspiration to keep fighting.My mother helps me with digestive supplements whenever she’s able to and I am trying. Please, can you email me any information that I can help. I would really and truly appreciate it. Thank you for your time, I appreciate you and what you are doing to help others. God bless you

  8. I have been diagnosed with grade A esophagus ‘and mild gastritis on endoscopy.I have severe burping and it stops only during sleep and bolting and mild burning sensation present always… kindly help me…

  9. Hi,
    I have had heartburn for almost 4 years now and cannot seem to find anything to relieve it. I have tired zinc carnosine, glutamine, slippery elm, aloe, DGL, mastic gum, zantac, gavisocn, apple cider vinegar, betaine ccl, digestive enzymes, gluten free & dairy free diet, no acidic foods etc. I am so desperate for any advice any one might have. I have it every single day…generally it gets worse throughout the day and is unbearable by night time.

    • Fast for 4 days. Don’t eat at all! This will allow stomach to reset. Drink lots of water. Then eat only veggies and protein. Very small meals. I started with rice and green veggies. Avoid dairy, gluten, soy, sugars, and night shades like potato-tomatoe- eggplant. No sugars is important! No bread, no pasta, no tortilla, no pancakes, etc. No carbs that turn into sugar, or else this won’t work. Use healthy fats and oils. Coconut oil helped me immensely. This protocol changed my life. Also enzymes! Don’t eat anything from a box! When the ingredients are longer than the bill of rights, it’s bull. Eat home prepared fresh food. No sugars or fruit for three months. It totally worked for me. Ever time I caved in and had that pizza and bread and burger for a few days my symptoms returned. I would start again. This happened 3 times and I realized I was tired of the agony. You can do it!

    • Maybe look into increasing vitamin D endogenously and working on sleep hygiene. This may help to reduce inflammation and any overgrowth you may have contributing to your heartburn.

    • Have you been checked to see if your les valve is functioning properly?

  10. Sir i have GERD problem and i have chest and stomach burn and throat scratch plz suggest me diet and some medicine it 4 months old

  11. John,

    I forgot to mention that I am 65-years-old. I also want to know if pure organic cocoa is as bad as chocolate. I use just a little of it in with some coconut flakes and ground nuts for a dessert, or even just a sprinkle of it in my tea.

    Thank you,
    August Roussel

  12. John, for a number of years(5?), I’ve had a problem that I called walking heartburn. Essentially, every time I walk for more than a block, I would start to feel painful soreness in my chest, shoulder blades, arms, even a little bit in what I think is the eustachian tube. But as soon as I stop walking the pain would go away. Until this year, I was always able to get immediate relief by ingesting 600+ milligrams of simethicone. For the longest time simethicone did the trick of making me an able-bodied, brisk walker and worker…. But then something happened during the summer of 2016, while I had spent nearly two weeks watching both the Democratic National Convention and the Repubilcan National Convention, and I was doing nothing but sitting in front of the computer watching everything for those few weeks.
    I began to get the severe heartburn while laying in bed at night–something I had never experienced before–and I found my arms and chest burning and I found it took a longer time of sitting upright to cause the pain to subside. On top of that, the simethicone wasn’t working anymore. To make a long story short, I discovered that ingesting a goodly amount of ginger(one ounce or more, with plenty of water behind it) took care of the pain, at least until the next meal(I also noticed a heartburn effect if I tried to take a walk after eating since those two convention weeks.). I am at a point where I am relying on making ginger “pudding” daily, which is nothing more than an ounce of ginger mixed with water and nuked for four to five minutes, that I eat with a spoon and more water to chase it down before it can be tasted by my tongue. It works, and I am happy that I have not had to go back to simethicone, but it seems like I can get away from it–I eat ginger continuously, in my tea, in some meals, etc. My doctor only wanted to treat me for a heart condition, but I can’t buy that, not after the success I’ve had and continue to have(my blood pressure last time was 144/80 and it has been dropping steadily, and I have been managing to lose weight steadily.) If it is a gerd problem, the only problem I have is the soreness I feel–no regurgitation or direct stomach problems or anything else except a good round of burping that the ginger seems to bring on. When I am not feeling any pain, I want to walk briskly and ride my bicycle fast, and do occasional physical labor tasks to the best of my ability. Needless to say, I have not been having the nighttime gerd problem much, although I still feel it slightly for an odd moment or so. All the othe spices you can think of, even the calcium citrate, has not made any noticeable difference. My question is can I go on relying on massive consumption of ginger without any serious side-effects? Is there anything about my condition that tells you something that I have not detected and need to look at?

    • The ginger is increasing gastric emptying and decreasing inflammation. Maybe ask your healthcare professional about zinc carnosine?

      • John,

        I did ask my healthcare professional about zinc carnosine, and she said she could not make any recommendations about non-traditional medicines(or words to that effect, I can’t remember exactly). I am interested in giving zinc carnosine a try and I would like a suggestion as to what on line, over the counter (organic, hopefully)product you would recommend, especially if it is just zinc carnosine and nothing else.

        I do want to mention though, that I do not feel any pain in my stomach–It’s only right from the LES valve where it radiates into my chest, arms, neck…as soon as a start running around–and I like to run around–that’s when I feel pressure from my stomach, but as soon as I clear the gas from my stomach the pain is all gone. It seems that a good dose of ginger does the trick in quelling the pain, and contrary to what I said in my first email to you, calcium citrate also seems to help(I realized that it did as I starting taking several level teaspoons daily.) I also consume several teaspoons of turmeric daily, but I can’t sense if it is really helping. Do I really need to try zinc carnosine? Phazyme Gas & Acid(Simethicone & Calcium Carbonate) is the good old standby for an emergency, but I don’t want to treat just the symptoms–I want to fix my gut, as you say. Will zinc carnosine help control the bacteria that produce the excess stomach gas? Or will I have to give up some cherished whole grain carbs to control the bacteria’s gas? Even ginger and calcium citrate leave me wondering if I am only treating the symptoms, not the causes. :et me thank you for any interest you may have in answering me–I am determined to beat this “Gerdy problem”.

  13. Hello, I have had issues with acid reflux/GERD for at least 15 years. I have taken every sort of H2 blockers and PPI’s as prescribed, been scoped, dilated, and still suffer from heartburn, sore throats, wheezy coughs. I have eliminated foods, don’t eat anything hours before bed, down to 100 pounds, I never smoked, don’t drink. What else can I do to get some lasting relief? Any suggestions would be greatly appreciated.

    • Dear Julie,

      I e-mailed you a free copy of my book Fix Your Gut. It should be able to help with your issues. Read the chapters on GERD and LERD.


      • John, thank you, thank you so much. I feel that I can get better if I have the knowledge and tools to address my issues. Thanks for your help.


      • hi sir! ive been diagnosed with Gerd and im having a sorethroat for 4months ive had taken omeprazole 2x a day for 1 month but to no effect my doctor prescribed me refluxid duo and its almost a month now. i avoided most of the foods most of the time i ate oatmeal and pourage. i dont know what else to do. hope you can help me. thank you very much sir

      • Can you send me this book to? I have belching so bad and can’t breath unless belch . Can eat very little then I can’t breath. I have to take zantac just to breath and belch. This is all new. Been taking ppr to for 4 weeks ….

  14. Will L-Glutamine heal the LES ?

    • It could help with LES repair BUT if you are having LES issues from having uppergut overgrowth it could worsen it as well. If you take glutamine and it causes anxiety, depression, mania, or increased inflammation or pain, stop it you probably either have uppergut overgrowth or a mutation of GAD1

  15. Hi

    I have suffered from chronic cough all my life on and off I am now 68. It was really bad last year and went to the doc who gave me inhalers, sent me for a chest xray and lung function test. Xray clear LFT borderline so said I might have mild COPD. However, I am not so sure. My congestion is in my throat and I wheeze on and off and that comes from my throat, nose and even ear. The inhalers help a bit so doc said it can’t be LPR. I wonder if it is despite what he says or could it be post nasal drip. Yesterday for instance perfectly well all morning, had lunch and three hours later congested and coughing.

    I’d really appreciate your comments on this

  16. Check your reference about citrus fruits weakening the LES as it does not appear to be correct.

    • Possibly, I will talk more in depth about this matter later in food blogs and how what we eat effects the LES and issues that arise from that. Citrus could have the same mechanism as mint in that it irritates damaged mucosal tissue because of the low pH, therefore needs to be avoided anyway.

  17. Hey!

    If the two week melatonin-diet doesn’t help, may the other stuff still help? I have mild looseness in GE-junction, basically weakened LES. If I start taking all these supplements, does taking PPI-medication have negative effect on them?

  18. Is there any anecdotal info or studies on whether any of these supplements can help regenerate damaged LES cells? I ask because I am told there is no cure for this (achalasia) ) but I refuse to give up hope that I can at least keep the swallowing function that I do have. My doc said the results were off-the/charts bad, (supposedly absent peristalsis) but by their measurements I should not be able to swallow at all.

    Any thoughts on nutritive help greatly appreciated.

    • E-mailed you some info. Good luck!

      • Could I possibly receive that info as well? Much appreciated, thank you.

      • Hi, can I also get the info? I’ve been diagnosed with gastritis, bulbitis and esophagitis type B about 10 months ago, and now I’ve been able to tone it down to type A with no erosion to the mucosa, which is good. But I’m looking for a long-term solutions since I’m only 26 and I don’t want to take meds until the rst of my life. I’m off PPI and antacids, since I’ve read that they’re not so healthy in the long run.
        I’ve tried with melatonin, for 40 days. I’m not sure if it’s worked. Probably did, at least a little bit.

      • Would you email me the same?

  19. Hi I had a problem with both acid reflux and retrograde ejaculation about 2 years ago. As I had studied clinical nutrition i decided to use “CalMag” a calcium/magnesium supplement fron Nutri Advanced in the Uk. Not only did it eleviate both of these conditions after a month of treatment at a theraputic dose, I found it also had a positive effect on my constipation. and i continue to use it one month on and two months off at a maintanance dose. This is anecdotal evidence I know so do your own research before taking the plunge and following me, please!!

  20. I am extremely interested in your recommendation to use Calcium Citrate, as I had the same idea myself. My only concern is that it will cause a Magnesium deficiency. Do you have any thoughts on this?

    • It possibly could if you supplemented with it over a long period of time. What about trying some transdermal magnesium to help balance it?

  21. Great post – does Serotonin not relax the LES? Have heard numerous people say it, is that why you say only to take for 2 weeks? Is there a reason that melatonin does not have the same time frame? many thanks

    • Serotonin may relax the LES you are correct about that. That is the reason the 5-HTP is given at night to help increase melatonin as well as serotonin production strictly in the bowels. Serotonin contracts muscles. We know that melatonin is also produced in the intestinal tract by bacteria, its current use by the body is up for debate, but I believe it contracts the LES, which is why we do not get reflux at night. I recommend only taking it for two weeks, because manipulation of neurotransmitters long term unless absolutely needed is not a good idea. I have revised the recommendation on melatonin, thank you, high doses of melatonin should not be taken forever because of reports of hormonal disruption.

  22. ok they both have alcohol in them I was wondering how much we should take in a whole day (assuming they’re right before meals split in 3-4 divided doses for 3-4 meals in one day)

  23. ok they both have alcohol in them I was wondering how much we should take in a whole day (assuming they’re right before meals split in 3-4 divided doses for 3-4 meals in one day)

  24. does the NatureWorks brand have gentian in it? I read the list of nutrition facts for it from many sites and I cannot seem to find gentian.

  25. does the NatureWorks brand have gentian in it? I read the list of nutrition facts for it from many sites and I cannot seem to find gentian.

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