Chinese Medicine for Acid Reflux
By Dr (TCM) Attilio D'Alberto | Traditional Chinese Medicine Practitioner, Wokingham, Berkshire
Acid reflux (gastro-oesophageal reflux disease, GERD) is one of the most common digestive complaints in the UK, affecting approximately 20–30% of adults. While proton pump inhibitors (PPIs) effectively suppress symptoms, they do not address the underlying dysfunction — and long-term use is associated with reduced magnesium absorption, increased risk of infections (including C. difficile and pneumonia), reduced B12 absorption, and rebound hyperacidity on withdrawal. Traditional Chinese medicine addresses acid reflux at the root by restoring the stomach's natural descending movement, often allowing patients to reduce or discontinue PPIs.
On this page
- Signs and symptoms
- Causes of acid reflux
- TCM patterns behind acid reflux
- Acupuncture treatment
- Chinese herbal medicine
- Coming off PPIs
- Dietary and lifestyle advice
- Frequently asked questions
Signs and symptoms
- Heartburn — burning sensation behind the breastbone, often worse after meals or lying down
- Acid regurgitation — acid or bitter taste rising to the throat or mouth
- Chest pain — can be severe; must be distinguished from cardiac pain (urgent assessment if in doubt)
- Difficulty swallowing (dysphagia) — warrants medical assessment
- Chronic cough — particularly worse at night; see my article on dry cough
- Hoarseness and sore throat — particularly morning throat discomfort
- Excessive throat clearing — from post-nasal drip caused by acid irritation
- Nausea — particularly after eating
- Burping and bloating
- Dental erosion — long-term acid exposure damages tooth enamel
Red flags requiring urgent medical assessment: Unexplained weight loss, difficulty swallowing, vomiting blood, black tarry stools, severe chest pain, persistent vomiting, or symptoms starting after age 55. These may indicate more serious conditions that need urgent investigation.
Causes of acid reflux
- Lower oesophageal sphincter (LOS) dysfunction — the valve between oesophagus and stomach weakens or relaxes inappropriately
- Hiatus hernia — the stomach partially protrudes through the diaphragm; see my article on Chinese medicine for hiatal hernia
- Obesity — increases abdominal pressure
- Pregnancy — hormonal relaxation of the LOS and pressure from the growing uterus
- Diet — large meals, eating late, spicy foods, fatty foods, chocolate, mint, citrus, tomato
- Alcohol and caffeine — relax the LOS
- Smoking — reduces LOS pressure
- Stress — increases acid production and impairs gastric motility
- Medications — NSAIDs, aspirin, calcium channel blockers, bisphosphonates
- H. pylori infection — a common bacterial cause; worth testing
- Low stomach acid (paradoxically) — can cause reflux symptoms through impaired digestion and fermentation
TCM patterns behind acid reflux
The Stomach in TCM governs the rotting and ripening of food and its downward passage. Acid reflux is an expression of Stomach qi failing to descend — instead rising upward, carrying stomach acid with it. The most common patterns are:
Liver qi stagnation invading the stomach
Stress-driven reflux, worsened by emotional tension. Accompanied by chest and hypochondriac distension, irritability, sighing, and a feeling of a lump in the throat. This is the most common pattern I see clinically.
Stomach heat
Burning reflux, acid taste, bad breath, thirst, preference for cold drinks, constipation, and a red tongue with yellow coating. Often seen in those with rich diets, alcohol use, and spicy food.
Stomach yin deficiency
Dry, chronic reflux with poor appetite, dry mouth, and a dry red tongue. Often seen in older patients, or those on long-term PPIs where the natural acid environment has been suppressed.
Spleen and Stomach qi deficiency with dampness
Reflux with bloating, fatigue after eating, loose stools, and a pale tongue with thick coating. Often with food sensitivities.
Cold in the stomach
Less common but seen in those who eat excessive cold, raw, or iced foods. Reflux improved by warmth, with pale tongue and slow pulse.
Acupuncture treatment
Acupuncture regulates gastric motility, reduces lower oesophageal sphincter pressure abnormalities, and addresses the Liver qi stagnation that is the most common driver of stress-related reflux. A systematic review of RCTs showed that acupuncture significantly improved GERD symptoms and reduced PPI requirements. Key points include:
- CV 12 (Zhongwan) — the front mu point of the Stomach; principal point for all stomach disorders
- ST 36 (Zusanli) — tonifies and harmonises the stomach
- PC 6 (Neiguan) — descends rebellious stomach qi; particularly effective for reflux
- LV 3 (Taichong) — soothes liver qi stagnation
- SP 4 (Gongsun) — pairs with PC 6 for digestive disorders
- ST 44 (Neiting) — clears stomach heat
Treatment is typically weekly for 6–8 sessions, with improvement often apparent within 2–3 sessions for functional reflux.
Chinese herbal medicine
- For Liver qi stagnation invading the stomach, Ban Xia Hou Po Tang harmonises the stomach and descends rebellious qi
- For Liver qi stagnation with stomach heat, Chai Hu Shu Gan San with heat-clearing additions
- For stomach heat, Ban Xia Xie Xin Tang clears heat and harmonises the middle
- For stomach yin deficiency, formulas based on Mai Men Dong nourish the stomach yin
- For Spleen and Stomach qi deficiency, Liu Jun Zi Tang
I prescribe pharmaceutical-grade granules from Sun Ten in Taiwan, tailored to the individual pattern.
Coming off PPIs
Stopping PPIs abruptly often produces rebound hyperacidity — a temporary surge in acid production that makes symptoms worse than before starting the medication. This is not a sign that you need the medication; it is a physiological rebound that typically settles over 2–4 weeks if managed properly. Never stop PPIs abruptly without support. The best approach is gradual reduction over several weeks, with TCM treatment started before the reduction begins. Many patients find they can discontinue PPIs entirely within 8–12 weeks of starting combined acupuncture and herbal treatment. This should always be done in consultation with your GP, who prescribed the medication.
Dietary and lifestyle advice
- Don't eat within 3 hours of bedtime — the single most important change
- Elevate the head of the bed — 15–20 cm block under the top of the bed frame
- Smaller, more frequent meals — reduces gastric pressure
- Avoid trigger foods — typically coffee, alcohol, citrus, tomato, chocolate, mint, spicy foods, fatty foods. Track your own triggers; they vary
- Lose excess weight — abdominal weight worsens reflux significantly
- Stop smoking
- Chew food thoroughly — digestion starts in the mouth
- Stress management — particularly for the Liver qi stagnation pattern
- Apple cider vinegar — paradoxically helpful for some people with low stomach acid; try with practitioner guidance
- Ginger tea — gentle, anti-nausea, pro-digestive
Frequently asked questions
Can acupuncture cure acid reflux?
For functional reflux without significant structural causes, yes — many patients achieve lasting resolution with combined acupuncture, Chinese herbs, and lifestyle changes. For reflux caused by significant hiatus hernia, Barrett's oesophagus, or other structural issues, acupuncture provides symptomatic relief rather than cure.
How long does it take to see improvement?
Most patients notice some improvement within 2–3 weekly sessions. Full benefit typically emerges over 8–12 weeks of combined treatment. For patients coming off PPIs, the transition period may involve some temporary worsening before stable improvement emerges.
Can I come off my PPI medication with TCM?
Many patients can — but it must be done gradually and in consultation with your GP. Never stop PPIs abruptly as this causes rebound hyperacidity. I typically recommend starting TCM treatment, allowing 2–4 weeks of stabilisation, then beginning a gradual PPI taper with GP support.
What foods should I avoid with acid reflux?
Common triggers include coffee, alcohol, chocolate, citrus fruits, tomatoes, mint, spicy foods, fatty foods, carbonated drinks, and large meals. Individual triggers vary significantly — food diary tracking is the most reliable way to identify your specific triggers.
Is acid reflux caused by too much or too little stomach acid?
Counterintuitively, many people with reflux symptoms have low rather than high stomach acid. Low acid causes fermentation, gas, and increased pressure that pushes acid upward. This is why PPIs sometimes worsen reflux over time. Proper assessment helps distinguish high-acid from low-acid reflux patterns.
Is acupuncture safe if I have a hiatus hernia?
Yes — acupuncture is safe with hiatus hernia and can help with symptoms. It won't reduce the hernia itself, but it helps the LOS function better and reduces acid reflux symptoms. See my article on Chinese medicine for hiatal hernia.
To discuss acid reflux or digestive problems, contact me or book a consultation at my Wokingham, Berkshire clinic.
