Reflux Knowledge Centre
Reflux, fermentation and gut health — explained with the evidence
Every article summarises what peer-reviewed research and international clinical guidelines actually say, then adds the clinical observations of Douglas Mizzi from more than 65,000 consultations since 1990. Research and observation are always clearly separated, and every article lists its sources.
28 peer-reviewed sources
Guidelines, trials and systematic reviews
12 in-depth articles
Written in plain Australian English
Clear boundaries
Nutrition support alongside your doctor
Gut health & medication
Gas, fermentation and reflux: how gut health influences reflux symptoms
The research linking gut fermentation, gas and bloating to reflux — and how improving gut health and dietary management can reduce symptoms. By Douglas Mizzi, Clinical Nutritionist.
Read article · 10 referencesDiet, gut health and reflux medication: working towards the lowest effective dose with your doctor
What guidelines say about reviewing and stepping down PPIs, why rebound symptoms happen, and how dietary management can support a doctor-supervised plan.
Read article · 8 referencesWhat is the relationship between H. pylori and reflux symptoms?
H. pylori, dyspepsia and reflux are often confused. What international consensus says about testing, treatment and ongoing digestive symptoms after eradication.
Read article · 4 referencesWhen should reflux symptoms be investigated medically?
Warning signs that need prompt medical assessment — difficulty swallowing, weight loss, vomiting, bleeding, anaemia — and when ongoing reflux warrants testing.
Read article · 3 referencesUnderstanding reflux
What is GORD (gastro-oesophageal reflux disease)?
An evidence-based explanation of GORD: how it is defined, why it happens, common symptoms, how it is diagnosed, and where diet and gut health fit in.
Read article · 7 referencesReflux vs heartburn vs GORD — what’s the difference?
Reflux, heartburn and GORD are often used interchangeably, but they mean different things. A clear, referenced explanation of each term.
Read article · 4 referencesCan reflux occur without heartburn?
Yes — reflux can show up as cough, throat clearing, hoarseness, regurgitation, nausea or disturbed sleep without any burning. What the research shows.
Read article · 4 referencesWhat is LPR or “silent reflux”?
Laryngopharyngeal reflux (LPR) affects the throat and voice box, often without heartburn. Symptoms, evidence on diet versus medication, and when to see a doctor.
Read article · 4 referencesTriggers & causes
Can bloating make reflux symptoms worse?
How abdominal bloating, gas and stomach distension can increase reflux episodes — the physiology research, and a nutritionist’s perspective on reducing it.
Read article · 4 referencesWhat causes reflux after eating?
Why reflux is most common after meals: stomach stretching, meal size and composition, eating late, and individual food reactions — with references.
Read article · 8 referencesWhy can reflux be worse at night?
Night-time reflux explained: lying flat, reduced swallowing, late meals and sleep position — plus the research on bed elevation and sleeping on your left side.
Read article · 5 referencesCommon dietary reflux triggers — and why they aren’t the same for everyone
Coffee, alcohol, chocolate, fatty and spicy foods are commonly blamed for reflux — but the evidence shows triggers are individual. How to identify yours.
Read article · 6 referencesOur editorial standards
- • Claims about causes, mechanisms and outcomes are supported by peer-reviewed literature or recognised clinical guidelines (ACG, AGA, NICE, Rome IV, Lyon, Maastricht), linked in full.
- • Where evidence is limited or mixed, we say so — including studies that did not find a benefit.
- • Douglas’s clinical observations are labelled as practice experience, not research findings.
- • We never advise stopping or changing prescribed medication; that is always a decision for you and your doctor.
- • Articles are reviewed and updated as new evidence emerges.
Written by
Douglas Mizzi, Clinical Nutritionist
ATMS member #8079 · In practice since 1990 · 65,000+ consultations
Douglas specialises in diet, fermentation, gut health and gut recovery. He is a nutritionist, not a medical practitioner: he does not diagnose medical conditions or prescribe or change medication. Clinical observations in these articles reflect his practice experience and are presented separately from the published research. About Douglas
This information is educational and does not replace medical advice. If you have difficulty swallowing, weight loss, vomiting, bleeding or chest pain, see your doctor promptly (call 000 in an emergency).