Acid reflux (GERD)
Also known as: gastro-oesophageal reflux disease, gastroesophageal reflux disease, GORD, GERD, heartburn, acid regurgitation
GERD is recurrent reflux of gastric contents causing heartburn, regurgitation or oesophageal irritation. TCM treatment focuses on restoring the descending function of Stomach Qì while addressing Liver constraint, Heat, food retention, phlegm-dampness or deficiency.
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Lifestyle & Diet
- •Use smaller meals and avoid lying down for at least two to three hours after eating.
- •Identify individual triggers rather than applying broad dietary exclusions.
- •Reduce late-night meals, excessive alcohol, tobacco and high-fat meals where these aggravate symptoms.
- •Elevate the head of the bed for troublesome nocturnal reflux.
- •Support gradual weight reduction where clinically appropriate.
- •Encourage regular meal timing, slower eating and thorough chewing.
- •Review medicines and supplements that may aggravate reflux with the prescribing clinician or pharmacist.
Cautions & Contraindications
- •Do not use acupuncture or herbal treatment to delay investigation of alarm symptoms or suspected cardiac chest pain.[]
- •Avoid abdominal needling over infection, open wounds, recent surgery or an undiagnosed abdominal mass.[]
- •Modify point selection and positioning during pregnancy.[,]
- •Check potential herb–drug interactions, particularly with anticoagulants, antiplatelet medicines, antihypertensives, diabetes medicines and acid-suppressing therapy.[]
- •Use caution with Huáng Lián-containing formulas in patients with marked cold, deficiency or gastrointestinal sensitivity.[,]
- •Herbal formulas require individual assessment and should not replace prescribed proton-pump inhibitors or other medicines without medical review.[]
When to reassess or seek care again
- •Reassess symptoms after 4 weeks of lifestyle change and any PPI trial; if reflux persists, worsens, or breakthrough occurs, review diagnosis and consider referral.[,]
- •Re-evaluate within 1–2 weeks if new dysphagia, odynophagia, unintentional weight loss, GI bleeding, or persistent vomiting develops — refer urgently for endoscopy.[,]
- •Review TCM pattern and point selection every 2–3 weeks; adjust if Liver-Stomach, Damp-Heat, or Deficient-Cold picture shifts.[]
- •Rich, greasy, spicy, or alcohol-heavy meals; late-night eating; overeating.[,]
- •Emotional stress, anger, or prolonged worry (Liver qi stagnation invading Stomach).[]
- •Weight gain, tight clothing, smoking, or resumption of NSAIDs.[,]
Long-term PPI users should have periodic medication review; step down to lowest effective dose where clinically appropriate.
Frequently Asked Questions
What are the main TCM patterns associated with acid reflux?+
Common patterns include Liver Qì invading the Stomach, Stomach Heat, food retention and Spleen Qì deficiency with rebellious Stomach Qì. Pattern differentiation depends on the full symptom picture, tongue and pulse [4].
Which acupuncture points are commonly considered for GERD?+
PC6, REN12, ST36 and SP4 are frequently considered, with additional points selected according to the presenting pattern. Point prescriptions should be individualised rather than applied as a fixed protocol [4].
When should a patient with reflux be referred for medical assessment?+
Refer for dysphagia, painful swallowing, gastrointestinal bleeding, unexplained anaemia, persistent vomiting, weight loss, food impaction, progressive symptoms or possible cardiac chest pain [3].
Can Chinese herbal medicine be used with reflux medication?+
Concurrent use may be possible following an individual assessment, medication review and herb–drug interaction check. Prescribed medicines should not be stopped or altered without the treating medical practitioner's involvement [4].
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Sources & Further Reading
Clinical guidance, red flags and safety notes on this page draw on the following current sources alongside the classical references above.
- NICE CKS · 2024
- Therapeutic Guidelines (Australia) — Gastrointestinal · 2024
- American College of Gastroenterology · 2022
- People's Medical Publishing House · 2017
Reference textbook for 吞酸 / 嘈杂 / 胃痛 pattern differentiation.
Educational reference for licensed practitioners. Not a substitute for individual clinical assessment. Refer to conventional care for any red-flag or undiagnosed presentation.