Heartburn / GERD
Functional medicine support tailored to uncover the root cause of complex symptoms.
Consult with our care team to understand next steps and build a personalized plan.
Serving Denver Metro, Fort Collins, and Colorado Springs.
About This Condition
Gastroesophageal reflux disease (GERD) is a chronic condition in which reflux of gastric contents into the esophagus causes troublesome symptoms, esophageal injury, or both. The cardinal symptom is heartburn, often described as a burning sensation rising from the epigastrium or lower chest toward the throat, with or without regurgitation of sour or bitter fluid. Symptoms commonly occur after meals, when lying down, or with increased intra-abdominal pressure.
Clinical presentations range from typical reflux symptoms without visible mucosal damage to erosive esophagitis, peptic strictures, and Barrett’s esophagus in a subset of patients. Extraesophageal manifestations may include chronic cough, hoarseness, throat clearing, globus sensation, and asthma exacerbation, although causal relationships vary. Many individuals have fluctuating symptom intensity over time, with symptom clustering around dietary indiscretion, weight gain, stress, or medication changes.
Diagnosis is usually clinical in patients with typical symptoms and absence of alarm features, supported by response to empiric acid suppression. Endoscopy, ambulatory reflux monitoring, and esophageal manometry are reserved for those with alarm features, refractory symptoms, or diagnostic uncertainty. Management focuses on lifestyle modification, acid suppression with pharmacologic therapy, and, in selected patients, anti-reflux procedures, while monitoring for complications and alternative diagnoses.
Common Symptoms
- •Burning retrosternal discomfort or “heartburn,” often rising from the epigastrium toward the throat
- •Regurgitation of sour, bitter, or acidic-tasting fluid into the throat or mouth
- •Worsening of symptoms after large or late meals, bending over, lying supine, or consuming specific trigger foods or beverages
- •Epigastric discomfort, chest pressure, or a sensation of fullness or bloating after meals
- •Chronic sore throat, hoarseness, frequent throat clearing, or globus sensation in some patients
- •Chronic cough, especially at night or when lying down, in a subset of individuals
Conventional Treatment Options
Nutrition and trigger mapping
Timing/position strategies
Gut support
Our Functional Medicine Approach
Reflux isn't usually too much acid
Most patients with chronic reflux land on a PPI and stay on it. PPIs work — they also blunt nutrient absorption, change the microbiome, and carry real long-term risks when used for years. The underlying story is rarely "too much acid." It's typically lower-esophageal sphincter dysfunction, delayed gastric emptying, food sensitivities, H. pylori or dysbiosis, hiatal anatomy, weight and posture factors, or vagal tone.
How Spire works the root cause
Patients usually start with our Viome Gut Intelligence pathway to map microbiome activity, plus targeted H. pylori screening, motility evaluation, and food / timing trials. We then taper acid suppression deliberately, repair the upstream contributor, and rebuild gastric and esophageal function instead of leaving you on a daily medication for years.
Who this is for
Adults on long-term PPIs who want a path off, patients with recurrent reflux despite "good" diet and lifestyle, and anyone with new-onset reflux that hasn't been worked up beyond a prescription.