Advertise on podcast: What's the Root Cause? by Dr Vikki Petersen

🔥 Still dealing with acid reflux after cutting out all the "bad" foods? Book a consultation: https://rootcausemedicalclinics.com/hiatal-hernia-natural-treatment/ | Clearwater, FL | Telehealth Available You eliminated coffee, wine, and spicy food - and your reflux is still there. If standard dietary advice hasn't worked, these three foods are likely why, and most doctors never think to check them. In this video, Dr. Vikki Petersen breaks down three commonly overlooked foods that silently drive acid reflux through inflammation, delayed gastric emptying, and a weakened lower esophageal sphincter - not excess acid. ━━━━━━━━━━━━━━━━━━━ 🧠 WHAT YOU'LL LEARN → Why gluten triggers acid reflux even without a celiac diagnosis → The dairy connection most doctors miss and how it affects your esophageal valve → Why a popular "digestive aid" is actually making your reflux worse → How these foods drive reflux through gut inflammation - not acid overproduction → Why finding the root cause of reflux means looking beyond antacids and standard elimination diets ━━━━━━━━━━━━━━━━━━━ 🔎 WANT TO FIND THE ROOT CAUSE? Our licensed medical team at Root Cause Medical Clinic can help identify what's truly driving your digestive symptoms. ➡️ Learn more or book a consultation: https://rootcausemedicalclinics.com/hiatal-hernia-natural-treatment/ 📞 Call us: (727) 335-0400 ━━━━━━━━━━━━━━━━━━━ 👩‍⚕️ ABOUT DR. VIKKI PETERSEN Dr. Vikki Petersen, DC, CFMP, is a Doctor of Chiropractic and Certified Functional Medicine Practitioner with 40 years of clinical experience, specializing in gut health, acid reflux, GERD, and chronic digestive conditions conventional medicine often misses. She is the founder of Root Cause Medical Clinic, where a multidisciplinary team of licensed APRNs and clinicians provides functional medicine care focused on gut, hormone, and metabolic health. ━━━━━━━━━━━━━━━━━━━ ⚠️ DISCLAIMER This video is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your physician or a qualified health provider with questions about your health or treatment options. Views expressed are based on Dr. Petersen's clinical experience and current scientific understanding as of the publication date. Individual results may vary. ━━━━━━━━━━━━━━━━━━━ #AcidReflux #GERD #FunctionalMedicine #RootCauseMedical #DrVikkiPetersen #GutHealth #AcidRefluxRelief #DigestiveHealth

Fatty liver prevalence is 40% and most people don’t know they have it. It's closely tied to diabetes, heart disease, and long-term liver damage.  In this episode, Dr Vikki Petersen explains the association between PPI medication and fatty liver. Secret #1 Observational studies have found that people taking proton pump inhibitors have a higher prevalence of Fatty Liver  Risk -dose and duration dependent (1–2 years) The mechanism: gut microbiome disruption PPIs reduce stomach acid → that changes what survives the upper GI tract. leads to: Increased bacterial overgrowth - SIBO link - PPIs are strongly linked with SIBO - creates gas, pressure and reflux.  Toxin-producing bacteria - lead to liver fat accumulation  PPI → SIBO → pressure + endotoxins → reflux + fatty liver PPIs change the gut in a way that makes the body send more fat to the liver. Secret #2: Your gut talks to your liver Almost everything absorbed from your intestines travels straight to the liver first.  1. The wrong bacteria start to grow when stomach acid is suppressed. You start getting more bacteria that create irritating byproducts. 2. Those bacteria produce toxins 3. The gut lining gets irritated and more permeable 4. Those toxins slip into the bloodstream 5. They go straight to the liver. Blood from the intestines goes directly to the liver through the portal vein.  6. The liver reacts like it’s under attack and activates an inflammatory response.  7. Changes how the liver handles fat- burning is less efficient and the fat export system gets impaired - the result is fat accumulating inside liver cells. 8. Fat plus inflammation is where the real problem starts That combination is what can drive progression from simple fatty liver toward a more damaged, inflamed liver. Secret #3 - fix the gut signal coming into your liver - the focus isn’t on the liver but what’s being sent to it. Restore stomach acid or stop suppressing it. It’s how you prevent bacterial overgrowth. Reduce overgrowth and fermentation  TIPS:  Stop snacking  Space meals 4 hours apart - MMC cleans house  Chew thoroughly   Walk after meals Strengthen gut barrier Eat whole foods - add polyphenols (berries, broccoli, tea, cacao,nuts and seeds) Fiber Get adequate high quality protein Remove triggers -  ultra-processed foods, alcohol, sugar Lower the fat coming into your liver  Reduce insulin spikes w/ less frequent eating  Reduce excess sugar/fructose intake  Improve insulin sensitivity w/ movement after meals and exercise - aerobic and resistance training helps manage blood sugar levels for 24 to 72 hours. If you’ve tried the basics and aren’t improving, it usually means something deeper is driving it—and that’s where a more comprehensive evaluation makes the difference.That’s exactly what we focus on—identifying and addressing the root causes behind these patterns, not just managing the surface symptoms evaluation of: SIBO / dysbiosis Gut barrier function Inflammation markers Insulin resistance / metabolic markers Liver function beyond basic labs References:  1. Pyo JH et al. Proton pump inhibitors use and the risk of fatty liver disease 2021, Journal of Gastroenterology and Hepatology 2. Yu H et al. Proton pump inhibitor use is associated with increased hepatic steatosis in US adults 2024, Biomedical Reports 3. Huang H et al. Long-term use of proton pump inhibitors is associated with increased risk of nonalcoholic fatty liver disease 2024, Journal of Clinical Gastroenterology 4. Fossmark R et al. Changes in the gastrointestinal microbiota induced by proton pump inhibitors 2024, Microorganisms #guthealth #acidreflux #fattyliver  Disclaimer: The information provided in this episode is intended for educational p

Have you noticed an increase in acid reflux with age? Some studies cite the increased risk at ~47% in women during perimenopause and menopause. Women using hormone replacement have an increased risk of reflux of 40 to 70% as compared to women not using hormones. In the video, Dr Vikki Petersen explains why women tend to experience more reflux as they approach perimenopause and menopause. This has prompted the question of whether those on hormones had to be put on a PPI to handle their reflux OR stop their hormones to settle the heartburn? You don’t need to make that decision. You can enjoy the benefits of HRT on your heart, your bones, your brain and your urinary tract without having to put up with the dangerous side effects of PPIs - on your heart, your bones, your brain and your kidneys!  Isn’t that interesting - The negative side effects on your organs mirror the benefits of HRT on the same organs! The good news is that the deeper causes of heartburn and reflux can be addressed without losing the benefits of hormones. Studies show women in perimenopause/menopause are several times more likely to experience reflux than younger women, with some surveys finding ~40–47% reporting symptoms in midlife. Large pooled studies have shown that women using systemic hormone therapy have higher odds of reporting GERD symptoms compared with women who haven’t used it — roughly 29–66% higher in various analyses. Is this associative or causal? Perimenopausal/menopausal women report more reflux even without hormone therapy, likely due to shifting estrogen and progesterone levels, slower gut motility, weight distribution changes, and other age-related factors. Most women do experience an increase in heartburn with age, especially around perimenopause and menopause. Some women notice a change in reflux when starting hormone therapy — and studies show a higher prevalence of reported reflux in hormone users — but this doesn’t prove HRT is a direct cause in every case. The mechanisms likely involve both hormone-related smooth muscle effects AND other underlying factors (pressure, motility, hernia mechanics, weight patterns), which is why the “full story” is more complex than just hormones alone. Progesterone does relax smooth muscle affecting the lower esophageal sphincter. So yes — in some women, HRT can lead to reflux. But here’s what matters. If your diaphragm is strong, abdominal pressure normal, stomach empties properly, and thee's no hiatal hernia — the small hormonal shift usually won’t cause symptoms. Reflux isn’t caused by acid alone. And it’s rarely caused by hormones alone. Solutions If a woman needs HRT for: hot flashes, bone protection, brain or mood support, genitourinary (bladder) syndrome  The answer is not: “Stop HRT and start a PPI.”,  but evaluate: ✔ Diaphragm function ✔ Constipation ✔ Abdominal pressure causes ✔ Weight distribution  ✔ Stomach motility In other words: fix the gut. References: 1. Jacobson BC et al. (2008) Postmenopausal hormone use and symptoms of gastroesophageal reflux, Archives of Internal Medicine 2. Aldhaleei WA et al. (2023) The association between menopausal hormone therapy and gastroesophageal reflux disease: a systematic review and meta-analysis, Menopause 3. Close H et al. (2012) Hormone replacement therapy is associated with gastro-oesophageal reflux disease: a retrospective cohort study, BMC Gastroenterology 4. Saleh S et al. (2022/2023) Effect of Hormonal Replacement Therapy on Gastroesophageal Reflux Disease and its Complications in Post-Menopausal Women, Clinical Gastroenterology and Hepatology #acidreflux #guthealth #rootcausemedicine #menopause  Disclaimer: The information provided in this video is intended for educational purposes only and is not a substitute for profes

3 Root Causes of Burning Stomach 1. Pressure 2. Poor digestion and resulting fermentation 3. Irritated stomach lining In this episode, Dr Vikki Petersen explains 3 reasons why an acidic stomach develops and what you can do to dramatically improve your symptoms. Most “acid stomach” symptoms are driven by pressure pushing contents upward, not acid being overproduced.  Key drivers: Increased intra-abdominal pressure Hiatal hernia Constipation Central weight gain Tight diaphragm / poor breathing mechanics When pressure rises, acid moves where it shouldn’t. If pressure inside the abdomen rises, acid gets pushed upward. That’s when it burns. What actually lowers pressure: Stop overeating (smaller meals) Eat slower Fix constipation Reduce bloating triggers Practice diaphragmatic breathing Don’t lie down within 2–3 hours of eating This alone has the potential to resolve symptoms for many people. Improve Digestion so Food doesn’t Sit and Ferment If food sits too long: It ferments Gas forms Pressure rises Reflux follows What can fix this: Chew thoroughly Avoid constant snacking Space meals 4–5 hours apart Support motility (walking after meals) Identify food triggers Acid suppression does not fix fermentation. Calm the Irritated Lining Sometimes the acid is normal — the lining is just sensitive. Common irritants: NSAIDs Alcohol Ultra-processed foods High sugar diet Chronic stress H. pylori infection (bacteria in stomach) What helps: Remove irritants Short-term targeted support (not lifelong suppression)  - e.g. antacid Improve sleep Lower stress Restore gut barrier function If you feel like your stomach has too much acid, here’s the truth — most of the time it’s not too much acid. It’s pressure. It’s poor digestion creating gas. Or it’s an irritated lining that’s become sensitive. Lower the pressure. Improve digestion. Calm the inflammation. That fixes the cause — not just the symptom. References: 1. Pandolfino et al., 2006 "High-resolution manometry of the EGJ: evidence of a pressure gradient driving reflux" Gastroenterology 2. Kahrilas et al., 2012 "The acid pocket and its role in GERD", American Journal of Gastroenterology 3. Penagini et al., 1998 "Mechanisms of postprandial gastroesophageal reflux in humans", Gastroenterology 4. Wu et al., 2004 "Overeating and GERD symptoms" American Journal of Gastroenterology 5. Parkman et al., 2004 "Delayed gastric emptying in GERD" American Journal of Gastroenterology 6. Piche et al., 2003 "Colonic fermentation influences LES relaxation" Gastroenterology 7. Freedberg et al., 2015 "The impact of PPIs on the gut microbiome", Gastroenterology 8. Imhann et al., 2016 "Proton pump inhibitors affect gut microbiome", Gut 9. Vanuytsel et al., 2014 "Psychological stress and intestinal barrier function" Gut 10. Fass et al., 2001 "Functional heartburn: acid is not always the cause" Gastroenterology #acidreflux #hiatalhernia #rootcausemedicine  Disclaimer: The information provided in this video is intended for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your physician or other qualified health provider with any questions you may have regarding your health, medical condition, or treatment options. Never disregard professional medical advice or delay in seeking it because of something you have seen or heard in this video. The views expressed are based on my clinical experience and current scientific understanding as of the date of publication. Individual results may vary. Many viewers ask what to do next if symptoms persist.  Our licensed medical team

Constipation isn’t just about what you eat — it’s about whether your gut is getting the right signals to move.  In the episode, Dr Vikki Petersen explains why you may be suffering from constipation. 3 secrets: 1.Your Gut Runs on Nerve Signals Your gut runs on nerve signals -which are highly energy dependent. Vitamin B1 is required to convert glucose → energy With lower B1 → weaker nerve signaling - the gut isn’t getting strong, signals and the result is constipation. Research- thiamine deficiency rates from about 20% to 90% depending on the population studied. Obese people - deficiency of 15% to 29%. Diabetics - B1 75% lower in the blood. High carbohydrate diet puts you at risk because glucose in blood requires more B1 to break down the carbs thereby creating a higher demand  2.Your Gut Muscles Have to Respond The nerves send the signal, but the muscles have to respond to the signal. muscles need to contract and relax in sequence Research -magnesium intake is commonly inadequate. ~60% of American adults do not meet the recommended magnesium intake. ~45% of Americans may be magnesium deficient. When magnesium levels low, those signals weaken and slow the gut. Constipation, reflux, and bloating often occur together -they are all motility disorders.  stomach emptying slows → reflux small intestine motility slows → fermentation of bacteria leading to infection, bloat, gas, SIBO, leaky gut, increased IAP. Leads to hiatal hernia. colon motility slows → constipation It’s all one issue: with constipation you cannot have a healthy gut. Why? Refined grains remove minerals- whole grains contain magnesium, refined don't. Ultra-processed food diets Certain medications - like PPIs, antibiotics, diuretics  Magnesium dense foods: pumpkin seeds, chia seeds, flax seeds, sunflower seeds (also B1), almonds, legumes (also have B1), dark leafy greens. Dark Chocolate and avocado. 3. How Modern Diets Slow Your Gut - SAD (standard American diet) works against motility Ultra-processed foods, sugar can: disrupt the gut microbiome - more bad bacteria reduce beneficial bacterial byproducts that stimulate motility increase inflammation - fatigue, feeling “off” and mood changes Causes B1 and magnesium depletion. People are missing good compounds: Polyphenols -plants, berries, tea, and herbs. Support beneficial bacteria and motility. Fiber -start low and slow: Insoluble fiber feeds microbes that produce short-chain fatty acids. with bad bacteria the fiber can eat that too - so you feel worse. SCFA - produced when good gut bacteria ferment fiber. They cause production of serotonin and brain makes “happy” mood hormones.  The Simple Foundations Still Matter Basics still support motility: Hydration  Movement -activity stimulates intestinal contractions Polyphenol-rich foods  Reducing ultra-processed foods and - deplete B1 B1 is high in pork, beef and fish TIPS If hard stool → magnesium citrate or oxide - 200 - 400 mg/day If stress,  or motility → magnesium glycinate ~300 -400 mg/day. References: 1. Camilleri M. Gastrointestinal complications of diabetes. 2007, New England Journal of Medicine 2. Bharucha AE, et al. American Gastroenterological Association technical review on constipation. 2013, Gastroenterology 3. Mori H et al. Magnesium oxide in constipation. 2021, Nutrients 4. DiNicolantonio JJ et al. Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis. 2018, Open Heart 5. Lonsdale D. A review of the biochemistry, metabolism and clinical benefits of thiamin(e). 2006, Evidence-Based Complementary and Alternative Medicine 6. Makki K et al. The impact of dietary fiber on gut microbiota i

Reflux that keeps coming back is usually not just an acid problem — it’s a pressure and mechanics problem. In the video, Dr Vikki Petersen explains why getting "relief" from an antacid is not addressing the core of the problem. In fact, it's perpetuating it. Acid blockers (PPIs and H2 blockers) reduce stomach acid and can decrease the burning sensation. That can be appropriate short-term, especially with esophagitis. But these medications do not address the root cause of reflux - it isn't too much acid.  It's actually a pressure problem. When pressure within your abdomen increases, stomach emptying slows, or a hiatal hernia develops, stomach contents can move upward regardless of acid level. Lowering acid may reduce symptoms, but it does not correct the mechanical dysfunction being caused by the pressure. Why stomach acid matters. Why do you need acid in your stomach? • Protein digestion begins in the stomach • It's a detergent/disinfectant that kills bad organisms. • Absorption of minerals only occurs due to the presence of acid: e.g. calcium, magnesium, iron, zinc • Release and absorption of vitamin B12 and folate Potential risks associated with long-term acid suppression Long-term PPI use has been associated in the literature with: • Increased risk of nutrient deficiencies (B12, magnesium, iron) • Higher rates of C. difficile infection - a bacterial infection that can be life-threatening • Altered gut microbiome - more bad bacteria present in the gut than good bacteria leading to inflammation, mood disorders, and more. • Increased fracture risk - osteoporosis due to lack of calcium absorption • Kidney injury (acute and chronic) • Increased risk of respiratory infections, e.g. pneumonia These associations do not mean every patient will experience harm, but they highlight that acid suppression can have negative health impacts across many organs and systems. Addressing the root contributors Long-term improvement often requires evaluating: • Intra-abdominal pressure (belly fat, chronic straining due to constipation) • Diaphragm function and breathing mechanics • Hiatal hernia alignment • Delayed stomach emptying • Dysbiosis or SIBO • Food triggers and inflammatory load The goal should not simply be eliminating the burn. The goal is restoring function and integrity. References 1. Lam JR, et al. Proton pump inhibitor and histamine-2 receptor antagonist use and vitamin B12 deficiency. JAMA. 2013 2.Hess MW, et al. Systematic review: hypomagnesaemia induced by PPIs. Aliment Pharmacol Ther. 2012.  3. Yang YX, et al. Long-term PPI therapy and risk of hip fracture. JAMA. 2006.  4. Xie Y, et al. Long-term kidney outcomes among PPI users without intervening acute kidney injury. J Am Soc Nephrol. 2017 5. Janarthanan S, et al. Clostridium difficile–associated diarrhea and PPI therapy: meta-analysis. Am J Gastroenterol. 2012 6. Kahrilas PJ, et al. Approaches to the diagnosis and grading of hiatal hernia. Best Pract Res Clin Gastroenterol. 2008. #acidreflux #hiatalhernia #rootcausemedicine  Disclaimer: The information provided in this video is intended for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your physician or other qualified health provider with any questions you may have regarding your health, medical condition, or treatment options. Never disregard professional medical advice or delay in seeking it because of something you have seen or heard in this video. The views expressed are based on my clinical experience and current scientific understanding as of the date of publication. Individual results may vary. Many viewers ask what to do next if symptoms persist.  Our licensed medical team at Root Cause Medical

Did you know a single course of antibiotics is linked to a 25% higher risk of anxiety and depression? Because antibiotics don’t just target the infection, the bad bacteria — they can disrupt the good gut bacteria that help regulate your brain. Educational content reviewed by licensed APRN medical staff. Not personal medical advice. In the video, Dr Vikki Petersen explains why there's an increased risk of anxiety and depression after taking antibiotics. Antibiotics kill both good and bad bacteria alike. Fewer beneficial bacteria means less control over inflammation. Inflammation can disrupt serotonin, dopamine, and the circuits that determine whether your brain feels calm or anxious. If you already deal with reflux, bloating, or constipation — common in hiatal hernia — the impact can be bigger and recovery slower. The increased risk shows up mainly in the months after treatment and can persist for up to about a year or longer. Many species rebound in weeks to a few months. Some do not fully return, especially after repeated exposure of antibiotics. Short chain fatty acids (SCFAs) are produced as a result of an abundance and variety of good bacteria. They strengthen the gut barrier - preventing leaky gut. With less leak, fewer inflammatory signals reach circulation resulting in less stimulation of brain immune cells. Too much activation of brain immune cells is associated with anxiety, depression, cognitive changes, and neurodegeneration. How does Hiatal Hernia fit in? Many people with hiatal hernia already have motility issues and microbial imbalance. That environment makes infections more likely. More infections often mean more antibiotics. And each round can deepen the imbalance. Hiatal hernia commonly overlaps with: impaired gastric emptying altered pressure gradients reflux of stomach and small intestinal contents changes in motility frequent acid suppression. All of those influence which organisms survive and where they grow. When movement and clearance are off, microbes accumulate in places they shouldn’t. TIPS Fermented foods - think of them as reseeding the garden after the antibiotic has wiped out the pretty flowers, not just the bad weeds. Variety is key with fiber - gradual increase. Insoluble fiber - feeds the good bacteria and inc SCFA production. E.g. nuts, seeds, legumes, dark green leafies, psyllium, chia, flax, raspberries. Sleep - repair time Movement - Regular moderate activity is linked with: greater diversity, better SCFA production, improved motility. Hydration supports stool transit, motility and mucosal health Stress regulation: A stressed brain sends stressed signals to the gut. Probiotics: They can help in certain situations, but they are not magic. After antibiotics, recovery isn’t about replacing one bug. It’s about rebuilding an environment where healthy microbes can grow again References: 1. Lurie I, et al. Antibiotic exposure and the risk for depression, anxiety, or psychosis. The Journal of Clinical Psychiatry, 2015. 2. Palleja A, et al. Recovery of gut microbiota of healthy adults following antibiotic exposure. Nature Microbiology, 2018. 3. Koh A, et al. From dietary fiber to host physiology: short-chain fatty acids as key bacterial metabolites. Cell, 2016. 4. Erny D, et al. Host microbiota constantly control maturation and function of microglia in the CNS. Nature Neuroscience, 2015. 5. Quigley EMM. Microbiota–gut–brain axis and neurogastroenterology. Gastroenterology, 2017. 6. Imhann F, et al. Proton pump inhibitors affect the gut microbiome. Gut, 2016. 7. Miller AH & Raison CL. The role of inflammation in depression. Nature Reviews Immunology, 2016. #guthealth #anxiety #hiatalhernia #rootcausemedicine  Disclaimer: The information provided in this video is inten

Do you take antacids like PPIs? The odds are it’s not right for you. Educational content reviewed by licensed APRN medical staff. Not personal medical advice. In the video, Dr Vikki Petersen explains why antacids such as PPIs may be causing your symptoms to worsen and perpetuate rather than being resolved. A global systematic review found that about 60% of PPI prescriptions were inappropriate or lacking a valid indication in clinical practice.  If you’re thinking - No - I really do have acid reflux, hang in there with me for a few minutes. Fact: It’s one of the most prescribed drugs worldwide  Fact: It has many dangerous side effects  Like what: Cause infections, worsen gut health (perpetuates the problem), heart disease, bone loss and dementia to name a few Why would your doctor ignore those risks? Drs do want to help - they want their patients to “feel” better.  In conventional medicine it’s all about controlling symptoms which is much easier than correcting why they started. What’s easier? Swallowing a pill or doing lifestyle and diet changes? The answer is obvious - but it the EASY answer the better one or the safe one? For patients it seems simple: I have “burn”, the drug stops it. That’s all they want to know. It’s easier to continue a prescription then admit the treatment failed - the reflux came back when the medication is stopped. It’s unfair that they’re not told what’s going to happen long term:  Nut’l deficiencies  Infections  Worsening gut health that will perpetuate the need for antacids and then more drugs - e.g. heart meds, anxiety meds, breathing meds, pain meds  Weak bones  Risk of heart disease, stroke, dementia Therapeutic inertia - It means treatment continues because it is easier and safer than changing direction, even if it’s not solving the underlying issue. This supports the point that long-term continuation often happens by default or habit, without re-checking whether it’s still truly indicated. Almost every reflux patient I meet was told they might need this medication forever.  -The real causes: impaired gastric emptying intra-abdominal pressure dysbiosis food triggers vagal or diaphragmatic dysfunction constipation obesity Note about rebound acid secretion  -Tips  No gluten, sugar or seed oils for 3 weeks Practice diaphragmatic breathing 3x/day - research shos 2 out of 3 decreased need and some stopped No tight clothes Don’t overeat - chew well Don’t eat and lie down Don’t eat late References 1. Dutta AK, Sharma V, Jain A, et al. (2024). Inappropriate use of proton pump inhibitors in clinical practice globally: A systematic review and meta-analysis. Gut. 2. Lüthold RV, et al. (2023). Inappropriate proton-pump inhibitor prescribing in primary care (study reporting high rates of potentially inappropriate long-term PPI use, including “no indication” and “too high dose”). Swiss Medical Weekly. 3. Lazarus B, et al. (2016). Proton Pump Inhibitor Use and Risk of Chronic Kidney Disease. JAMA Internal Medicine. 4. Finke M, et al. (2025). Proton pump inhibitors and the risk of Clostridioides difficile infection: A systematic review and dose-response meta-analysis. Journal of Infection 5. Liu J, et al. (2019). Proton pump inhibitors therapy and risk of bone diseases: An update meta-analysis. Life Sciences. 6. Choudhury A, et al. (2023). Vitamin B12 deficiency and use of proton pump inhibitors: a systematic review. Expert Review of Clinical Pharmacology. #acidreflux #guthealth #hiatalhernia #rootcausemedicine  ➡ Learn more or book a consultation: https://rootcausemedicalclinics.com/hiatal-hernia-natural-treatment/ 📞 Call us directly: (727) 335-0400

Have you rushed to the ER convinced you were having a heart attack?  You had heart palpitations, shortness of breath and anxiety out the roof? You also suffer with acid reflux, bloat, gas, and/or constipation. Educational content reviewed by licensed APRN medical staff. Not personal medical advice. Every test comes back normal, but your heart still races, the shortness of breath impacts your day to day life and your gut is a mess. Your cardiologist assures you there's nothing wrong, yet you feel "off" and keep suffering. In the video, Dr Vikki Petersen explains what the 3 missing "pieces" of Hiatal Hernia Syndrome are and why they need to be evaluated in order to achieve successful relief. We utilize a patient-tailored approach - Personalized medicine, because there isn't a "one size fits all" solution. Diet, posture, breathing - why “one size doesn’t fit all” Symptoms influenced by: diet, digestion efficiency, motility within the gut, microbiome health, diaphragmatic breathing, and vagal nerve tone 1. DIET  Recent work highlights that diet composition—not just acid suppression—matters for reflux and hiatal hernia symptom burden. Interventions focusing on reduced overall sugar intake, increased fiber, and mindful eating patterns SMOKING & WEIGHT  Risk factor data indicate abdominal pressure, physical workload, smoking, and central adiposity are risk factors. 2. MOTILITY & MICROBIOME  Current GERD/hiatal hernia literature recognizes the influence of gut motility and possibly microbiome interactions on reflux patterns. PPIs, given for reflux, can make it worse - can’t be the only treatment. You can’t feel the reflux but it’s still there.  It doesn’t correct motility or pressure issues 3. STRESS  Stress reduction and vagal nerve influence TIPS Eat smaller meals Stop eating 3–4 hours before bed Avoid tight clothing Chew thoroughly Avoid large mixed meals late at night Pay attention to early fullness, bloating, or nausea Walk after meals Stay upright for at least 20–30 minutes after eating. Belly breathing - before meals and practiced during the day Diaphragm part of anti-reflux barrier so needs to be exercised Address constipation and gas - increases pressure References: Martinucci I et al., “Esophageal motility abnormalities in gastroesophageal reflux disease,” 2014, World Journal of Gastroenterology Voulgaris T et al., “Is there a direct relationship between hiatal hernia size and reflux events,” 2023, Annals of Gastroenterology Bucan JI et al., “Updates in Gastroesophageal Reflux Disease Management,” 2025, Medicines (MDPI) Lin S et al., “Esophageal Motor Dysfunctions in Gastroesophageal Reflux Disease,” 2019, Journal of Neurogastroenterology and Motility Freedberg DE et al., “The impact of proton pump inhibitors on the human gastrointestinal microbiome,” 2014, Gut Tian L et al., “Proton pump inhibitors may enhance the risk of digestive complications,” 2023, Frontiers in Pharmacology Remes-Troche JM, “PPIs Have It: Does Tegoprazan Affect Gastric Emptying and Produce Dyspeptic Symptoms?,” 2025, Digestive Diseases and Sciences Andrews WG et al., “The relationship of hiatal hernia and gastroesophageal reflux,” 2021, Annals of the American Thoracic Society #hiatalhernia #acidreflux #guthealth #rootcausemedicine  Disclaimer: The information provided in this video is intended for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your physician or other qualified health provider with any questions you may have regarding your health, medical condition, or treatment options. Never disregard professional medical advice or delay in seeking it because of something you have seen or heard in this video. The view

What health problems are you trying to solve? Fatigue? Weight gain? Poor sleep? Mood swings? Brain fog? Educational content reviewed by licensed APRN medical staff. Not personal medical advice. In the video, Dr Vikki Petersen explains why fasting results are different between men and women and what is the optimal approach for women. Time restricted eating or fasting is a physiological stressor - not a bad one, but still a stressor and women react differently to it than men.  Women are not “small men” and our metabolism and hormones are different- therefore the “dose” of fasting matters. A fasting window of 12 to 14 hours allows for adequate protein consumption, better quality sleep, and lowers stress load. Long fasting windows make it harder to hit protein targets - this matters for satiety (stops cravings) and lean muscle mass retention. Protein maintains:  Muscle and bone  Hormones and enzymes  Neurotransmitters - brain chemicals  Immune system strength If protein intake drops the body breaks down muscle. Lower muscle = more fat, and slower metabolism. Men exhibit more predictable improvements like weight loss and insulin sensitivity while women, who mobilize fuel differently, commonly show weight gain, loss of muscle, insulin resistance, adverse hormone and stress responses. Initially you may not notice negative effects - your fatty acids are elevated meaning you're breaking down stored fat - you lose weight, feel more energy and that convinces you to continue longer fasts. It’s what happens long-term that is concerning - long-term elevation of fatty acids leads to:  Reduced glucose uptake into muscle and liver, leading to  Insulin resistance - type 2 diabetes, and fatty liver,  Greater difficulty losing fat  Increased visceral fat/belly weight  Muscle breakdown so you lose lean muscle  Sleep disruption  Brain effects:     Fatigue   Lowered stress tolerance   Brain fog  Particularly important if you are in the following categories: Fertile Irregular or missed periods PMS or heavy periods Feel “wired” but tired High training volume Trouble sleeping Menopause/Perimenopause Trouble maintaining muscle Fat gain despite eating less Poor sleep Brain fog or stress Cold intolerance of thyroid symptoms Fatigue and need caffeine Tips Fast while you’re sleeping… and a bit more before and after = 12 to 14 hours. Prioritize protein - aim for 1 gram of protein per lean pound of body weight.  Book end protein at the beginning and end of the day with a lighter dose mid-day. Aim for 25 grams of fiber daily from whole food - fruit, veggie, nuts, seeds, beans. Healthy fats come along with much of the foods you’re eating References: Soeters MR et al. Gender-related differences in the metabolic response to fasting 2007 — Journal of Clinical Endocrinology & Metabolism Bene-Alhasan Y et al. Determinants of fasting non-esterified fatty acids 2023 — Journal of Clinical & Translational Endocrinology Takeuchi M et al. Higher fasting and postprandial free fatty acid levels are associated with muscle insulin resistance in young women 2018 — Journal of Clinical Medicine Research Pankow JS et al. Fasting plasma free fatty acids and the risk of type 2 diabetes 2004 — Diabetes Care Abraham SB et al. Cortisol, obesity and the metabolic syndrome 2013 — Endocrine Reviews Kim BH et al. Effects of intermittent fasting on circulating hormone levels and circadian rhythms 2021 — Endocrinology and Metabolism Uhart M et al. Gender differences in hypothalamic–pituitary–adrenal axis reactivity 2006 — Psychoneuroendocrinology #fasting #weightloss #musclelossprevention #rootcausemedicine  Disclaimer: The information provide

Sleep isn’t one thing. It’s four. Quantity. Quality. Regularity. Timing. Think of them like the legs of a chair. Lose one, and your health collapses. In the podcast, Dr Vikki Petersen explains how to reset sleep, its connection to weight, fat loss, and how to avoid dying prematurely. Quantity - Shorter sleep = a shorter life. Predicts all cause mortality. Recommended is 7 to 9 hours. 7 is minimum to survive - not what you need to thrive. Quality - Important for mental health. AKA sleep efficiency-want to keep it above 85%. Desired  is 1 to 2 long bouts of sleep vs fragmented sleep due to awakenings.  Regularity - decreases risk of all-cause mortality by 49%, risk of cancer by 39%, risk of heart disease by 57%.  Regularity refers to wake & sleep time. Best to keep it within 15 minutes on either side Worst was a variation of 90 to 120 minutes. You need both, but regularity beat out quantity in reducing all cause mortality. Timing (aligning with your natural body clock, or chronotype), using light cues (morning sun, dim evening light) to set it right.  E.g. morning lark, night owl - but most people fall in the middle - bears. Sleep Killers Artificial light - Artificial light confuses the brain -“junk” light. Think candles - a little essential oils added Eliminate Alcohol Caffeine Marijuana Eating before bed - wait 3 hours TIP to help you fall asleep For 7 days set alarm 1 hour before bedtime. Turn off most of the lights, candle light is fine, cool room to 68 degrees F. Do you feel more sleepy? Go back to your regular routine & note difference. Set an alarm to wake up 8 to 9 hours after your regular bedtime. As your sleep quality improves you won’t need an alarm. Don’t skimp on that last hour of sleep - impacts mood, learning and mental performance - very restorative TIP to help you get back to sleep - described in video 3 options: Box breathing  Body scan Mental walk  Weight and Sleep How you sleep dictates what you eat and how you burn calories Underslept = Cravings Leptin and ghrelin go in opposite directions when underslept-increases your hunger drive 40%. Burning calories More likely to store calories as fat when underslept vs storing them as glycogen in muscles. Dieters: lost the same weight but poor sleepers lost 70% of weight from lean muscle while keeping the fat.  Fasting Longer fasts your body makes more Orexin - hormone promotes wakefulness & appetite. May see your sleep scores drop during longer fasts Melatonin - do you need it? Helpful to prevent jet lag or if you’re someone who doesn’t get sleepy until 3 to 4 am. It doesn’t make you sleep or generate sleep - it starts the sleep cycle.  Doesn’t improve the speed you fall asleep or the efficiency in any meaningful way.  Safe dose is 0.1 to 3 mg. More not better because you can confuse your morning brain - melatonin should be zero in the morning - taking too much will cause you to have levels of it for the first 3 to 4 hours and you’ll be groggy and needing caffeine. Note: it’s otherwise safe and an anti-oxidant, but there’s been erroneous data re; amounts that are too high. Don’t give it to children - melatonin is a hormone that influences puberty and some studies indicate that it can perhaps stunt reproductive development. Short-term use seems safe, but long term is concerning. Magnesium - most doesn’t cross blood brain barrier, except L-threonate. But just being insufficient makes a difference - 50% of us are. Magnesium relaxes muscles and vagus nerve is activated with relaxation. References: 1.Windred D, et al. (2024) Sleep regularity is a stronger predictor of mortality risk than sleep duration. Sleep  2.Cribb L, et al. (2023) Sleep regularity and mortality... eLife 3.Miao Y, et

If you suffer with acid reflux you are in good company. But acid reflux doesn't respond well to lowering acid levels. The proof? Educational content reviewed by licensed APRN medical staff. Not personal medical advice. In the video, Dr Vikki Petersen explains why "blaming" the acid in your stomach is the wrong approach. Millions continue to suffer despite taking a standard acid reducing medication like PPIs. Up to 40% of GERD patients report dissatisfaction and have incomplete or no response to a standard PPI dose. Up to 55% continue to have persistent symptoms despite “optimal therapy”. What’s going on: Your stomach is supposed to contain acid. It kills bad organisms, begins protein digestion, and absorbs minerals and  B12.  Reflux is not due to too much acid -real problem is acid in the wrong location - your esophagus. Why? The anti-reflux barrier fails. Why? 1.Digestion slows, stomach remains full, food ferments, gas builds and pressure rises, pushing stomach upward. 2.The diaphragm loses its coordinated support of the LES, becomes flattened, and less able to prevent reflux. 3.Vagus dysfunction - leads to fight or flight resulting in shallow breathing, diaphragmatic excursion decreases, decreased tone of LES, slowed gastric emptying,  4.Hiatal hernia - stomach elevates and compromises anti-reflux barrier 5. H pylori -bacterial infection. More susceptible if older or taking PPI. Symptoms of H. pyrlori are often mistaken for reflux:   Stomach burning or gnawing pain, nausea, early fullness, worse on an empty stomach.   H. pylori infection can cause anti-reflux barrier to fail H. pylori is leading cause of atrophic gastritis globally.  Stomach lining thins, loses gastric gland cells, leads to low acid, B12 deficiency and risk of stomach cancer. Gastric gland cells produce HCl, enzymes, protective mucus to prevent the stomach from digesting itself.  Strains: CagA - most dangerous, higher risk of ulcer, cancer  VacA - all H pylori carry the gene - s1 more toxic, s2 less toxic The strain matters as much as the infection. If reflux isn’t just acid problem, what do you do? 1.stop assuming acid is the enemy. Goal is restore normal stomach function. 2. support digestion so stomach can empty properly. e.g. real food, adequate protein, hydration 3. reduce pressure. e.g. handle constipation, bloating, tight clothing, large late meals 4. restore coordination between diaphragm and esophageal sphincter. e.g. nasal breathing, diaphragmatic breathing, posture awareness, daily movement  5. support vagal tone. e.g. handle chronic stress, shallow breathing, poor sleep, fight or flight  6.identify upstream disruptors. e.g. H. pylori, low stomach acid, hiatal hernia,  testing microbiome, ruling out mold, viruses, heavy metals, and food sensitivities. Reflux improves when the body as a coordinated system works together again-not when acid is simply suppressed. References: 1.El-Serag HB, et al. Update on the epidemiology of gastro-oesophageal reflux disease.. Gut, 2014. 2.Pandolfino JE, et al. Mechanical properties of the lower esophageal sphincter and crural diaphragm. Gastroenterology, 2007. 3.Sifrim D, et al. Transient lower esophageal sphincter relaxations and reflux. American Journal of Medicine, 2001. 4.Farmer AD, et al. The role of the vagus nerve...Nature Reviews Gastroenterology & Hepatology, 2014. 5.Martinucci I, et al. Esophageal impedance-pH monitoring... Neurogastro & Motility, 2018. 6.Malfertheiner P, et al. Helicobacter pylori infection. Nature Rev Dis Primers, 2017. 7.Cover TL, et al, H pylori VacA, ...Nat Rev Micro, 2005. 8.Hatakeyama M. H pylori CagA...Nat Rev Cancer, 2004. #acidreflux #guthealth #hiatalhernia #rootcausemedicine  Disclaimer: The information provided in this video is

Do you have chronic acid reflux or hiatal hernia symptoms that bother you?  Are you considering surgery? Dr Vikki Petersen explains why you may want to consider all your options before jumping into surgery that is not a medical emergency.  Fundoplication surgery reinforces the lower esophageal sphincter by wrapping the upper pat of the stomach around the lower esophagus. The surgery reinforces the lower esophageal sphincter (LES) by wrapping the upper part of the stomach (the fundus) around the lower esophagus. This: What the surgery aims to accomplish: Prevents stomach acid from refluxing upward Improves LES pressure Reduces regurgitation and heartburn Who is a good candidate?  Persistent GERD, Hiatal Hernia, esophagitis, regurgitation, want to avoid long-term PPIs Stated Benefits  Reduction of reflux, eliminate need for PPI, long-lasting symptom relief - Note: it states "symptom reflief" not cure. Risks and side effects  Trouble swallowing  Gas/bloat syndrome - can’t belch or vomit  Increased gas  Wrap loosening or slipping over time         Damage to vagus nerve         Dumping syndrome Fundoplication does not address the root cause contributors such as: Impaired gastric emptying Low stomach acid Dysbiosis or SIBO Increased intra-abdominal pressure Poor diaphragmatic function Why it Fails - wrap loosens - Why? Ongoing increased intra-abdominal pressure or obesity. The cause of the increased pressure is the "contributors" just mentioned above. “Failure” statistics: ~30% develop recurrent symptoms over time At 10 years, 40%  have had symptoms return and require medication. Failure rates increase with time — many studies show good short-term outcomes but gradual decline over years. Revisions surgeries fail at a rate of 40% Bottom line: Short-term success: high Long-term durability: moderate Many failures are driven by ongoing pressure and motility issues, not acid alone. References: 1.Spechler SJ, et al. Medical or surgical management of GERD JAMA – 2019 2.Gyawali CP, et al. Modern diagnosis of GERD and surgical candidacy. American Journal of Gastroenterology – 2018 3.Broeders JA, et al. Ten-year outcome of laparoscopic fundoplication. British Journal of Surgery – 2013 4.Oelschlager BK, et al. Symptom recurrence after fundoplication Journal of Gastrointestinal Surgery – 2011 5.Herregods TVK, et al. Esophageal motility disorders and reflux surgery outcomes. Neurogastroenterology & Motility – 2015 #hiatalhernia #acidreflux #guthealth #rootcausemedicine    Disclaimer: The information provided in this is intended for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your physician or other qualified health provider with any questions you may have regarding your health, medical condition, or treatment options. Never disregard professional medical advice or delay in seeking it because of something you have seen or heard in this. The views expressed are based on my clinical experience and current scientific understanding as of the date of publication. Individual results may vary. Many viewers ask what to do next if symptoms persist.  Our licensed medical team at Root Cause Medical Clinic can help you identify the root cause.  ➡ Learn more or book a consultation: https://rootcausemedicalclinics.com/hiatal-hernia-natural-treatment/ 📞 Call us directly: (727) 335-0400 About this channel: Dr. Vikki Petersen, DC, CFMP, is founder of Root Cause Medical Clinic. Our multidisciplinary team of licensed APRNs and clinicians provides functional medicine care focusing on gut, hormone, and metabolic health. These are reviewed by licensed

Bloating and gas are common symptoms with up to 30% of the population suffering enough to complain to their doctors.  Educational content reviewed by licensed APRN medical staff. Not personal medical advice. Dr Vikki Petersen explains what the 5 most common causes are and what you can do to determine which may be bothering you and some steps you can take to alleviate the discomfort. 1. Low stomach acid - the common symptoms are fatigue, heartburn, feeling full, bad brath, undigested food in stool, diarrhea/constipation.  Home test: 1/4 tsp baking soda in 4-6 oz cold water first thing in the morning before any food or drink. Time when you burp. Normal is within 2-3 minutes. If no burp at 5 minutes it may indicate low stomach acid. You can trial some betaine hydrochloric acid but check with your doctor first. 2. Poor gallbladder health - bile breaks down fats and absorbs fat soluble vitamins. Bile also works with the pancreatic enzymes which we are about to discuss. Symptoms include - bloat after a fatty meal, nausea, upper right quadrant (just below your ribs on the right) discomfort that can radiate around to your shoulder blade, nausea and feeling full after a fatty meal. You can try adding bitters such as ginger, arugula, milk thistle to see if it improves symptoms. check with you doctor first however. 3. SIBO - small intestinal bacterial overgrowth. Symptoms include cramping, gas, pain, diarrhea and or constipation. Causes are PPI meds, antibiotics, low stomach acid, slowed motility Test - your doctor can order a Breath Test. You can trial oregano, garlic, fasting and a carnivore diet for 2 weeks - consult with your doctor first. 4. Poor pancreatic function - the pancreas makes enzymes to digest every type of food: fat, carbohydrate and protein. Symptoms include bloat, greasy, smelly stool, nausea, vomiting, bloat and diabetes symptoms. You can trial pancreatic enzymes with your doctor's approval. 5. Food sensitivities - common foods can cause a variety of symptoms including bloating. Trial a modified elimination diet and a planned reintroduction after 3 weeks. This is the gold standard for food sensitivity testing.  References: Vavallo M et al. Autoimmune gastritis and hypochlorhydria: Known concepts from a new perspective. International Journal of Molecular Sciences. 2024. Filardo S et al. The potential role of hypochlorhydria in the development of duodenal dysbiosis. Microorganisms. 2022. Whitcomb DC et al. AGA Clinical Practice Update on the epidemiology, evaluation, and management of exocrine pancreatic insufficiency (EPI). Gastroenterology. 2023. Jung SW et al. Epigastric symptoms of gallbladder dyskinesia mistaken for functional dyspepsia. Korean Journal of Gastroenterology. 2017. Feng X et al. Prevalence and predictors of small intestinal bacterial overgrowth in inflammatory bowel disease: a meta-analysis. Frontiers in Medicine. 2025. Saadati S et al. Effects of a gluten challenge in patients with irritable bowel syndrome: A randomized clinical trial. Scientific Reports. 2022. Pasta A, et al. Food Intolerances, Food Allergies and IBS: Lights and Shadows, Nutrients 2024. #bloating #guthealth #rootcausemedicine  Disclaimer: The information provided in this is intended for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your physician or other qualified health provider with any questions you may have regarding your health, medical condition, or treatment options. Never disregard professional medical advice or delay in seeking it because of something you have seen or heard in this. The views expressed are based on my clinical experience and current scientific understanding as of the date of publication. Individual results may vary.

This video is for every woman and every man who loves a woman.  What if: You could reduce your risk of heart disease and death by up to 50%. You could decrease your risk of colon cancer by up to 56%. You could reduce your risk of diabetes by up to 30%? You could reduce your Alzheimer’s risk by 35%?  What if you could reduce your fracture risk by 50 to 60%?  And, what if you could add a healthy 10 years to your life expectancy? Educational content reviewed by licensed APRN medical staff. Not personal medical advice. In the video, Dr Vikki Petersen explains why there has been fear and confusion regarding hormone replacement therapy (HRT) for the past 23 years. What's the solution? Hormone replacement therapy (HRT). When I said that, what did you think of?    Did you think: “Wait, isn’t there a risk of breast cancer and stroke with HRT?  It’s time to set the record straight. 23 years ago a $1 billion study (WHI) was conducted on HRT and stopped early due to supposed increased risk of breast cancer, blood clots and cardiovascular disease. A press conference occurred before the study results were released.  The media frenzy stated that HRT caused breast cancer, leading to panic. By the time the actual study results came out and smart doctors and scientists saw the results, the fact that the study showed no statistical significance was ignored. NO study has even shown that HRT increases the risk of breast cancer mortality. In fact, taking estrogen alone shows a 24% decreased risk in breast cancer.   The FDA has recently set the record straight and corrected this mistake by revealing the exact science and removing the black box warnings that created fear in so many. The truth is that menopause shortens lives because of the loss of estrogen. There is no organ in the human body that does NOT have estrogen receptor sites. Estrogen factually does the following: It protects your heart, protects your bones, acts as a protective shield for your brain, lowers risk of mental decline, memory loss and Alzheimer’s. It reduces all cause mortality, thus extending women’s lives by a decade. It reduces your risk of diabetes. It is factually one of the most effective longevity interventions for women.  Is there a risk of taking HRT if you’re  10 yrs past menopause? Not necessarily. You may not be eligible especially if you have cardiac risk. But for ALL women, regardless of your age, or cancer history, you ARE eligible for vaginal estrogen therapy. With loss of estrogen, urinary tract infections increase, vaginal dryness and painful sex. A UTI in an older woman can be life threatening due to sepsis.  Unlike UTIs in younger women where painful urination is the key symptom, in older women the symptoms of confusion, fatigue or agitation can be the only signs - leading to confusion with onset of dementia.  80 to 90% of elderly women have bacteria in their urine. Vaginal estrogen prevents this - it can be started at any age and should be taken for life. Many doctors are afraid to recommend hormones because if they were educated during the past two decades they received no education on menopause. ➡ Learn more or book a consultation: https://rootcausemedicalclinics.com/locations/telemedicine/ 📞 Call us directly: (727) 335-0400 #womenshealth #hormones #rootcausemedicine References: Marty Makary MD, et al. Updated Labeling for Menopausal Hormone Therapy. JAMA, 2025;  Howard N. Hodis, eta al. HRT And Reduction of All‑Cause Mortality and CVD .  menopauselearning.com. The Cancer Journal June 2022 Ferrante KL, et al. Vaginal Estrogen for the Prevention of Recurrent Urinary Tract Infection in Postmenopausal Women. Female Pelvic Med Reconstr Surg. 2021 Tan-Kim J, et al. Efficacy of vaginal estroge