Can stress cause gastritis?

Yes, stress can cause or worsen gastritis. Chronic stress raises cortisol, thins the stomach lining's protective mucus layer, and moves the nervous system away from digestion mode. That makes the lining more vulnerable to acid, food, and medications. Calming the nervous system is a central part of the treatment.

Are PPIs safe to take long-term?

Long-term PPI use is generally safe for most people, though it does carry trade-offs. Long-term use has been linked with lower magnesium and B12, slightly higher risk of certain infections, and reduced absorption of some nutrients. That is why we use the lowest effective dose for the shortest time needed.

What foods commonly trigger GERD?

Foods that commonly trigger GERD include caffeine, alcohol, chocolate, peppermint, spicy foods, citrus, tomato-based sauces, and large or fatty meals. Late-night eating is a major trigger because lying down removes gravity's help. Triggers vary, so a 2-week food and symptom log usually reveals your personal list.

Can GERD cause a chronic cough?

Yes, GERD can cause a chronic cough, hoarseness, throat clearing, or even asthma-like symptoms, even without classic heartburn. This is sometimes called "silent reflux" or laryngopharyngeal reflux (LPR). If you have an unexplained cough that lingers for weeks, reflux is worth considering.

Is H. pylori contagious?

Yes, H. pylori can be passed from person to person, usually through saliva, contaminated food, or water, often within families during childhood. Most carriers never develop symptoms. When it does cause gastritis or an ulcer, a short course of antibiotics plus acid suppression can clear it.

Will losing weight help my reflux?

Yes, losing even a modest amount of weight, particularly around the midsection, often reduces reflux. Extra abdominal pressure pushes stomach contents upward and stresses the LES. Many people see meaningful improvement with a 5% to 10% reduction in body weight.

How long does it take to heal gastritis?

Healing gastritis usually takes 2 to 8 weeks, depending on the cause and how irritated the lining is. Stopping NSAIDs, treating H. pylori if present, and using short-term acid suppression all speed healing. Lining repair tools like zinc carnosine and DGL can support the process.

Can I drink coffee if I have GERD?

You can sometimes drink coffee with GERD, but it depends on you. Coffee relaxes the LES and can stimulate acid, so it is a common trigger. If you cannot give it up, try smaller amounts, drink it with food, choose lower-acid roasts, and avoid coffee within a few hours of bed.

Why does too little stomach acid sometimes look like too much?

Too little stomach acid (hypochlorhydria) can mimic high-acid symptoms because food lingers longer, ferments, and creates gas. That gas pressure pushes whatever acid is there back up into the esophagus. People feel the burn and assume they make too much acid, when the deeper problem may be the opposite.

How does the vagus nerve connect stress and reflux?

The vagus nerve controls how the stomach empties, how the LES tones up, and how digestive juices are released. When stress keeps the nervous system in "fight or flight," vagal tone drops, motility slows, and the LES does not work as crisply. That is why deep breathing, sleep, and stress work count as treatment rather than optional extras.

What is a hiatal hernia and how does it factor in?

A hiatal hernia is when part of the stomach slides up through the diaphragm into the chest, weakening the natural barrier against reflux. Small hiatal hernias are very common and often missed. Diaphragmatic strengthening, weight management, and avoiding large meals all reduce the impact of a hernia, and surgery is reserved for severe cases.

How does H. pylori damage the stomach?

H. pylori burrows into the protective mucus layer and produces ammonia to neutralize acid in its local environment. That weakens the lining and triggers chronic inflammation, which can lead to gastritis, ulcers, and, over many years, an increased risk of stomach cancer. Treating it usually involves a 10 to 14 day course of antibiotics plus acid suppression.

Why do NSAIDs damage the stomach lining?

NSAIDs like ibuprofen and naproxen block enzymes called COX-1 and COX-2. COX-1 helps maintain the protective mucus layer of the stomach, so blocking it leaves the lining exposed to acid. Daily NSAID use is one of the most common causes of gastritis, ulcers, and bleeds in adults.

What is Barrett's esophagus?

Barrett's esophagus is a change in the lining of the lower esophagus caused by repeated acid exposure over many years. The cells start to look more like intestinal cells, and a small percentage of patients with Barrett's go on to develop esophageal cancer. That is why we do not ignore chronic reflux, even when the symptoms feel manageable.

How does sleep position affect reflux?

Your sleeping position affects reflux, so it helps to sleep on your left side and raise the head of the bed by about 6 inches, using gravity to keep stomach contents down. Sleeping flat on your back or right side often makes nighttime reflux worse. A wedge pillow is a simple, low-cost upgrade.

Can a gluten-free or low-FODMAP diet help reflux?

A gluten-free or low-FODMAP diet can help reflux for some people, particularly when bloating and slow motility are major drivers. FODMAPs are short-chain carbs that ferment in the gut and create gas. Reducing them temporarily, then reintroducing foods one at a time, helps identify personal triggers without unnecessary restriction.

Why does melatonin help with reflux?

Melatonin helps with reflux because the gut produces large amounts of it, and it appears to support LES tone and protect the lining of the esophagus. A low dose at bedtime can reduce reflux symptoms for some patients, often alongside standard treatment. We use it to support treatment while we work on the root causes.

How does intermittent fasting affect GERD?

Intermittent fasting can help GERD by reducing late-night eating and giving the stomach longer to empty between meals. For some people, it cuts symptoms dramatically. For others, very long fasts can increase acid and trigger reflux on an empty stomach, so timing and meal composition matter.

Can SIBO drive GERD-like symptoms?

Yes, small intestinal bacterial overgrowth (SIBO) can drive GERD-like symptoms, including bloating, fullness, and reflux. When bacteria over-ferment carbohydrates in the small intestine, gas pressure pushes contents upward. Targeted treatment, often with specific antibiotics or herbal antimicrobials and dietary change, can resolve both sets of symptoms.

How do prokinetic medications help?

Prokinetic medications speed up how fast the stomach empties and tighten the LES, which helps when the problem is food lingering too long rather than too much acid. Metoclopramide (Reglan) is the usual example, and low-dose erythromycin is sometimes used off-label for the same effect. They are useful in selected cases of slow gastric emptying rather than as a general reflux treatment.

Is there a connection between thyroid problems and reflux?

Yes, low thyroid function (hypothyroidism) can slow stomach emptying and worsen reflux and bloating. Hyperthyroidism can also affect motility in the opposite direction. If your reflux is paired with fatigue, weight change, or temperature intolerance, a full thyroid panel is worth checking rather than TSH alone.

What role does the microbiome play in stomach health?

The microbiome influences stomach health by shaping inflammation, motility, immune tone, and even how you tolerate certain foods. An imbalanced microbiome can drive bloating, reflux, and lining irritation. Targeted probiotics, fermented foods, and fiber can help, but the right approach depends on your particular pattern.

When should I see a specialist for GERD?

You should see a specialist for GERD if symptoms persist despite lifestyle and medication changes, if you have alarm symptoms (weight loss, trouble swallowing, anemia, blood in stool), or if you have been on a PPI for more than a few months without a clear plan. A gastroenterologist can perform an endoscopy, look for Barrett's esophagus, and personalize next steps.

Can pregnancy cause GERD, and is it the same condition?

Pregnancy commonly causes GERD because of hormone changes and pressure from the growing uterus on the stomach. The mechanism is similar to other GERD, but the triggers and treatment options are different. Most pregnancy-related reflux improves quickly after delivery, and any medication choice should be reviewed with the OB or primary care doctor.

How does sleep apnea relate to GERD?

Sleep apnea and GERD often travel together. The drops in airway pressure during apneas can pull stomach contents upward, and reflux can worsen sleep fragmentation. Treating apnea, often with a CPAP, frequently improves nighttime reflux and overall sleep quality at the same time.

Can chronic GERD cause dental problems?

Yes, chronic GERD can erode tooth enamel because stomach acid that reaches the mouth, particularly at night, is much more acidic than anything in food. Patients may notice sensitivity, color changes, or rounded tooth edges. Dentists often catch silent reflux first, which is one more reason regular dental visits matter.

Can stress cause gastritis?

Yes, stress can cause or worsen gastritis. Chronic stress raises cortisol, thins the stomach lining's protective mucus layer, and moves the nervous system away from digestion mode. That makes the lining more vulnerable to acid, food, and medications. Calming the nervous system is a central part of the treatment.

Are PPIs safe to take long-term?

Long-term PPI use is generally safe for most people, though it does carry trade-offs. Long-term use has been linked with lower magnesium and B12, slightly higher risk of certain infections, and reduced absorption of some nutrients. That is why we use the lowest effective dose for the shortest time needed.

What foods commonly trigger GERD?

Foods that commonly trigger GERD include caffeine, alcohol, chocolate, peppermint, spicy foods, citrus, tomato-based sauces, and large or fatty meals. Late-night eating is a major trigger because lying down removes gravity's help. Triggers vary, so a 2-week food and symptom log usually reveals your personal list.

Can GERD cause a chronic cough?

Yes, GERD can cause a chronic cough, hoarseness, throat clearing, or even asthma-like symptoms, even without classic heartburn. This is sometimes called "silent reflux" or laryngopharyngeal reflux (LPR). If you have an unexplained cough that lingers for weeks, reflux is worth considering.

Is H. pylori contagious?

Yes, H. pylori can be passed from person to person, usually through saliva, contaminated food, or water, often within families during childhood. Most carriers never develop symptoms. When it does cause gastritis or an ulcer, a short course of antibiotics plus acid suppression can clear it.

GERD and Gastritis: A Root-Cause Approach

TL;DR30-second take

Acid reflux is not always about too much acid. Often it is about a loose valve at the top of the stomach, a stressed-out nervous system, certain medications, or imbalanced gut bacteria. A root-cause plan looks at all of these instead of just blocking acid forever.

TL;DR: Acid reflux is often misunderstood. The problem is rarely "too much acid" alone. It is usually some mix of a loose valve, an inflamed stomach lining, your nervous system being stuck in stress mode, and certain medications. We look beyond symptom suppression to find why this is happening to you.

Understanding the Difference
How We Diagnose It
Treatment Strategies
Lifestyle and the Vagus Nerve
Common Questions
Deep Questions

What Is the Difference Between GERD and Gastritis?

GERD and gastritis are both painful, but they are different problems with different fixes. Knowing which one you have changes the plan.

GERD (Gastroesophageal Reflux Disease) is mostly a mechanical issue. The valve between your stomach and esophagus, called the lower esophageal sphincter (LES), gets loose or relaxed at the wrong times, and stomach acid splashes up into the esophagus.

Common symptoms: Burning chest pain, a bitter or sour taste, chronic cough or hoarseness, and worse symptoms when you lie down.

Gastritis is inflammation of the stomach lining itself. The lining can be irritated by infection with H. pylori, certain medications, heavy alcohol use, or chronic stress. Less often the immune system is what attacks the lining, and that version tends to be painless and to show up as stubbornly low iron or B12 rather than as burning, which our guide to autoimmune gastritis covers in full.

Common symptoms: A gnawing or aching pain in the upper belly, nausea, feeling full too fast, and sometimes a low appetite.

Both can make you miserable, but the treatments are not the same.

How Do You Diagnose GERD or Gastritis?

Diagnosis here starts with the data rather than a guess.

H. pylori testing: H. pylori is a common bacterial infection of the stomach and a leading cause of gastritis and ulcers. A stool antigen test or a urea breath test can find it, and so can a biopsy taken during an endoscopy.
Targeted labs: Alongside the H. pylori test we look for anemia and for markers of systemic inflammation, since a slow bleed from an irritated lining often turns up in a blood count before it turns up anywhere else.
Symptom timing: Pain before meals often points to acid or an ulcer. Pain after meals can point to slow stomach emptying or motility problems.
Medication review: NSAIDs (ibuprofen, naproxen, aspirin) are one of the most common causes of stomach lining damage, and they have company. Iron supplements and some antibiotics such as doxycycline irritate the lining directly. Steroids like prednisone, bisphosphonates for bone density such as alendronate, nitrates, calcium channel blockers for blood pressure, and some sleep medications either loosen the valve or wear on the lining. If your symptoms started or worsened after a new prescription, bring that timing to your visit, because there is usually a way to keep the benefit and lose the burn. When daily NSAIDs are there for joint pain, Boswellia works on a different inflammation pathway and spares the stomach lining.
A short acid-reduction trial: When the picture already points one way, a brief course of acid suppression doubles as a diagnostic. Symptoms that settle on it and return off it tell us something a test cannot.
Trigger and lifestyle review: We map your meals, sleep timing, stress, and exercise to find clear patterns.

What Are the Best Treatment Strategies for GERD and Gastritis?

Treatment for GERD and gastritis works best in phases. First we calm the fire so tissue can heal. Then we fix the underlying drivers so symptoms do not come right back.

1. The "Put Out the Fire" Phase

Sometimes you need medications to give the stomach and esophagus a chance to heal.

PPIs and H2 blockers: Short-term use to lower acid and let the lining recover. The goal is a short course rather than a permanent one.
Mucosal protection: Agents like sucralfate that coat and protect the stomach lining.
Alginate rafts: Gaviscon and products like it float a gel layer on top of the stomach contents and block reflux mechanically, without lowering acid any further. That makes them useful alongside everything else and particularly during a taper. Which over-the-counter option to use, and when, is covered in the questions below.

2. The "Fix the Root" Phase

Eliminate triggers: Common ones include caffeine, alcohol, spicy food, large meals, and late-night eating.
Mechanical fixes: Specific breathing exercises strengthen the diaphragm, which acts like an external support for the LES (lower esophageal sphincter, the valve at the top of the stomach).
Microbiome support: Probiotics or specific fibers can help if dysbiosis (an unhealthy mix of gut bacteria) is part of the picture.

3. Targeted Supplementation

We use integrative tools to help the lining heal rather than numb the pain.

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Zinc carnosine: A form of zinc that sticks to the stomach lining and acts like a "biological bandage" to support repair.
DGL (deglycyrrhizinated licorice): A form of licorice with the blood-pressure-raising compound removed. DGL helps the stomach make more of its own protective mucus. It is best taken about 20 minutes before meals.
Melatonin: The gut contains far more melatonin than the pineal gland in the brain. Melatonin appears to help tighten the LES and reduce nighttime reflux.

Lifestyle and the Vagus Nerve

Your vagus nerve is the main highway between your brain and your gut. When you are stressed, your body moves into "fight or flight" mode, and digestion slows down. That alone can drive reflux and bloating. When gut symptoms track with old stress rather than with this week's, the trauma-informed side of care becomes part of the plan, and our guide to nervous system regulation walks through the specific breath and somatic tools we use for it.

Diaphragmatic Breathing

The diaphragm wraps right around the LES and acts like an external support for that valve. A weak or held-tight diaphragm makes the valve work less well.

The exercise: 5 minutes of slow, deep "belly breathing" before each meal. This gently strengthens the diaphragm, mechanically supports the valve, and signals your vagus nerve to switch into "rest and digest" mode.

Meal Hygiene

Chew your food well: Digestion starts in the mouth. Undigested food ferments in the stomach, creates gas pressure, and pushes acid upward.
Stay upright after eating: Sit or stand for 30 to 60 minutes after a meal rather than settling onto the couch. The valve has an easier job when gravity is helping it.
Sip water between meals rather than with them: A large volume of liquid on top of a full meal raises the pressure inside the stomach, and that pressure is what pushes acid up.
Put protein first: Easily digestible protein gives the lining the raw material it repairs with, and it tends to sit better than a large fatty meal does.
The 3-hour rule: Gravity is your friend. Try not to lie down within 3 hours of eating, particularly before bed.

Guidance from the Clinic

"The biggest mistake I see is people staying on omeprazole for years without ever asking, 'why is this happening?' Stomach acid is essential for digestion and absorbing nutrients. The goal is to restore your natural function, not suppress it forever."

Actionable Steps in Philly

A simple plan you can start this week, before any specialist visit.

Stop eating 3 hours before bed: Gravity does a lot of the work. This one change often cuts nighttime symptoms in half.
Audit your medications: Look for daily NSAIDs (ibuprofen, naproxen, aspirin). Talk to your doctor about safer pain options.
Try 5 minutes of belly breathing before meals: This trains the diaphragm and moves your nervous system into digest mode.
Ask for an H. pylori test: A stool antigen or breath test is simple and changes the plan if it is positive.
Track triggers for 2 weeks: Note caffeine, alcohol, spicy meals, and meal size. Patterns show up fast.

Key Takeaways

Do not ignore it: Chronic, untreated reflux can lead to Barrett's esophagus, a precancerous change in the lining of the esophagus.
Timing matters: Stop eating 3 hours before bed. Gravity is your friend.
Check your medications: Daily ibuprofen is hard on the stomach lining.
Acid is not the enemy: Long-term acid suppression has trade-offs. We aim to restore normal function rather than block acid forever.

Scientific References

Kahrilas PJ, et al. American Gastroenterological Association Medical Position Statement on the Management of Gastroesophageal Reflux Disease. Gastroenterology. 2008;135(4):1383-1391.
Chey WD, et al. ACG Clinical Guideline: Treatment of Helicobacter pylori Infection. Am J Gastroenterol. 2017;112(2):212-239.
Mayer EA. Gut feelings: the emerging biology of gut-brain communication. Nat Rev Neurosci. 2011;12(8):453-466. Background on the vagus nerve and digestion.
Pereira RS. Regression of gastroesophageal reflux disease symptoms using dietary supplementation with melatonin, vitamins and aminoacids. J Pineal Res. 2006;41(3):195-200.
Mahmood Z, et al. Zinc carnosine, a health food supplement that stabilises small bowel integrity and stimulates gut repair processes. Gut. 2007;56(2):168-175.
Katz PO, et al. ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease. Am J Gastroenterol. 2022.
Jung HK, et al. Systematic review with meta-analysis: the association between weight loss and reflux symptoms in obese patients. Aliment Pharmacol Ther. 2013.
Ness-Jensen E, et al. Lifestyle Intervention in Gastroesophageal Reflux Disease. Clin Gastroenterol Hepatol. 2016.

Autoimmune Gastritis and Low Iron - the painless kind, which shows up as iron or B12 that will not come up
Costochondritis and Chest Wall Pain - the musculoskeletal chest pain that reflux is often mistaken for
Bloating & Digestive Discomfort - the structured GI workup
Nausea - when nausea is the dominant symptom
Tonsil Stones - the other common source of bad breath and a lump-in-the-throat feeling that gets blamed on reflux
Direct Primary Care in Philadelphia - the membership model behind the access to deep GI workup

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Frequently Asked Questions

Common Questions

Yes. When acid reaches the upper esophagus and throat, it can produce globus, the sensation of a lump or tightness in the throat, often worse with meals and later in the day. It can travel with belching, chest tightness, and even asthma-like symptoms. If eating has become uncomfortable enough that you are losing weight, or food is sticking on the way down, that changes the workup - our lump-in-throat guide walks through what to check and in what order.

You may need an endoscopy if you have any "alarm symptoms," which include unexplained weight loss, trouble or pain with swallowing, anemia, vomiting blood, black or tarry stools, or symptoms that do not improve with treatment. In those cases, we coordinate with a gastroenterologist (a specialist in the digestive system). Most younger people without alarm symptoms can start with a conservative plan first. Heartburn on its own earns a visit once it is happening more than twice a week or waking you at night, which is the point where it has stopped being occasional indigestion.

Each tool has a role, and the timing matters more than most people expect. An alginate such as Gaviscon Advance works within minutes by forming a physical raft on top of the stomach contents; take it after meals and at bedtime, it is safe in pregnancy, and it combines safely with everything else here. Antacids such as calcium carbonate (Tums) give quick relief for breakthrough burning but last only 30 to 60 minutes. Famotidine (Pepcid) at 10 to 20 mg with dinner or at bedtime starts working in 30 to 60 minutes and covers 6 to 12 hours, which makes it the right tool for nighttime symptoms, though daily use builds tolerance, so it works best as needed. Omeprazole (Prilosec) at 20 to 40 mg taken 30 to 60 minutes before breakfast is the strongest of the group, and it takes 1 to 4 days to reach full effect, so it is for daily symptoms and for healing rather than for quick relief. The over-the-counter label allows a 14-day course, up to 3 times a year.

H. pylori is tested with a stool antigen test, a urea breath test, or a biopsy taken during an upper endoscopy. We choose between them based on what you can get to and on whether you have already been taking acid blockers, because acid suppression lowers the bacterial load enough to make a stool or breath test read as negative while the infection is still there. That is why we ask about your current medications before ordering the test rather than after the result comes back.

Raising usually matters more than switching. The proton pump inhibitors are more alike than different at equivalent doses, and the common failure is a starter dose (like omeprazole 20 mg once daily) against symptoms that need twice-daily dosing taken 30 to 60 minutes before meals. Timing matters too: these medicines work best taken before food rather than after symptoms start. If an adequate dose for several weeks still is not enough, that is a signal to look deeper rather than rotate brands.

Probiotics can help with reflux in some people, particularly when symptoms are linked to bloating, slow stomach emptying, or recent antibiotic use. They are not a magic cure, but in the right context they can reduce gas pressure and support a healthier microbiome. The clearest use is alongside H. pylori treatment, where certain strains ease the side effects of the antibiotics and help the microbiome recover afterward. The strain matters, so we try to match the strain to the issue and choose it from the evidence rather than from the label.

Deep-Dive Questions

Functional dyspepsia is upper abdominal discomfort, fullness, or pain with no structural cause visible on endoscopy. It is common, and being told your scope was normal while you are still in pain is a frustrating place to be, so it is worth saying plainly that a normal scope and nothing being wrong are two different findings. Functional dyspepsia often responds to a combination of low-dose neuromodulators, gut-directed therapy, and the same lifestyle work that helps reflux.

When reflux resists a well-run plan, the first move is to question the diagnosis rather than to escalate the dose. Silent reflux, gastroparesis, and eosinophilic esophagitis all present as treatment-resistant GERD and each needs a different approach. From there we run advanced GI testing where it is indicated and coordinate with gastroenterology for endoscopy and for pH monitoring, which measures how much acid is reaching the esophagus and when. We also go back through sleep, stress, and the medication list, since a hidden driver in one of those is a common reason a reasonable plan stalls.

Surgery is considered for reflux when severe symptoms persist despite optimal medical therapy and lifestyle changes, particularly when there is a sizable hiatal hernia or Barrett's esophagus in the picture. The most common procedure is a fundoplication, which strengthens the LES. It stays reserved for that situation, and the months of medical treatment beforehand are what establish whether you are in it.

The right way to come off a PPI is gradually, because stopping abruptly can trigger "rebound" acid hypersecretion, where you feel even worse for 1 to 2 weeks. The schedule that works for most people starts once you have felt good for 2 weeks: drop to every other day for a week, then stop. Cover the gap on the way down and for a while afterward with famotidine as needed, twice daily if the transition is rough, plus an alginate after the meals that tend to give you trouble. We build the lifestyle habits underneath while that is happening, so that coming off the PPI holds rather than setting off another rebound. If symptoms return after a proper taper, that is a signal to go looking for the driver rather than to restart the PPI on autopilot.

It does, and it is the step most tapers skip. The PPIs are not interchangeable when the goal is stopping. Esomeprazole is potent and long-acting, which makes it effective while you are on it and awkward to step down from, since there is little room between a full dose and nothing. Omeprazole and pantoprazole come in more dose steps and are more forgiving to reduce gradually, so switching to one of those first often makes the taper itself work. The switch is direct rather than gradual, since these are close enough cousins that you finish one and begin the other the next day.

Two approaches, and both are worth asking about when a standard step-down has failed. Alternate-day dosing is the simpler one: full dose every other day for a few weeks, then every third day, before stopping. The finer method uses a capsule that opens, such as omeprazole delayed-release, where the contents are enteric-coated granules that can be counted into applesauce and reduced over successive weeks. It is fussy, and for people who have rebounded through 2 or 3 attempts it is often the thing that works. Do not crush or open a tablet formulation, since the coating is what protects the drug from stomach acid, and confirm your specific product is one that can be opened.

Alginate is a seaweed-derived compound that reacts with stomach acid to form a light gel raft that floats on top of the stomach contents, physically blocking reflux rather than neutralizing acid. That makes it useful in a way antacids are not, particularly for people tapering off acid suppression, since it protects the esophagus without further reducing the acid you are trying to restore. Gaviscon is the common brand. Formulations differ by country, and the UK and Canadian versions carry more alginate than the standard US product, which is why some people import them or use an alginate-forward product such as Reflux Gourmet.

No. Calcium carbonate antacids are designed for occasional heartburn rather than as a bone strategy, and using them as a daily calcium source is a common and unhelpful habit. Calcium supplementation does not reliably build bone density, and there is reasonable concern that supplemental calcium contributes to vascular calcification rather than to the skeleton. Bone responds to loading and to adequate vitamin D far more than to a calcium tablet, and our DEXA guide covers what a bone density report is telling you. Keep antacids for the symptom they treat.

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