Ashley Koff, RD

Heartburn and Bloating

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The Fullscript Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By adding this protocol to your Fullscript template library, you understand and accept that the recommendations in the protocol are for initial guidance and may not be appropriate for every patient.

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Heartburn and Bloating


The body sends signals, but often patients & practitioners miss them or band-aid them with OTC (over the counter) or medications. Better total nutrition as well as lifestyle adjustments can help persons with acid reflux (of course, they should be assessed by their practitioner to ensure the proper diagnosis). Questions to consider include medications (especially those that suppress stomach acid), current digestive health, activity, and nutrient intake (you can use The Better Digestive Evaluation as an intake form to easily assess these).

Lifestyle Recommendations:

Lifestyle recommendations that do NOT work include telling someone to “reduce their stress”. You want to help them with specific ways to turn off the stress response cellularly as well as to improve digestion (which receives less attention when the body is in the stressed phase)

    1. The 4-7-8 breath (in through the nose for 4, hold for 7, exhale for 8) repeated 10 rounds helps the body shift from fight or flight to relaxed.
    2. Abdominal movement and twists such as chair twists, laying on the ground with knees to chest and rotating them side to side, and forward bends / folds can all help generate some movement to reduce gas and pressure that contributes to reflux and bloating.
    3. Walking or staying upright for 2-3 hours after eating.

Nutrition Recommendations:

    1. Assess their magnesium and calcium intakes to ensure a better balance (1:1 for most) as magnesium in the cells helps the body turn off the stress response. Often that imbalance (more calcium than magnesium, or not enough magnesium) leads to digestive complaints because the system does not adequately relax. No labs can tell you about total body (cellular) magnesium, nor can a food assessment as many people take in these minerals from supplements including baths and creams.
    2. Bubbles – many turn to sparkling water to replace soda and that’s a health win but not a digestive one. Assess their beverage intake to see if they consume bubbles.
    3. Alkaline formers – a person will benefit from getting in enough of these to counterbalance acid formers especially coffee, alcohol and sugar. You can learn more or use the Better Nutrition Alkaline Forming Guide to help your patients balance out excess acidity.
    4. PPIs & low stomach acid – assess your patient for these as they may be contributing to poorly digested / absorbed protein and fats and thus to the reflux and bloating.
    5. Better liquid nutrition – especially in the evening – may help alleviate reflux and bloating that keeps your patient from better sleep. This can also help during travel or days of high stress.

Protocol – Heartburn and Bloating:

Metagenics – Glutagenics

1 scoop, once per day

This combination of DGL, glutamine and aloe does a better job healing the different aspects of irritation for better overall digestive health than a single ingredient. Better to start with one scoop daily in water, herbal tea, even juice (if they are consuming) and ideally consume after their morning coffee or evening glass of wine/drink. Many do well with a second daily dose.

Transformation Enzymes – Digest 

1 capsule with every meal

To be consumed with meals and snacks (including liquid nutrition). Follow product’s specific directions. Use these daily or when symptoms occur.

Ortho Molecular Products – Ortho Biotic

1 capsule, once per day

Probiotics – ensure a good source of bifidobacteria (at least 1 billion live active CFUs).

Innate Response – Magnesium 300

1 scoop, once per day

As indicated based on the results of their Better Magnesium Evaluation BUT you can also recommend magnesium food choices too with this menu. The magnesium supplement may be better in the evening to contribute to muscle relaxation that helps shift the body to prepare for sleep.

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