Fried food, alcohol, caffeine, and soda can all trigger reflux. Spicy, tomato-based or citrus foods may also cause problems for some people. Smoking also increases the risk of reflux. Being overweight and having your belly fat push up on your stomach can prevent it from emptying, triggering reflux. Having a hiatal hernia (where your stomach pushes up through your diaphragm) can also cause trouble and can be diagnosed by x-ray. Eating large meals and eating before bed are two other main reasons for reflux. These are the most obvious causes, and the ones you have probably heard about. However, there are a few more that bear mentioning.

Stress contributes to reflux. Clearly, food is supposed to go down, not up, when you eat. That’s why there are two main valves, or sphincters, that control food going in and out of your stomach — the one at the top (or the lower esophageal sphincter) and one at the bottom (the pyloric valve). When you’re stressed, the valve on the top relaxes and the valve on the bottom tightens up. This may result in food traveling back up your esophagus. Practice active relaxation and you mitigate this problem.

Magnesium deficiency is another cause of reflux because magnesium helps the sphincter at the bottom of the stomach relax, allowing the food to go down.

Food sensitivities or allergies can also cause reflux. Common culprits include dairy and gluten-containing foods like wheat, barley, rye, and oats. Plus, overgrowth of bacteria in the small bowel or yeast overgrowth in the gut can cause reflux.

These are all treatable conditions that you don’t need powerful acid blocking drugs to fix.

To properly diagnose the causes of your reflux, you may need to do the following.

1. Ask your doctor for an H. pylori blood antibody test or breathe test.

2. Consider a test for IgG food allergies and celiac disease.

3. Get a breath or urine organic acid test to check for small bowel bacterial overgrowth.

4. If you don’t get better with the suggestions below, consider getting an upper endoscopy or upper GI series x-ray to see if there is anything else wrong.