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Tolle Causem

Tolle Causem

Dr. Erika Krumbeck

One of the 6 prinicples of naturopathic medicine is Tolle Causem, or Treat the Cause. The ultimate goal of a naturopathic physician is to identify and treat the cause of the patient’s disease or symptoms.

Conventional physicians will often claim to do the same thing. I recently saw an advertisement for a medication for GERD (also known as heartburn) that claims to treat the “cause” of heartburn by preventing the stomach from making stomach acid.

Do people with heartburn really have a deficiency of Tums or Prilosec? Wait a second…does stomach acid actually cause heartburn? Why do we even have stomach acid?

According to MDConsult.com (a great resource for you aspiring physicians), stomach acid is a requirement to break down proteins into smaller pieces for easier digestion. Stomach acids also help the body absorb certain minerals and vitamins (did you know that long-term suppression of stomach acids can lead to osteoporosis?). Having stomach acid is also a vital part of our immune system (not very many bacteria can survive in that acid!), and decreasing your stomach acid can leave you vulnerable to infections by nasty bacteria like E. coli and others.

In fact, stomach acids are not the cause of GERD. Heartburn is actually caused by a weakness or relaxation of the muscle that separates the stomach from the esophagus. When this muscle relaxes, stomach acids come up into the esophagus and cause heartburn.

The job of a naturopathic physician is to figure out why this is happening, and to treat the true cause (not just give a bunch of drugs).

Note: this information is not intended to diagnose or treat any condition. Always consult your physician (preferably an ND) before making any medication or lifestyle changes. Remember, this is a blog, not a virtual doctor.


  • Iosif
    August 24, 2015 at 3:52 am

    I found this article very invormatife. I am going to try the apple cider vinegar diluted w/meal to see what happens. What I am not seeing in any of these articles is that not all people have actual heartburn. I have almost constant burning in my throat, nose, eyes and around my mouth. I have been on Nexium twice daily for 14 months. I still suffer everyday. I have had 2 endoscopies, one with Bravo and was refluxing at a 35. However they say when I took the PPI it brought it right down to normal. I still always have burning. Are there other people out there who like me do not suffer from heartburn but are refluxing?

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