And no, eating at different times won’t magically make your sphincter to your stomach close any tighter.
Stomach acid is also produced as reaction to food intake and other signals. Less acid => less reflux?
BTW probiotics have been found potentially effective by this systematic review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019778/
This is probably not as simple as blaming the dysfunctional sphincter.
IMO early time restricted feeding shouldn’t be dismissed so quickly, it‘s potentially a fix for a number of systemic and gastric/enteric issues. The evidence is still weak but promising. The most important part here is „early“ - intermittent fasting usually has an eating window in the afternoon and maybe right until bed time. According to some (weak) studies, moving the eating window to the morning and early afternoon has vastly different effects.
Weirdly, I've also heard from people in that situation that more acid => less reflux because the sphincter only closes in high-pH environments. So one of the things prescribed can be hydrochloric acid supplements. Some people swear by them.
Finally instilled some healthy habits by 32, namely no excessively large meals and no eating big meals ~3 hours before bed and it magically disappeared.
I just had my first bout in a while yesterday - 2 smalls pizza is still 2 pizzas folks!
Also alginate based products create a raft that block the acid from physically coming up.
The early time restricted feeding stuff is very interesting, and new to me - but I did learn a lot about it reading this guys blog -https://caloriesproper.com/etrf-2022/
I'll check out the hiatal hernia exercises, thanks!
Other possible solutions: d-limone In one unpublished trial, subjects took one gram of d-limonene every other day for 20 days, on an empty stomach (that is, half an hour before eating or an hour afterward). A third of them experienced relief from their heartburn after a single capsule, and within two weeks 90 percent had relief. After a single course of treatment, relief lasted for up to six months.
Licorice The natural solution for ulcers, deglycyrrhizinated licorice root (DGL), can also be an effective acid reflux treatment. The suggested dose of DGL is two tablets, chewed about 20 minutes before meals, three times a day, or it can be taken shortly before bedtime if you suffer mostly from nighttime acid reflux. Use only chewable DGL—it must be mixed with saliva in order to be effective.
IQORO - It's like a pacifier put behind lips and pull.
inspiratory muscle training
Throat Band https://blog.fauquierent.net/2014/05/cricoid-pressure-may-mi... https://www.accessdata.fda.gov/cdrh_docs/reviews/DEN130046.p...
and then the standard advice of inclining your bed / sleep on your left side.
In my case, that is exactly what it is (a hernia). Other people may have different reasons for it.