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Ashwagandha does this via natural compounds called withanolides

A retrospectively analyzed study, by comparing the intestinal microbiome between patients with GERD and healthy subjects, found that the abundance of microorganisms such as Desulfovibrioides , Halobacterium sp ecies , and Sphingobacterium was higher in patients with GERD, and that microorganisms such as Lactobacillus intestinalis and Streptococcus pepticus were in higher abundance in a control group made up of healthy subjects (32)

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ICER has also estimated current net annual prices in the thousands of dollars for these medications, underscoring why long-term affordability is such a central issue