Most people experience acid reflux, also known as ‘heartburn’, on occasion. It happens when acid from the stomach or acidic gases from half-digested foods flows back up into the oesophagus, irritating the delicate lining of the oesophagus, resulting in a burning pain across the front of the chest. Although in its milder form, its other name is ‘heartburn’, this condition usually has anything to do with the heart.
Symptoms of acid reflux
Sufferers experience a crushing chest pain and an intense pressure beneath the breastbone. Sometimes the pain can be so great that it is mistaken for a heart attack. Due to the ulcers/wound formed from the stomach acid burns, sufferers may have difficulty swallowing food as if there is a lump. These “lumps” are really the scarred tissues that have thickened over time.
Other symptoms include excessive mucus in the throat, sore throat, stomach pain, bloating, belching, flatulence and even constipation. For some, there would also be constant coughing, choking in the sleep, upper respiratory infections and bad breath.
Understanding acid reflux
Normally the sphincter, a muscle between the oesophagus and stomach, tightens up to stop food and stomach acid coming back up out of the stomach. Acid reflux happens when the sphincter does not work effectively, or when the stomach is very full (for example, after a large meal).
When reflux occurs frequently the lining of the oesophagus can become damaged, a condition known as Gastro-Oesophageal Reflux Disease (GORD 0r GERD if you are spell ‘oesophagus’ as ‘esophagus’!) has developed. GORD is not a disease. Contrary to what many people believe, that GORD occurs due to over-production of stomach acid, it is likely that this is due to under-production of stomach acid. Read more about stomach acid test.
Sufferers who don’t understand this take antacids to neutralize the supposedly “over-acidity” and this adds on to the problem. Antacids may be a temporary relief but really it is causing the under-production of stomach acid to be further suppressed and in the long run, indigestion will just cause a host of many other digestive disorders.
Another scenario is when intestinal fluids from your duodenum (the top part of your small intestine) can also become part of reflux. This is called DGER, or ‘duodenogastro-oesophageal reflux’ (DGER), also known as ‘alkaline reflux’ or ‘bile reflux.
Chronic acid reflux or heartburn must not be taken lightly. It can result in obstruction, ulceration and formation of an abnormal lining which may turn cancerous.
What is the cause of acid reflux?
Acid reflux can also happen when there is a lot of pressure on your stomach forcing the stomach contents out and back up into the oesophagus; constipation, pregnancy, obesity, tight clothing and bending all cause such pressure. Some medications, including aspirin and ibuprofen, can cause acid reflux.
There are various possible causes of chronic heartburn, and they are mostly attributable to a lifestyle factor. Some of the risk factors are: obesity, smoking, habitually overeating, poor food combining that cause indigestion, eating processed foods that are high in sugar, salt, fats and low in fibre, long-term medications, gut dysbiosis, prolonged stress, eating just before bed, drinking coffee, alcohol, chlorinated and fluoridated water. Typical foods that can exacerbate an attack may include spicy, fried, some citrus and tomato based foods.
In addition, it is important to find out if you are over or under-producing stomach acid. Take the stomach acid test.
Other possible causes could be hiatus hernia — a condition that occurs when the upper part of the stomach pushes up through the diaphragm and into the chest cavity.
Stress and your gut
We know our digestive system is intricately linked to our nervous system. So it makes sense that when under acute or chronic stress, because of the stress hormone, cortisol triggers not only gut inflammation but also a disruption to our gut bacteria that symptoms can be worse. Bad bacteria and yeasts growing in your stomach can cause an unpleasant fermentation that will cause acid to bubble too far up. These imbalances can originate from the gut where certain medications including antibiotics, alcohol, processed foods and sugary foods cause dysbiosis (imbalanced gut bacteria) which in turn affects the breakdown of carbohydrates and can cause fermentation.
H. Pylori and acid reflux
And last, but by no means least Helicobactor pylori (H.Pylori) which can be connected to acid reflux. H. pylori is a bacterial infection occurring in the gut. It is said that two thirds of the world’s population may have H. pylori but it will only affect a few of us adversely. In your gut, H. pylori can change the environment around them by reducing the acidity so they can survive. They penetrate the stomach lining effectively hiding where they are protected by the mucous membrane so the body’s immune cells cannot reach them. These bacteria also secrete an enzyme called ‘urease’ which converts urea to ammonia. The ammonia reduces the stomach acidity around the area where the bacteria is enabling the bacteria to survive. Ironically, it’s this lowered stomach acid that can actually be mistaken for acid reflux. We need stomach acid in order to digest our foods. When there is not enough, undigested foods, especially carbohydrates start to ferment in the stomach pushing the valve between the stomach and the oesophagus open, causing the burn. Additionally, undigested foods will then travel down to the gut causing further problems. Not only this, but stomach acid is also protective against pathogenic bacteria, ensuring that these are killed before entering the digestive system. Antacids may therefore in fact exacerbate the problem further.
Allopathic treatment of acid reflux
There are several different types of medications used for acid reflux, each works in a different way. Over-the-counter antacids (e.g. Rennie) neutralise the stomach acids, histamine H2 blockers (e.g. Zantac) interfere with the production of acid, and proton pump inhibitors (PPI) such as ‘Lansoprazole’ suppress the release of acid.
Recent research indicates that prolonged use of PPI medication can deplete vitamin B12 levels which can lead to memory loss, dizziness, fatigue and an increased risk of developing dementia. These popular antacid drugs have also been linked to a range of ills: bone fractures, kidney problems, infections, just to name a few.
Natural alternatives for acid reflux
Firstly, find out if your acid reflux is due to too much stomach acid or too little stomach acid. Check out my blog post here: stomach acid test
A holistic approach to the management of acid reflux is ultimately the best way forward. By identifying and treating such causal factors, listed above, will assist your body to self-heal.
In addition, speak with your doctor/ naturopath about stopping antacids which continue to further reduce the stomach acid production that causes indigestion. Your naturopath can advise you of the most effective and suitable natural alternatives for managing your symptoms, and ultimately, addressing the cause of the acid reflux.
Below are some natural treatments for acid reflux:
- Prevention is the best cure for indigestion. The easiest way to prevent heartburn is to avoid foods that trigger it which will vary from person to person. Consider food allergy/intolerance testing if you are unsure what foods may be triggering your acid reflux or heartburn. Typical foods include sugar, processed foods, dietary fats, red meat, chocolate, mint, alcohol, caffeine, hot-spicy foods, citrus fruits, and gas-causing foods. Some foods associated with heartburn (notably oranges and chocolate) are in fact alkaline forming. It is important to remember that there are two types of reflux, where the stomach contents are too acidic you get acid reflux, where stomach contents are not acidic enough (too alkaline) you get alkaline reflux.
- The simplest way that you can kick start the production of your own stomach acid by being in a relaxed and mindful state prior to and whilst eating. That’s to say, eat with mindfulness – enjoying each mouthful, its taste and flavour and how great it makes you feel. However, being aware of
- Your breathing before and during a meal is paramount. Be aware of your posture and don’t slouch when eating your food.
- Drink a large glass of filtered water at the first sign of pain.
- To stimulate acid production, have a dessertspoon of organic apple cider vinegar 5-10 minutes before a meal to encourage stomach acid production.
- Eat slowly; eat smaller meals and incorporate more fresh fruit especially bananas (less citrus if it is a known irritant) and vegetables, especially avocado.
- Do not lie down or exercise soon after food and try not to eat or drink within 2-3 hours of going to bed.
- For a natural alternative to antacids try a calcium and magnesium supplement.
- Try slippery elm which is a soothing ‘demulcent’ herb which coats and assists in healing irritated, inflamed membranes. T
- Have some bitter herbs about 5-10 minutes before a meal to stimulate bile production and improve stomach acid. Example of bitter herbs gentian, dandelion, barberry, bupleurum, golden seal and chamomile
- I also prescribe my ‘antacid’ herb mix which contains a healing and soothing combination of meadowsweet, chamomile, golden seal and liquorice – famed for their ability to prevent and help heal gastric ulcers, a potential complication of acid reflux.
- Probiotics may be able to modify inflammation levels by interacting with the epithelial cells and managing the secretion of inflammatory proteins. Probiotics are strain -specific in their action so it is important to get advice from your naturopath for the most appropriate one for you.
- Probiotics are also thought to help strengthen the barrier against H. pylori by producing antimicrobial substances, and competes with H. pylori for adhesion receptors, i.e. space on the stomach lining! What’s more, the production of relatively large amounts of lactate by lactobacilli is also an inhibitory factor of H. pylori as it’s possible it might lower the H.pylori ‘urease’.
- Natural acid supplements and digestive enzymes can also assist in the management of acid reflux.
- Some more long-term preventative measures include losing weight and avoiding stress. I can assist in addressing these issues with you – providing a suitable diet for weight loss and appropriate stress management.
As I have highlighted in this post, it is important to try to ascertain the root cause of the problem and then use a combination of approaches to address the causes. A multi pronged approach is likely to be best. Book an appointment to start your healing journey today.