What to do when you're feeling Burned by acid reflux
It is estimated that over 15 million Americans are being prescribed PPIs or Proton Pump Inhibitors for their acid reflux. It is also estimated that Americans spend about $10 billion a year on acid-suppressing prescription drugs. This does not even account for the over the counter PPIs and antacid medications such as Tums & Prilosec that many use on top of their prescription or in place of. With this great popularity in this specific class of drugs; why aren't we questioning what is causing the symptoms and why this is becoming so much more prevalent, even with the increased use of acid suppressing medications? It is also important to notes that temporary use only is recommended with these products. In fact the warning labels ( yes there are warning labels) on OTC antacids warn to avoid using for over 2 week. Prescription PPI and acid suppressing medications are also not recommended for long term use over 3 months either. This blog contains general anatomy and physiology in regards to reflux and poor digestion and also discusses natural alternatives and resolutions to treat the underlying cause of acid reflux rather than addressing the symptom itself.
Though acidity in foods is often discussed, the ideal pH balance of your stomach is not. Your stomach is ideally supposed to be around a pH of 2, meaning that the gastric pouch is designed to be acidic enough to break down a copper penny! Gastric acid plays an important role in the digestion of proteins and absorption of nutrients such as; B12, Calcium and Iron. It also helps ensure pressure is high enough in the gastric pouch so that it will keep the esophageal sphincter tightly closed. If pressure is lost; the esophageal sphincter is allowed to loosen. This allows contents of the stomach to be pushed back up into the esophagus, causing symptoms of Acid Reflux and GERD. Gastric acid also plays a crucial role in protecting the body from foreign invaders (for example, E. coli) that have been consumed orally. Those without adequate gastric or stomach acid might be at higher risk for bacterial infection as not enough acid is present to kill off unwanted pathogens. Those with low production of stomach acid also might experience symptoms such as; bloating, belching, feeling of fullness and nausea. These are signs that food is not being digested properly and can consequently sit in the stomach for prolonged periods of time. Low production of gastric acid or hypochlorhydria might contribute to food allergies and sensitivities as well.
So if a LACK of stomach acid or hypochlorhydria is typically the culprit behind bloating, belching and symptoms of acid reflux, what is causing this low stomach acidity? Well one of the main culprits is actually stress! To explain this in greater detail, the body is actually a well oiled machine and only has two divisions in the nervous system. The first being the Sympathetic nervous system which is responsible for "fight or flight" responses, and the second being the Parasympathetic nervous system that is responsible for "rest or digest" responses. This means at any given time we are either in "rest or digest" mode or "fight or flight" mode. As you can gather during times of stress or "fight or flight" mode, processes in the body are shifted AWAY from the digestive system to protect the body from a potential perceived threat. This perceived threat could come in the form of; a deadline at work, a big meeting, traffic, or even an event or holiday gathering. During times of stress or "fight or flight", the amount of digestive enzymes secreted dramatically decreases and digestion slows or even stops. Have you ever found yourself eating your lunch in your car during lunch hour traffic? Also, how many times have you been cut off on the freeway during this time? Did you notice a biological Sympathetic response such as; pricks on your arms or legs or rapid heart rate? These are all signs that we should NOT be eating as we are not at all in a state of "rest or digest". Instead, meal times should be in a slow and relaxed setting with no potential stressors. If already experiencing reflux symptoms, it is important to eat slowly and chew your food adequately as digestive enzymes are produced in the mouth and so your digestion actually starts there!
Other potential causes of acid reflux could be microbial imbalances, particularly the bacteria H. Pylori which purposely reduces stomach acid in order to ensure its survival. This particular bacteria is notorious for causing peptic ulcers, belching, bloating and nausea and could be the root cause of acid reflux or indigestion for some individuals. Using a DNA based stool sample is key in determining the presence of this bacteria and with those results we can make the appropriate supplement and dietary changes to address any microbial imbalances. I use the GI map stool panel in my practice
Now that we understand that a lack of stomach acid often leads to acid reflux, then why are medications that BLOCK the production of stomach acid used most? Well the easy answer is because.. it's easy! Changing your diet, reducing inflammation, addressing stress and initiating a supplement regimen are all much more difficult and much more time consuming than taking a medication. Another point is that the use of an antacid or PPI will TEMPORARILY relieve symptoms and will work much more quickly than changing your lifestyle. Unfortunately, these types of medications do not soothe discomfort or irritation of the esophagus due to reflux, and they certainly do not address the underlying issue.
Starting with the root cause; it is ideal to work to restore balance with the GI tract by decreasing inflammation and replacing with necessary enzymes. This means use of digestive enzymes and possibly even Oxbile or Betaine, which can directly stimulate the gallbladder to secrete bile might be needed. Bile is stored in the gallbladder and secreted by the liver and is a necessary component of the digestive system in that it works to emulsify and break down fat. Use of an Apple Cider Vinegar "Flush" upon rise can have similar effects on the gallbladder and liver function and reduce signs and symptoms of hypochlorhydria (low stomach acid). Begin by adding 1-2 tbsp of raw Apple Cider Vinegar to 2 oz of water and take as a "shooter" first thing in the morning. Use of bone broth, collagen peptides and glutamine rich foods can also help to support both the esophagus and the intestines. You might also consider the use of foods products like aloe vera and ginger as the aloe with soothe and coat the esophagus and ginger acts as a anti-spasmodic to reduce nausea. If using aloe vera juice or the plant in whole food form, it is important to utilize only the inner gel component of the aloe plant. Some commercially available aloe vera juice contains the entire plant, including the outer layer, which does not have soothing properties. If experiencing active burning in the esophagus, it would be BEST to start with the soothing foods like; aloe vera, ginger, collagen and bone broth FIRST before working with Apple Cider Vinegar.
Lastly, if looking to prevent and ultimately treat acid reflux it is ideal to make a few dietary changes. Removal of food chemicals, refined (white) carbohydrates and alcohol, for starters, can help reduce inflammation and reduce GI symptoms. Removal of known food triggers such as spicy foods, peppermint and large portion sizes should also be avoided. A food Sensitivity Test such, as the MRT (Mediator Release Test), is also recommended to uncover unknown food sensitivities in order to reduce inflammation. It is also important to note that the production of enzymes changes during times of stress. This means that when you decide to take your meal on the go and eat in the car, you are not secreting as much digestive enzymes as you would if you were eating at a table and in a calm and stress free state.
Ways to Improve your Digestion Naturally
1. Utilize the Apple Cider Vinegar "Flush" to promote natural production of stomach acid and enzymes
2. Avoid "Fight & Flight" Dining by ensuring meal times are in a calm setting so as to have optimal production of digestive enzymes
3. Utilize GI supporting foods like aloe vera, slipper elm, marshmallow root, okra, ginger, collagen peptides and bone broth
This article is solely meant for educational purposes. Reading of this article does not make you an active client of Lindsay Reno RD LD. It is always recommended to seek the guidance of your health care practitioner before starting any new diet or supplement regimen. Please email me directly to discuss your individual symptoms.