Heartburn, Acid Reflux and GERD

Heartburn or acid reflux is where stomach acid is regurgitating up the esophagus. Long term acid reflux can damage the esophagus and lead to Barrett's esophagitis and esophageal cancer. Medical treatment for acid reflux involves neutralizing stomach acid either through over the counter products that contain calcium carbonate or through prescription proton pump inhibitors. This will often alleviate the symptoms but does not address the underlying cause of the disease and long term use of PPI medications can lead to osteoporosis. PPI's can be difficult to discontinue as there can be a rebound hyperacidity after discontinuing them which worsens heartburn symptoms.

Why Do People Get Heartburn?

There are a number of possible explanations for why heartburn occurs:
1. Excessive acid production in the stomach. This is the usual assumption, however it's not often the case.
2. Low stomach acid production. This is more often the case. Because stomach acid is low, food ferments in the stomach and creates bloating and gas, which creates pressure and forces stomach contents up the esophagus.
3. Inflammation in the stomach and/or intestines. Food sensitivities (mild food allergies that almost everyone has but are unaware that they have) are often responsible for this inflammation which impairs secretion of digestive juices like stomach acid and digestive enzymes, leading to poor digestion, bloating, gas and pressure again. The inflammed tissue and low acid in the stomach that ensues make for a good environment for bacteria growth like Helicobacter pylori, a bacteria that is often associated with GERD and can cause stomach ulcers and contribute to stomach cancer development. Chronic inflammation also promotes cancer.
4. Floppy valve - patients are often told this is the problem but no explanation for why it's "floppy". My opinion is that it is due to either low stomach acid not signalling tight closure of the valve or inflammation inhibiting function of the valve or both.

How Can We Fix Heartburn?
1. Determine food sensitivities either through an elimination diet or through food sensitivity testing.
2. Eradicate any harmful bacteria that may be inhabiting the stomach, this is easier to do once you've removed the food sensitivities which allows the tissue to heal.
3. Stomach aciditiy and enzyme production may normalize themselves once the inflammation in the gut has been reduced. If not, there are herbs and supplements to increase stomach acidity, supplement digestive enzymes and increase bile production and flow.

Acid Reflux/Heartburn Research

Water & Acid Reflux: Drinking water with meals should be avoided as this may result in a worsening of acid reflux symptoms.

Source: Complementary Prescriptions Journal, Vol.26, Issue 12, Dec. 2012

 

Astaxanthin & Acid Reflux: Patients who took astaxanthin saw a reduction in acid reflux symptoms with a dose of 40 mg.

Source: Complementary Prescriptions Journal, Vol.26, Issue 12, Dec. 2012

 

Licorice Root & Acid Reflux: Licorice might help protect the stomach and duodenum from gastric acid irritation.

 

Source: Complementary Prescriptions Journal, Vol.26, Issue 12, Dec. 2012

 

Melatonin & Acid Reflux: Melatonin has been found to improve acid reflux symptoms such as heartburn and epigastric pain after supplementation.

 

Source: Complementary Prescriptions Journal, Vol.26, Issue 12, Dec. 2012

 

Weight Loss & Acid Reflux: Weight loss in acid reflux patients was found to be an effective lifestyle intervention.

 

Source: Complementary Prescriptions Journal, Vol.26, Issue 12, Dec. 2012

 

Peppermint & Acid Reflux: Peppermint oil has been found to enhance gastric emptying and therefore may be beneficial to acid reflux patients.

 

Source: Complementary Prescriptions Journal, Vol.26, Issue 12, Dec. 2012

 

Caffeine & Acid Reflux: Higher instances of acid reflux have been reported after ingesting coffee.

 

Source: Complementary Prescriptions Journal, Vol.26, Issue 12, Dec. 2012

 

Meals & Acid Reflux: Meals should be eaten at least 2 to 3 hours before lying down to decrease the likelihood of acid reflux.

 

Source: Complementary Prescriptions Journal, Vol.26, Issue 12, Dec. 2012

 

Mastic Gum & Acid Reflux: Mastic is the resin from a shrub found in the Mediterranean, and it has been found to soothe and relieve symptoms of acid reflux.

 

Source: Complementary Prescriptions Journal, Vol.26, Issue 12, Dec. 2012

 

Overeating & Acid Reflux: Portion size of meals should be decreased and/or eat 4 or 5 small meals instead of 3 large ones.

 

Source: Complementary Prescriptions Journal, Vol.26, Issue 12, Dec. 2012

 

Vitamins & PPIs: Proton Pump Inhibitors are acid blocking drugs that increase pH in the stomach. Higher pH limits the absorption of many vitamins and minerals such as beta carotene, calcium, chromium, folic acid, iron, vit C, B12 and zinc.

 

Source: Complementary Prescriptions Journal, Vol.26, Issue 12, Dec. 2012

 

Salt & Acid Reflux: Intake of table salt should be limited because it is a risk factor for acid reflux symptoms.

 

Source: Complementary Prescriptions Journal, Vol.26, Issue 12, Dec. 2012

 

Exercise & Acid Reflux: Physical exercise has been shown to protect against acid reflux.

 

Source: Complementary Prescriptions Journal, Vol.26, Issue 12, Dec. 2012

 

Fiber & Acid Reflux: Increased intake of dietary fiber has been found to protect against acid reflux.

 

Source: Complementary Prescriptions Journal, Vol.26, Issue 12, Dec. 2012

 

Tobacco & Acid Reflux: Patients who smoke should undergo a smoking cessation program, as tobacco smoking is a risk factor for acid reflex symptoms.

 

Source: Complementary Prescriptions Journal, Vol.26, Issue 12, Dec. 2012