Acid reflux occurs when stomach acid refluxes into the esophagus through the lower esophageal sphincter (AKA cardiac sphincter), causing pain, irritation and possibly damage to the esophageal lining. In some cases, people experience the sensation of heartburn radiating out from the stomach and esophageal area into the chest and hear area, giving the sensation of a burning heart. If this happens chronically, it is usually diagnosed as GERD (Gastroesophageal reflux disease).
Causes of acid reflux
Occasional acid reflux may occur from overeating or eating foods that irritate the esophagus, stomach lining or, more commonly the small intestine. In fact, most of the patients we see at BioLounge are experiencing acid reflux as a result of irritation to the upper area of the small intestine called the duodenum, where food passes from the stomach, through the pyloric sphincter and into the small intestine.
The upper area of the duodenum sees a lot of action The intestines are lined with immune cells that respond to the constantly changing environment. As soon as food enters, the pancreas and gallbladder begin secreting fluids that continue digestions so you can absorb your food while also neutralizing the low pH of stomach acid that has traveled with your meal into the intestine. Immune cells go to work identifying the mush that has just entered to make sure it is safe for you (if you've ever experienced food poisoning, this is your body's way of telling you that your food was NOT safe).
Irritation of this section of your digestive track can cause pressure which forces the stomach acid back up into the esophagus causing acid reflux. This irritation can be caused by too much food, food sensitivities, poor motility (food is moving too slowly) and even too little stomach acid, which seems counterintuitive.
It's important to note that on rare occasion, chronic acid reflux can be caused by a hiatal hernia which occurs near the lower esophageal sphincter which must be corrected with surgical intervention.
Risks of acid reflux
Aside from discomfort, the low pH of stomach acid is dangerous to the esophageal tissue and over time can increase risk of esophagitis, ulcers, strictures, aspiration pneumonia, Barrett's esophagus, and esophageal cancer.
For this reason, your provider will be motivated to treat the acid reflux to prevent those serious risks. The standard of care is a class of drugs called PPIs (proton pump inhibitors) which reduce the amount of acid produced in the stomach. While this action may calm symptoms, it does nothing to address the cause of acid reflux and PPIs carry serious risk if used for longer than their intended 6 week max duration.
Risk of PPI use
Research now shows that using PPI's such as:
- Omeprazole (Prilosec)
- Esomeprazole (Nexium)
- Lansoprazole (Prevacid)
- Rabeprazole (AcipHex)
- Pantoprazole (Protonix)
for more than the intended max duration of 6 weeks, increases risk of serious diseases including:
- Kidney injury
- Kidney disease
- Dementia and cognitive decline
- Stomach cancer
- Esophageal cancer
- Iron deficiency anemia
- Pernicious anemia (B12 deficiency)
- Osteoporosis and fractures
Why do these risks occur?
BECAUSE WE NEED STOMACH ACID TO DIGEST AND ABSORB OUR FOOD!
Moreover, the low acidity of the stomach is the first barrier to infections. Pathogenic microbes from our mouth and our food should be killed in the stomach before they have a chance to infect us through the intestines.
How to heal acid reflux naturally
- Avoid refined carbs and sugar that irritate the small intestinal bacteria and lining and increase pressure in the small intestine and stomach.
- Consume fewer calories at each meal and avoid high fat/high carb/high caloric meals which slow digestion.
- Increase soluble fiber. Research shows that increasing soluble fiber by 12.5 grams per day is an effective treatment for GERD. You can increase soluble fiber by adding beans, lentils, flax, chia and avocado to your meals. To reach your daily increase of 12.5g, you may also add a high quality soluble fiber supplement that does not use additives that may irritate your GI tract. We have a favorite soluble fiber at BioLounge, click here to check it out!
- Take 3 mg melatonin 1 hour before bed for 8 weeks. Melatonin reduces stomach acid and strengthens the lower esophageal sphincter. Studies have shown that after 8 weeks, it works just as well as a PPI.
- Try Chinese herbs. We love referring to our good friend, Tracy Thorne, LAc who uses acupuncture and Chinese herbs masterfully to successfully treat acid reflux.
- Assess food sensitivities. Identifying and removing foods that cause an inflammatory response in the small intestine improves countless inflammatory conditions and 9 times out of 10, reverses acid reflux completely. We offer powerful food sensitivity testing at BioLounge that has proven to be a priceless tool for reversing GI conditions.
- Do not eat within 3 hours of bedtime. It puts a lot of pressure on the GI tract to eat and then position your body horizontally (against gravity). Avoiding food and alcohol within 3 hours of bedtime will not only reduce acid reflux, it will improve sleep and metabolism.
- Take a broad spectrum digestive enzyme with your meals. Yes, instead of taking PPIs to reduce stomach acid, take a digestive enzyme with stomach acid (HCl), pancreatic enzymes and ox bile. This will help your body digest food more efficiently and prevent pressure build-up and irritation. If this makes things worse, you should speak with your provider to rule out hernia or structural issues.
Next steps
Like many drugs, PPIs have utility and can be helpful in the short-term, but it's critical to look at their action and long-term risk. Many of the natural remedies listed above can be experimented with at home, but if acid reflux persists, please contact your provider and consider a deeper investigation into the cause of your symptoms. Every body is different so work closely with your functional medicine provider to identify the factors affecting your unique body.