healing heartburn: why antacids aren’t the answer
Heartburn and ACID reflux are incredibly commoN.
the most common remedy?
Prescription strength antacids.
For some people these medications can help, but they were actually only designed to be used for no more than 6 weeks for the treatment of ulcers - not for managing chronic heartburn.
Ironically, you actually need your stomach acid to prevent heartburn and optimize your digestion.
Without it, you’re more likely to:
have heartburn/indigestion or silent reflux
develop nutrient deficiencies
have increased gas, bloating and other gut symptoms
have more food intolerances or sensitivities
develop gut bacteria imbalances (dysbiosis) that can worsen gut issues and create chronic inflammation and immune dysregulation
Before we dive into natural treatments for heartburn and acid reflux, let’s talk about why you might have heartburn in the first place.
Heartburn or reflux can be caused by:
overeating
eating too quickly
low stomach acid: due to medications, stress or autoimmunity (atrophic gastritis) or aging
foods that loosen the sphincter between your esophagus and stomach (the LES) including mint, coffee, alcohol, dark chocolate, onion, tomatoes, cinnamon, greasy foods
SIBO - small intestine bacterial overgrowth - due to the gas production by intestinal bacteria
immune system dysregulation
food sensitivities
liver or gallbladder dysfunction including bile reflux
chronic gut inflammation and food sensitivities
chronic constipation
That’s a pretty big list!
It’s tempting to just pop an antacid pill, Gaviscon, Pepto or Tums for instant relief, and while that’s fine once in a while, it’s important to treat the underlying root causes, otherwise you could end up with worsened gut and other chronic health issues down the road.
Some people are more likely to have chronic heartburn or GERD (gastroesophageal reflux disease) including:
those with many allergies/immune system dysregulation
those on long term antacids or antibiotics
those with autoimmune conditions such as Celiac or Hashimoto’s or any form of hypothyroidism
those who have had abdominal surgeries or trauma
What about silent reflux (aka LPR)?
Silent reflux can have similar root causes, but its treatment approach is different from general heartburn - stay tuned for a separate blog post on silent reflux coming soon!
how do we manage heartburn naturally?
Optimize stomach acid levels
Low stomach acid is incredibly common, and one of the main causes of heartburn. I know it doesn’t seem to make sense, but hear me out. Your stomach acid is the trigger that tells the flap between your esophagus and stomach to close. So if it’s low, there will be less of a signal to close the flap, and any acid and food that you have in your stomach will be able to flux upward into your esophagus.
Stomach acid is needed for digestion - if your food enters your intestines undigested your gut bacteria will ferment it, causing more gas, bloating and indigestion.
It’s also needed as a protective barrier to prevent infections and bacterial overgrowth.
This is why low stomach acid is a risk factor for dysbiosis and SIBO.
If you’re on an antacid, it’s recommend to gradually wean yourself off, however, this is something you’d need to discuss with your doctor.
I use a variety of approaches to optimize stomach acid production, including specific supplements. I also use high quality digestive enzymes that are a combination of stomach acid (HCl), enzymes and sometimes, ox bile.
ADDRESS THE MICROBIOME
Dysbiosis is a general term that refers to imbalances in your gut microbiome - the ecosystem of bacteria, yeasts, viruses and even parasites that live in your gut.
Most people have some degree of dysbiosis due to our modern lifestyles including produce with pesticides, use of antibiotics, poor diets (high in processed foods and sugar, low in fibre) and other medications or restrictive diets.
A type of dysbiosis called SIBO commonly causes heartburn and indigestion.
This is when gut bacteria from the large intestine migrate upward and colonize the small intestine, which normally has very low levels of bacteria.
This can cause increased gas and pressure on the pyloric valve (valve between the small intestine and stomach) which can cause acid reflux/heartburn.
Left untreated, dysbiosis can lead to many health issues including:
leaky gut and food sensitivities
chronic inflammation
autoimmune conditions
nutrient deficiencies
chronic fatigue
brain fog and mental health issues
histamine intolerance and rashes
allergies
hormone imbalances
weight gain or inability to lose weight
I use a 4 step approach to treat dysbiosis including diet adjustments and specific antimicrobial supplements (ie oregano, berberine, garlic) as well as probiotics and other supplements to repair leaky gut and restore balance to the microbiome.
This is done gradually over several months.
Support liver and gallbladder function
An often overlooked step, your liver produces bile, that is used to digest fats and helps promote gut motility. It’s also an important preventative barrier to prevent bacterial overgrowth and infections.
This bile is stored in your gallbladder.
As we age, we tend to have more issues with the liver and gallbladder, including thickened, sludgy bile that your gallbladder may not be able to excrete properly.
This is more common in women over 40, in women who have ever lost weight rapidly, have used birth control or who have long term dysbiosis (especially SIBO).
I support bile flow by using bitters and other herbal supplements as well as dietary changes to support liver function.
This is especially important in people with bile reflux, which can feel like heartburn, but the burning sensation is actually from bile, and not stomach acid. This is more common after any type of stomach or intestine surgery and in those with autoimmune conditions.
Address any immune dysregulation
Most of my clients have some degree of immune dysfunction because up to 70% of your immune system is in your gut!
This is more common in people who have had a lot of allergies since childhood, have used many rounds of antibiotics, have a family history of autoimmune disease, anxiety, trauma or burnout (adrenal fatigue).
Long term gut issues can cause a wide range of immune issues including:
allergies
chronic inflammation: headaches, aches and pains
brain fog
frequent infections or illnesses
autoimmunity
Typically I can determine this from a thorough assessment, but I will also review blood work and I use a specific immune function questionnaire as well.
Restoring balance to the immune system can be tricky, but it often involves several steps:
gut microbiome balancing
adaptogen herbs
addressing nutrient deficiencies
adjusting diet
adjusting lifestyle when adrenal fatigue (burnout) is present - nervous system regulation practices
working on mindset shifts
using a personalized immunomodulation supplement protocol to support and balance out the two “arms” of the immune system (TH1 vs. TH2 and TH17 when autoimmunity is invovled) - this is especially important in those with autoimmune conditions, IBD or silent reflux.
I’m currently completing a course in autoimmunity called Cogence by Dr. Samuel Yanick to ensure I’m serving my clients as best as possible and creating personalized protocols that help you feel better faster.
I’m always doing the research, so you don’t have to!
Address structural issues
For some people, structural issues may be contributing to their heartburn.
This can include:
hiatial hernia
IC (ileocecal) valve dysfunction - the valve between your small and large intestine
spine misalignment (subluxation) - especially the mid back - addressed with chiropractic
scar tissue and adhesions - can be addressed with osteopathy and/or massage therapy
having extra weight in your midsection - puts pressure on your stomach and esophagus/LES
AVOID TRIGGER FOODS
For some people, they may need to temporarily avoid trigger foods” (ie those that loose then LES) in order to keep symptoms under control and prevent long term complications of chronic acid reflux including Barrett’s esophagus.
Others may simply need to avoid foods that trigger IBS symptoms such as gluten, dairy, processed foods, known food sensitivities, or those high in FODMAPS, at least temporarily, while we heal the underlying root causes.
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