What Is Heartburn or Reflux?
Heartburn or reflux is a common digestive complaint that can involve chest or stomach pain, burning, burping, or coughing.
Reflux involves a few key parts of our anatomy: our esophagus, our stomach and the muscular section between the two called the lower esophageal sphincter (LES). The esophagus is the tube that our food travels down after we swallow it. The food travels through the esophagus and the LES as it makes its way into the stomach. The LES has a really important function. It's supposed to let food into the stomach, but not let anything back up into the esophagus. It should be a one way street, but in reflux, there's a dysfunction in the LES that allows acid to get out of the stomach and into the esophagus.
It's commonly believed that heartburn is due to too much stomach acid, but that's not the case. Heartburn happens because stomach acid is getting into the esophagus, where it shouldn't be. The esophagus isn't made to withstand the acidity of our stomach acid like our stomach is. So, while acid reducing medications can work, they're not solving the real problem.
Why does the LES relax and let acid through? Well, I'm going to cover a few reasons and some natural tips for dealing with heartburn. So keep reading if this is something you suffer from!
If you are someone who has heartburn and are wanting to get off medications check out my blog about tapering off acid blockers.
Lifestyle and Dietary Factors that Contribute to Heartburn
Being overweight - the added pressure from abdominal weight can put pressure on the abdomen, stomach and LES so losing weight may help with heartburn.
Laying down after meals - this is similar to having extra weight around your abdomen in that gravity is pushing the stomach contents against the LES. It may help to stay upright after meals for at least an hour. If you tend to get heartburn in the evening or when you go to bed, you could try having your last meal of the day at least 2 hours before going to bed. There are also wedge pillows that can prop you up as you sleep or you can raise the head of your bed a few inches by propping it up with blocks.
Irritating foods - there are a variety of foods that may weaken the LES. These include acidic foods like citrus, tomato, coffee and wine as well as chocolate, alcohol and mints. Citrus can be helpful for some and worsen heartburn for others so this one just depends on the individual.
Food sensitivities - common foods that people can be sensitive to are dairy, wheat, eggs, soy, corn and nightshades. For some people, avoiding these foods can relieve heartburn altogether. If you think you might be sensitive to certain foods you might want to try an elimination diet. I go over how to do an elimination diet in a post or you can download this guide!
Hiatal hernia - the stomach usually sits below the diaphragm but in this condition the upper stomach bulges through the diaphragm. This puts pressure around the upper stomach, making it difficult for food to pass through. This can be diagnosed through imaging.
Natural Remedies for Heartburn
I wrote a post on acid reducing medications and in that post I go into the importance of stomach acid, but I wanted to mention it here too. We need stomach acid to help us digest protein, to absorb vitamins and minerals and to kill pathogens that may be in our food. Our stomach acid is even a signal to the LES to stay shut and not let the stomach contents back up into the esophagus.
Stomach acid is important for our overall health and reducing it over the long term may not be a good idea. Acid reducing medications aren't intended to be used for more than a couple weeks, it even says this on the box, but many people are put on them for years.
Natural therapies for heartburn are usually soothing compounds that coat the esophagus and stomach, lessen the pain of heartburn and reduce inflammation of the tissue. I'm not saying they're a long term solution, but may be short term relief if you don't want to use acid blockers.
DGL (deglycyrrhizinated licorice) - Licorice root has a soothing, coating action when it's mixed with liquid or chewed and mixed with saliva. DGL comes in powder or chewable tablets and may be helpful when used before or after meals. A compound found in licorice called glycyrrhizin can raise blood pressure in some people, which is why this form has taken it out.
D-limonene - this compound found in citrus can help tone the LES and keep it closed, preventing acid from reaching the esophagus.
Aloe, marshmallow root, slippery elm - all of these herbs are anti-inflammatory and soothing similar to licorice. They come in liquid, powder or loose herb. Aloe already has a thick consistency, but marshmallow root and slippery elm develop a thick, gelatinous consistency when mixed with water and that's what makes them effective. Note: Herbs like these with this coating action may prevent the absorption of other medications or supplements if taken at the same time. Taking these away from other medications may be a good idea to prevent them interfering with each other.
Digestive enzymes - certain foods may irritate the stomach and LES and digestive enzymes with meals can help you to break down and absorb nutrients more effectively. If you've been on acid blockers for a while and your stomach acid is low, you may not be absorbing them well. Some formulas also contain betaine HCl, which is a supplemental form of hydrochloric acid.
Summary
Heartburn or reflux is a common digestive complaint that can involve chest or stomach pain, burning, burping, or coughing. Causes of heartburn can include being overweight, laying down after meals, irritating foods, food sensitivities, and hiatal hernia. Stomach acid is needed for optimal health and it's not recommended to use acid blocking medications for long term use. Natural options include DGL, d-limonene, herbs like aloe, marshmallow root, slippery elm, digestive enzymes, and betaine HCl.
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In health,
Dr. Jamie
This website is not intended for the purpose of providing medical advice. All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.
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