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Heartburn and GERD: Why Conventional Treatments Fall Short

Heartburn and GERD can be extremely frustrating to deal with. Both are painful and debilitating, and always carry some anxiety since the symptoms can resemble a cardiac event. To further complicate matters, many traditional “cures” carry their own serious risks to health - and they can actually make things worse!


But rest easy. I’ve got your back. Keep reading to learn how to end heartburn and GERD the natural way


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What Is Heartburn And GERD?


Despite its name, heartburn has nothing to do with your heart, but it certainly feels like it sometimes. The prime symptom of heartburn is a burning pain in the chest that typically starts after eating or drinking, and worsens when you lie down. It can also be accompanied by an unpleasant taste in your mouth and difficulty swallowing.


Heartburn is caused by acid reflux, which happens when acid from your stomach flows into your esophagus. The resulting pain is because the lining of the esophagus is far more sensitive than your stomach lining. When acid reflux becomes a chronic condition, it’s called gastroesophageal reflux disease (GERD).


In addition to the uncomfortable and worrisome symptoms, GERD and heartburn can have serious health consequences, including an increased risk of esophageal cancer and esophagitis. There is also a correlation between GERD and irritable bowel syndrome (IBS) - more on that below.


Note: If you have severe chest pain and other signs of a heart attack, like arm or jaw pain or shortness of breath, get immediate medical help. It’s always better to be safe than sorry.


The Root Causes Of Heartburn And GERD


Given the definitions above, it would be easy to assume the cause of heartburn and GERD is an excess stomach acid. However, these contradictory stats suggest otherwise.

  • Heartburn and GERD are increasingly common with age.

  • We produce less stomach acid as we age.

Unfortunately, the typical approach to addressing heartburn and GERD is to slow the production of stomach acid. No wonder those treatments are often ineffective - they don’t address the root cause, and only mask the symptoms - temporarily!


In fact, they can make a bad situation worse. Over-the-counter antacids such as Tums or Maalox can cause constipation, for example. Other treatments such as proton pump inhibitors can impact the balance of bacteria in your gut, with far-reaching effects, with long-term use.


So, what causes heartburn and GERD?


It’s helpful to take a step back. Because the esophagus is sensitive, any amount of acid can be harmful. That’s why the lower esophageal valve (LES) acts as a one-way “gate” that allows food and liquids to go into the stomach, but that keeps stomach acid from escaping into the esophagus. With this in mind, it makes sense that the root cause isn’t necessarily an excess of acid that must be somehow stopped, but a malfunction of the LES.


Several things can cause the LES to perform ineffectively, including:

  • Overeating

  • Obesity

  • Lying down after eating

  • Bending over with a full stomach

Most people with heartburn and GERD notice the impact of those things on their symptoms, and it certainly makes sense that abdominal pressure would cause the stomach contents to travel backwards into the esophagus. However, a vital element is often missing - the role of gut bacteria.


Research shows that a bacterial imbalance in the intestine produces enough gas to create the same kind of pressure as the factors above, which pushes stomach acid into the esophagus. The role of bacteria also explains the correlation between GERD and IBS, since IBS is also the result of gut bacteria imbalances.


This bacterial overgrowth is triggered by maldigestion of carbohydrates. Somewhat ironically, reduced stomach acid contributes to further bacterial overgrowth. The resulting gas leads to a malfunction of the LES, so acid escapes the stomach into the esophagus.


This dynamic highlights the difficulties with proton pump inhibitors as a treatment for GERD. If they create bacterial overgrowth, ultimately, they contribute to an increase, not a decrease, in GERD. In other words, the treatment only makes the disease worse in the long run.


Stop GERD And Heartburn By Addressing The True Cause


As mentioned, many conventional treatments can make matters worse and act as a band-aid solution at best. A better approach is to get to the root of the problem: bacterial overgrowth caused in part by a shortage of stomach acid. The following steps may help.


1 - Aim for a diet that prevents bacteria overgrowth and protects stomach acid


The food you consume plays a big role in your bacteria balance. Some studies have found that a low-carb diet slows the growth of “bad” bacteria in the gut, and consequently reduces symptoms. Some strategies include:

  • Focus on complex carbohydrates like sweet potatoes and oats when you do eat carbs.

  • Avoid overly processed foods marketed as “low carb”.

  • Eliminate artificial sweeteners and reduce fructose consumption.

  • Avoid foods extremely high in fiber, as they can contribute to increased gas.

  • Follow a low FODMAP diet. FODMAPs are a type of carb that some people can’t digest efficiently.

2 - Restore a healthy level of stomach acid


Testing your stomach acid levels is a good first step - a natural health practitioner can help with that! From there, we can work together to increase acid production if necessary. Some ways to increase stomach acid production include:

  • Tiny doses of bitter herbs, including dandelion root, ginger, gentian root, ginger, milk thistle, and carraway.

  • Apple cider vinegar, lemon juice, and unpasteurized honey.

  • Hydrochloric acid supplements. (These are best used under supervision as it takes some testing to get the right dose.)

  • Lifestyle changes such as avoiding drinking too much water with meals, which can dilute stomach acid.

3 - Restore beneficial gut bacteria and gut lining


The end goal is to bring bacterial balance back to your digestive system. Probiotic supplements can help restore good bacteria, but fermented foods and drinks are an even better option since they contain other beneficial nutrients. That includes items like kefir, yogurt, kimchi, sauerkraut, tempeh and kombucha (but be aware of the sugar content in your kombucha!).


It’s also important to protect the lining of your stomach. Certain medications like steroids, aspirin and ibuprofen can irritate the gut lining. Stress can also damage your stomach lining, so stress reduction strategies are always a good idea.




I want to remind you that while I am a doctor, I am not your doctor. The information being shared throughout this blog is for educational purposes only, it is not meant to diagnose or treat any medical condition. Please consult your physician before making any radical changes to your personal health program, especially if you have been diagnosed with a disease and are on prescription medication.


Sources


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Krasinski SD, Russell RM, Samloff IM, Jacob RA, Dallal GE, McGandy RB, Hartz SC. Fundic atrophic gastritis in an elderly population. Effect on hemoglobin and several serum nutritional indicators. J Am Geriatr Soc. 1986 Nov;34(11):800-6. doi: 10.1111/j.1532-5415.1986.tb03985.x. PMID: 3771980.


Jaynes M, Kumar AB. The risks of long-term use of proton pump inhibitors: a critical review. Ther Adv Drug Saf. 2018;10:2042098618809927. Published 2018 Nov 19. doi:10.1177/2042098618809927


Mayo Clinic, Proton Pump Inhibitors Decrease Diversity in Gut Microbiome, Increase Risk for Complications


Seto, Charlie & Jeraldo, Patricio & Orenstein, Robert & Chia, Nicholas & DiBaise, John. (2014). Prolonged use of a proton pump inhibitor reduces microbial diversity: Implications for Clostridium difficile susceptibility. Microbiome. 2. 42. 10.1186/2049-2618-2-42.


Piche T, des Varannes SB, Sacher-Huvelin S, Holst JJ, Cuber JC, Galmiche JP. Colonic fermentation influences lower esophageal sphincter function in gastroesophageal reflux disease. Gastroenterology. 2003 Apr;124(4):894-902. doi:10.1053/gast.2003.50159

Pimentel, Mark M.D., F.R.C.P.C; Rossi, Federico M.D.; Chow, Evelyn J. B.A.; Ofman, Joshua M.D., M.P.H.; Fullerton, Steven M.D.; Hassard, Phillip M.D., F.R.C.P.C; Lin, Henry C. M.D. Increased Prevalence of Irritable Bowel Syndrome in Patients With Gastroesophageal Reflux, Journal of Clinical Gastroenterology: March 2002 - Volume 34 - Issue 3 - p 221-224


Yancy WS Jr, Provenzale D, Westman EC. Improvement of gastroesophageal reflux disease after initiation of a low-carbohydrate diet: five brief case reports. Altern Ther Health Med. 2001 Nov-Dec;7(6):120, 116-9. PMID: 11712463.


Barrett JS, Canale KE, Gearry RB, Irving PM, Gibson PR. Probiotic effects on intestinal fermentation patterns in patients with irritable bowel syndrome. World J Gastroenterol. 2008 Aug 28;14(32):5020-4. doi: 10.3748/wjg.14.5020. PMID: 18763284; PMCID: PMC2742929.



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