Acid Reflux Realities

What if I told you acid reflux actually can be related to low stomach acid?!

Many of us have been led to believe that acid reflux is a condition of too much stomach acid. I actually treat it regularly as a condition of not enough stomach acid. Let me explain. Generally the stomach desires to be a place of high acidity. It’s meant to be that way! When there is proper acidity levels, the acid works to break down your food, so it can be assimilated in your lower digestive tract.

When there are proper levels of acid in the stomach, the acid comes up and touches the lower esophageal sphincter (the gateway between the esophagus and the stomach). When acid touches the sphincter, it automatically closes. If there is not enough acid in the stomach, the sphincter doesn’t close all the way and this creates many acid reflux symptoms. There is a small subset of folks who do have too much stomach acid, but this is less common. 

While proton pump inhibitors (like Prilosec, Nexium, and Protonix) and acid reducers (like Tums and Rolaids) can help reduce the symptoms of acid reflux, very rarely do they treat the root of the problem. Therefore requiring the patient to need to keep using them to manage the symptoms.
I treat acid reflux successfully in my practice often. Let’s start with the basics. There are certain foods and beverages that can irritate the digestive system. Common trigger foods include: Coffee, Chocolate, Refined Carbohydrates, Tomatoes, Oranges, Pop (soda), Alcohol, and Peppermint. Eating a lot of food before bed can also be problematic. 

I often tell my patients to pay attention to the list above. It does not necessarily mean that you are sensitive to everything or you can never eat it again. Only it is worthwhile to pay attention to how you feel when you ingest these foods/drinks.

It’s also important to be conscious of how you are eating. Eating in a stressed environment (i.e. behind your desk frantically typing emails or while driving) can cause blood to go to your muscles. While, eating in a relaxed environment causes blood to shunt to the abdomen to help with digestion. It is also important to chew your food properly to help break it down.

When working with patients with suspected low stomach acid, I have common treatments that I have found to be helpful. First, I like to calm the inflammation and assist the digestive process. I often do this with some version of digestive enzymes and demulcent herbs. Demulcent herbs have a mucusy like function that coats the esophagus and stomach lining. Next, I like to stimulate acid production. This can be done with using some form of bitters. 

When thinking of bitters, I like to think back to when we started meals with a dark green leafy salad. This bitter salad was often served before the meal to help stimulate your stomach in the production of acid. Bitters can be used in a variety of ways, through bitter foods, drinks, or tinctures. I often like to use a combination of bitter herbs that is made to be more palatable. Some people will use apple cider vinegar or small amounts of lemon or lime juice. Note: some people with excessive yeast issues, can have issues with apple cider vinegar. The taste of the bitterness on the tongue is part of what stimulates the acid production. 

I usually have people do these two treatments regularly with each of their meals. Using this protocol, I have weaned many patients off of proton pump inhibitors and regular use of Tums or Rolaids. The great news is they don’t have to continue this protocol forever. 

Of course this protocol does not work for everyone. Nothing in medicine is that simple! I often say that this protocol works well for about 80% of my patients. The other 20% have a different problem that needs to be addressed first. Variables of this problem could include a hiatal hernia, digestive microbiome imbalances, and a common condition called SIBO. Further testing can help identify the path for the individual. 
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Please locate a trained naturopathic doctor to guide you through this process, as not everyone is able to do it at the same pace.

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