What is acid reflux?
Acid reflux is also known as heartburn. When the acid in the stomach backs up to the esophagus it causes discomfort. Like heartburn/chest pain sometimes.
Heartburn was always thought of as too much acid in the stomach but now we know it’s due to low acidity in the gut. When food sits in the stomach for too long or there is low stomach acid, digestion is slow, which prolongs transit time.
Acid reflux is a common digestive disorder, especially in the developed world. The more frequent acid reflux occurs it changes into Gastroesophageal reflux disease (GERD).
Approximately 60 million Americans get heartburn once a month. And about 1.5 million adults including pregnant women get it on a daily basis. Also, GERD was also found to be more common among infants and children than healthcare providers thought it.
GERD more often causes vomiting that can lead to coughing and even aspiration.
What Are some common causes of Acid reflux?
You see in normal digestion as you swallow the food it goes through the esophagus passing through the sphincter to the stomach. No backup occurs in this process. But when the sphincter becomes loose and doesn’t close it lets some stomach content to backflow. This causes a burning sensation which is heartburn.
Symptoms of heartburn/acid reflux/GERD
- Burning sensation in the chest
- Throat burning
- bitter/sour taste on the tongue
- Difficulty swallowing
- Food getting stuck in the chest/throat
- Sore throat, coughing
- Stomach pain a few minutes after eating
Common causes of heartburn
- Low stomach acid
- Stress and anxiety
- Eating to fasting
- To much caffeine
- Too much refined carbohydrates and sugar
- Hiatal hernia
- H.pylori/overgrowth of bad microbes
- GI conditions such as ulcers, IBS
- Food sensitivities
- Medications eg. blood pressure, sleeping pills, protamin pump inhibitors, antibiotics, iron, and many more cause LES to relax
- Magnesium deficiency – magnesium helps the sphincter at the bottom of the stomach to relax so the food can go down.
Factors such as old age, obesity, smoking, anxiety/depression, and inactivity contributed to the risk of heartburn/GERD.
Also, pregnant women are likely to experience heartburn due to the pressure from the baby in the womb.
What is the root cause of heartburn?
The main underlying root cause of heartburn is the weakening of the lower esophageal sphincter (LES) in short. This is a muscle that connects the esophagus to the stomach. Even though some foods, alcohol, and caffeine can contribute to acid reflux a weak structure of LES can offset heartburn/GERD.
Here are some structural causes of acid reflux
- Lower esophageal sphincter dysfunction
So weakening in the Lower esophageal sphincter is one of the structural defects that can cause heartburn. When LES is weak it can not close properly which lets the stomach acid to backup
to the esophagus.
- Slow stomach emptying
Some individuals might have abnormal formation in their gut. This issue might stop the stomach muscle from contracting delaying stomach content from emptying at the proper time.
By eating a large meal, fatty or spicy food the chances of acid reflux problems increases.
- Eosinophilic Esophagitis
Acid reflux irritates the esophagus leading to inflammation as a result.
This destroys the lining of the esophagus. Which makes it more sensitive to acid leading to the formation of ulcers, bleeding, and narrowing of the esophagus.
The esophagus forms rings that make swallowing difficult. The risk for choking, malnutrition, dehydration and aspiration are also increased.
- Barrett’s esophagus
As acid reflux/GERD occurs frequently, it damages the normal cells in the esophagus and replaces them with abnormal cells. This increases the risk of getting cancer.
Some studies state that some uncommon symptoms of GERD such as hoarseness, chronic cough, and food stuck in the throat could happen due to defects in the esophagus.
- Hiatal Hernia
A hiatal hernia occurs when the upper part of the stomach protrudes from the diaphragm ( the muscle that separates ) the stomach and the chest. You can literally see it bulging through the stomach.
What can you do to avoid complications?
Here are some lifestyle changes that are helpful to avoid complications.
- Eating 2-3 hours before bedtime
- Chewing slowly and thoroughly before swallowing
- Avoid food that contains chocolate, spicy, citrus fruits, caffeine, and tomatoes.
- Losing weight if you are overweight
- Avoiding alcohol
- Stop smoking
- Avoiding tight clothing that puts pressure on the waist
- Gluten-free diet for those who have celiac disease or gluten sensitivity.
- Raising the head of the bed and not sleeping flat on your back.
- Eat small meals
- Increase probiotic foods
- Increase vegetables
- Avoid ice-cold drinks
If these lifestyle changes don’t help, it’s important you see your healthcare provider.
Conventional Ways of Treating Acid Reflux/GERD
These are the most common drugs prescribed by a physician.
- Antiacids – Sometimes relieve acid reflux or provide fast-acting relief for mild acidity. Over-the-counter (OTC) examples are Tums, Maalox, etc.
2. H2 blockers- Take more time to provide relief but last longer than antacids. Pepcid, Rolaids, and Axis are of them. They aid in the reduction of acid in the stomach. These can be found over-the-counter or are prescribed by a physician
3. Proton pump inhibitors (PPIs)- They work better than both
antacids and H2 blockers providing long-lasting relief but the downside is they take longer to work. Examples of PPIs are Prilosec, Nexium, and Protonix.
Now these medications come with unpleasant side effects, as they’re used to treat the symptoms, not the underlying cause. These side effects can be mild to severe in nature.
Here are some of them.
- Kidney disease
- Stomach cancer
Problems caused by these drugs are not limited to the ones above. There are many more side effects including decreased food digestion. And also vitamin and mineral deficiency, depression, hip fractures the list goes on.
Studies have shown taking antiacid medications for a long time can lead to infections such as clostridium difficule. This is a deadly infection with severe diarrhea and colitis.
Can Surgery be the answer for GERD?
In April of 2020, the FDA ( U.S Food and Drug Administration) requested an over-the-counter and prescription ranitidine ( Zantac) be removed from the market. A chemical called N-nitrosodimethylamine (NDMA) which causes cancer was found in Zantac.
No one likes to go under the knife unless it is necessary. But when lifestyle changes and medications fail some people end up getting surgery as an option.
One of the most common surgery is Fundoplication whereby the upper part of the stomach is wrapped around LES. This fixes the weakened valve to prevent the stomach from backflow.
The risk of surgery has pros and cons. It is paramount to do all your research before resorting to this option. Discuss the benefits and risks with your healthcare provider to see if you are a good candidate. Try your best to do all the other options before considering surgery.
What Are Natural Remedies to treat Acid reflux?
Most research points to fixing our diet as the one important thing that we need to focus on that can help.
1. Apple cider vinegar – helps increase acid production in the stomach
2. Ginger – It is used to help with many digestive issues for instance reduction of inflammation in the gut.
3. Baking Soda – Baking soda is a neutralizer but use it only as a temporary measure. Also if you have high blood pressure it is not recommended since sodium content is high.
4. Slippery elm – calms down the lining of the esophagus and protects it from damage caused by the acid.
5. Aloe Vera Juice – Soothes the esophagus and reduces inflammation.
6. Bananas – They are alkaline foods and neutralize acidic stomachs.
7. Betaine HCL – Studies have shown Betaine to have increased stomach acid in people with low acid levels. which improves digestion as a result helps with acid reflux.
8. Deglycyrrhizinated Licorice (DGL) – It soothes, the esophagus and stomach. Gives protection and healing to the lining from damage done by acid.
9. Fennel tea – It relaxes muscles around lower esophageal sphincter (LES)
10. Vitamin A, beta-carotene, and zinc – help heal the mucosa membrane
11. Digestive enzymes – Take it with meals to help with digestion
12. Glutamine powder- Is known to heal the gut lining
13. Magnesium citrate – helps soothe the gut
What are some functional tests for heartburn?
- H.pylori test (stool) – If H.pylori is positive, it needs to be treated to improve heartburn.
- IgG food sensitivity testing – Positive results can be used to find which foods are the trigger for acid reflux and to avoid them
- Barium swallow – This can reveal the abnormality of the esophagus by showing the barium or food particles during and after swallowing.
- Endoscopy – This test can verify the diagnosis of acid reflux as well as complications caused by the acid for example esophageal cancer.
Here are some steps for overcoming acid reflux
Step 1 – Healing your gut from bugs such as
- H.pylori either using the traditional way of treating with antibiotics or a holistic approach
- Treating small bacterial overgrowth also known as SIBO
- Treat yeast overgrowth
Step 2- Diet change is crucial to healing acid reflux
- Avoiding alcohol, citrus fruits, spicy food, caffeine
- Avoid processed food
- Avoid large meals, instead eat a small portions
- Avoid lying down after eating
- Eliminating dairy and gluten
- Eat cooked organic food like fish, vegetables, and chicken.
Step 3 – Natural remedies -You can use the natural remedies mentioned above to
heal the gut which doesn’t cause you all the unpleasant side effects and at the same time it is economical.
- Aging, esophageal motility, and gastroesophageal reflux – PubMed (nih.gov)
- Complications of Acid Reflux: Eric Ibegbu, MD: Gastroenterologist (amg-gi.com)
- FDA Requests Removal of All Ranitidine Products (Zantac) from the Market | FDA
- Use of Gastric Acid–Suppressive Agents and the Risk of Community-Acquired Clostridium difficile–Associated Disease | Gastroenterology | JAMA | JAMA Network
- Acid Reflux Home Remedy (homeremediesweb.com)
- Acid reflux and GERD: The same thing? – Mayo Clinic