I bet you have at least once in your life experienced that awful burn in your throat after eating a meal. Maybe you have popped some Tums or tried the old school drinking a glass of milk to calm the fire. Perhaps heartburn is a regular occurrence so you take a proton pump inhibitor, a medication that work by reducing the amount of stomach acid made by glands in the lining of your stomach and you have been led to believe that this fixes the root cause of the issue. Ah, but this is very rarely the case and not addressing the root cause can actually lead to more downstream health issues.
In the center of your chest, there is a small, muscular tunnel that separates the end of your esophagus from your stomach. Think of it like a fist that can be closed tightly or loosely. It’s a muscle called your lower esophageal sphincter (LES). When you’re eating, the fist should be open and loose, so food can travel to your stomach. But at all other times, unless you need to vomit, the sphincter should be tightly closed. This prevents all food and digestive fluids from traveling upward. Despite many myths otherwise, acid reflux is just having a loose sphincter when it should be tight.
Your stomach produces a few different digestive juices. But the dominant one is hydrochloric acid (HCl). One of nature’s strongest acids, HCl is designed to make light work of breaking down the tough meat in that steak you just ate. I often describe it to clients like a really sharp steak knife cutting up the meat into little digestible bits. If you put HCl directly on your hand, it would quickly burn you it is that strong. The stomach acid produces pepsin, a digestive enzyme that breaks down protein. The cells of your stomach lining are coated with mucus to protect them from acid and pepsin so as not to digest your stomach lining. The lining of your esophagus, however, is not coated. So when the LES is loose and acid bubbles upward, it hurts and can damage the tissue. Hello fiery heartburn!
There are many reasons why you might have acid reflux. But let me put one myth to rest; having too much overall stomach acid production is actually an extremely rare cause of acid reflux. Remember that reflux is just a matter of having acid and pepsin in the wrong place (the esophagus). For almost everyone, there are controllable drivers for reflux that can bring you lasting pain relief without the side effects of drugs.
You can address this painful issue without Tums or PPI’s and save yourself from the long-term consequences of them by applying the following:
- Slow Down and Chew, Chew, Chew. The average American chews each bite of food only a few times before swallowing it down hard, often with big gulps of liquid as a chaser, racing through our meals. Instead, slow down, savor your food and be present with it and try to chew your food until it’s liquid as this significantly reduces the work of your stomach. This may sound too simple to be of any benefit but I cannot even tell you how many clients I have worked with who have learned to slow down and chew and have seen their heartburn and indigestion disappear!
- Drink as little liquid as possible with your meals. Mealtime is not the time to remember to hydrate and guzzle your 32 ounce water bottle. In between meals is by far the best time to hydrate. Liquids during meals just dilute your stomach acid and make it less potent, leading to belching and bloating. Food can hang around in your stomach longer than it should and ferment and gas builds up and blows open your LES – causing reflux. Have only a small glass handy during meals to help clear your palate. Too much liquid during a meal can also increase the pH of your stomach juices and make your esophageal sphincter work less effectively and we want it working FOR us not against us!
- Eat more often and less at once. Sometimes our LES gets blown open by the sheer volume of food we try to cram into our bellies. I am sure you have experienced this when at your favorite restaurant or on Thanksgiving. The stomach will stretch but only so far. Research shows better digestion and better healthy weight maintenance for people who eat smaller meals 4-5 times per day. This is not the same as grazing as your body needs a break from digestion, so eating here-and-there all the time isn’t helpful, but small meals every 3-4 hours is ideal. Then stop eating when you are 80% full. You have to literally leave room for digestion to take place. Think about how hard it would be to stir a pot of soup if it was full to the very top of the rim!
- Wear loose clothing around your midsection. If you wear a tight belt or waistband, you put tremendous pressure on your digestive organs. This can push food and digestive fluids physically upward and beyond your LES. Muffin-Tops and Belted Beer Bellies, take particular note of this one!Fix your magnesium deficiency. Magnesium is one of the minerals Americans are most deficient in. Low magnesium can cause specific muscles to be too tight or to spasm erratically and this includes your LES. If you also struggle with any regular constipation, headaches, irritability, leg spasms, or tight muscles, be sure to give supplementing with some magnesium a try.
- Stop eating foods that cause your LES to spasm. Unfortunately many people love some of the foods which are most irritating to the LES. If you struggle with daily GERD, I highly encourage you to consider giving your body a break from these foods to allow the body to heal. I know you may love these foods, but continuing to eat them and just pop a pill to ignore the pain is likely to turn into a serious illness or disease for you some day. These are the most powerful triggers of LES spasms: cooked tomato sauce, citrus juices, coffee, soda, alcohol, peppery or spicy foods, fried food, chocolate, and things with mint in them such as gum, mints, toothpaste, and tea.
- Don’t eat or drink anything 2-3 hours before bedtime. Reflux can often be worst at night. This is when all of our muscles relax at least a little bit, including our LES. If you put food in your stomach and then go to bed before it’s fully digested, reflux is much more likely. The goal is to eat throughout the day such that you just go to bed with an empty stomach – but not hungry. Not eating a full 3 hours before bed is also an excellent way to improve the quality of your sleep.
If all the above fails, rule out other physiological drivers of chronic reflux. Don’t settle for suffering – or for a long-term medication that will harm you. Work with your doctor to find out if you have a hiatal hernia, found via a simple x-ray, food sensitivities through an IgG food antibody panel blood test, an H Pylori bacterial overgrowth, which is a bacteria that commonly causes ulcers but can also cause chronic GERD – diagnosed with a simple breath and blood test, or insufficient stomach acid, very common as we age. I have successfully supported many clients in working through all of these – including how to approach your doctor about testing.
Long-term use of PPI medications is dangerous and often has systemic consequences such as mineral depletion, maldigestion and bacterial overgrowth in the gut leading to a whole host of other health issues. Give yourself a gift of real healing and take steps to get rid of acid reflux permanently by addressing its cause at the root. You deserve to savor your food without fearing the fire and burn!