Acid Reflux: Symptoms, Causes and Natural Support Strategies
Acid reflux or gastric esophageal reflux disease (GERD) is one of the most common conditions affecting Americans today. This condition is characterized by a burning sensation in the chest that has coined the term “heartburn.” An anti-inflammatory lifestyle has been shown to beat acid reflux naturally.
Upon eating, food naturally passes from the throat to the stomach through the esophagus. The esophagus contains a group of muscle fibers in the shape of a ring that prevent food from moving backward from the stomach to the esophagus. These muscle fibers make the lower esophageal sphincter (LES).
If the LES is not closing well it allows for food, liquid and hydrochloric acid to leak back into the esophagus. The inner esophageal tissue is not designed to handle the strong acidity which inflames the region. This causes the characteristic heartburn sensation. Chronically damaging the esophageal tissue often results in esophageal cancer and other more serious conditions (1, 2).
Common Risk Factors for GERD:
The most common risk factors for GERD include anything that obstructs the esophagus or stomach region such as hiatal hernia, pregnancy, and scleroderma. Other proven risk factors include obesity, smoking, and alcohol usage. Many prescription medications list GERD or acid reflux as a common side effect so this should always be considered (3).
The popular belief is that acid reflux is due to an excessive amount of hydrochloric acid in the stomach. New science has revealed that this is not the case. GERD is most often caused by too little hydrochloric acid being secreted by the stomach (4, 5).
The Need for Stomach Acid:
During digestion the stomach secretes acid to lower its pH to around 1.5-2.5 range. More protein in the meal results in a greater need for stomach acid. Individuals with non-obstructive acid reflux are often not able to get their pH low enough.
The LES is known to be a pH sensitive valve that initiates closure when pH drops under 3.0. When the stomach does not have enough acid the LES remains open and acid can spill into the esophageal region and damage the tissue. Additionally, when the diaphragm herniates through the stomach sphincter it is called a hiatal hernia and can lead to the symptoms of acid reflux.
A hiatal hernia sounds like a painful condition, considering the stomach pushes through an opening in the diaphragm and into the chest, but most people don’t notice any symptoms. It is frequently discovered when a person has a chest x-ray or abdominal x-rays (including upper GI series and CT scans where the patient swallows barium or another contrast material) (6). It can also be found when a gastrointestinal endoscopy of the esophagus, stomach, and duodenum is performed.
You may also be able to feel a hiatal hernia if you put your hand under your left breast bone and feel a little bulge. If so, you can try a self-massage by pushing this bulge down. I go over a number of strategies you can apply to reduce a hiatal hernia in this article.
The Problem With Acid Reflux and Antacids:
Many people use antacids to relieve the pain of heartburn. This covers up the symptom (reducing acidity) but only makes the problem worse by decreasing the acidity. This process limits the body from effectively digesting the food.
This causes further stress on the enzymatic system of the pancreas as well as the other digestive organs. Antacids, processed foods and many medications deplete the body of critical b vitamins and trace minerals that are necessary to create a sufficient supply of stomach acid (6, 7).
H Pylori and Acid Reflux:
H.Pylori is a very sophisticated microorganism that has incredible adaptive advantages that give it the ability to survive the stomach’s harsh environment. It produces an enzyme called “urease” which breaks down the urea in the stomach into carbon dioxide and ammonia. This causes belching and halitosis (bad breath) for the individual and it neutralizes the acidifying effects of hydrochloric acid (8).
Hydrochloric acid (HCL) is necessary for creating an acidic environment in the stomach to digest protein and ionize minerals. This also helps to stimulate bile release from the gallbladder to effectively metabolize fat in the small intestine. When the body is unable to secrete enough HCL, we have poor protein and fat digestion and may develop key nutrient deficiencies.
H Pylori disrupts the digestive process so it can lead to inflammation throughout the gut and gastrointestinal permeability. This state of leaky gut can also cause iron-deficient anemia, irritable bowel symptoms with fluctuating diarrhea and constipation and ulcerative colitis. By damaging the gut lining, we also develop an increased risk for anemia, thyroid problems, osteoporosis & auto-immunity (9).
Good Digestion Begins in the Stomach:
Hydrochloric acid is necessary for creating an acidic environment in the stomach to digest protein and ionize minerals. This also helps to stimulate bile release from the gallbladder to effectively metabolize fat in the small intestine. Without these key functions working optimally we become at risk for anemia, thyroid problems, osteoporosis and auto-immunity (10,11,12).
Low stomach acid in a very common problem especially in older individuals or those who have suffered from various infections like H Pylori, been on anti-biotics and other medications like non-steroidal anti-inflammatories (13, 14, 15). Low stomach acid sets the stage for damage to the delicate lining of the digestive tract and the formation of leaky gut syndrome.
The Importance of Healthy Stomach Acid:
When you have low stomach acid you are unable to effectively breakdown protein in the stomach. This allows very large proteins to get into the small intestine and creates major stress on the pancreas to produce enough enzymes to metabolize the proteins.
This ultimately wears out the pancreatic enzyme stores and creates stress and irritation throughout the gut. It also leads to insufficient absorption and utilization of key amino acids that make up the protein molecules (16)
Large proteins and incomplete digestion can cause leaky gut syndrome and trigger auto-immune activity in different regions of the body. Improper protein digestion also leads to small intestinal bacterial overgrowth, fuels candida, fungal and other parasites. It also creates an acidic blood stream and depletes minerals throughout the body. Mineral depletion leads to the inability to form stomach acid and the vicious cycle continues.
The Baking Soda Stomach Acid Test
This unique test involves drinking baking soda and creating a chemical reaction within your stomach between the baking soda (sodium bicarbonate) and the hydrochloric acid (HCL). This normally results in carbon dioxide gas production which leads to burping. Ingesting baking soda has been a natural remedy for upset stomachs for centuries.
This test costs you about $3 if you need to buy a new box of baking soda, so there is not much to lose. I advise this test because of its safety and low cost and you could easily do it tomorrow.
But, there are problems with this test. Overall, there are a lot of variables to control. Trying to minimize all the variables can be tough and I would recommend performing the test 3 consecutive mornings to find an average. By doing this, you’re looking for more of a pattern than a onetime test of “yes” or “no.” Also, to increase accuracy of the test, you must do it as soon as you wake up in the morning before putting anything in your mouth.
There are no scientific studies proving this method as either reliable or unreliable. The results of this test can vary widely and it’s up to your interpretation, both of which are not ideal. Here is how to do the test:
- Mix 1/4 teaspoon of baking soda in 4-6 ounces of cold water first thing in the morning before eating or drinking anything.
- Drink the baking soda solution.
- Time how long it takes you to belch. Time up to five minutes.
If you have not belched within five minutes stop timing.
In theory, if your stomach is producing adequate amounts of stomach acid you’ll likely belch within two to three minutes. Early and repeated belching may be due to excessive stomach acid (but don’t confuse these burps with small little burps from swallowing air when drinking the solution). Any belching after 3 minutes indicates a low acid level.
An anti-inflammatory lifestyle incorporates a diet rich in phytonutrient dense vegetables, healthy fat and clean protein sources. Healthy fat sources include coconut products, avocados, olive oil, & purified omega-3 fish oil supplements.
Healthy protein includes wild-caught fish, grass-fed red meat and free range poultry and eggs. Anti-inflammatory herbs such as turmeric, cinnamon, ginger, oregano & garlic are also powerful aids. Non-processed pink salts, sea vegetables, sea algae and cereal grasses should be used regularly to provide an abundance of critical trace minerals.
Individuals should avoid eating excessively large meals. Food should be eaten at least 2 hours before bed to allow gravity to push food through the system. Digestive enzymes and probiotics are particularly helpful at enhancing the digestive process.
Raw apple cider vinegar with the fermented mother intact is rich in acetic acid, digestive enzymes and good bacteria. 2 tsp of raw apple cider vinegar in water before a high protein meal is particularly helpful at improving stomach acid levels to prepare for digestion. It is also helpful to use apple cider vinegar to marinate meat, as a salad dressing and on grains such as rice.
10 Steps to Beat Acid Reflux Naturally:
1. Use an Anti-Inflammatory Nutrition Plan: Most people notice a reduction in acid reflux symptoms when they take out the most common inflammatory foods from their diet. This would include eliminating gluten, pasteurized dairy, soy, peanuts, corn and refined vegetable oils. Instead, consume a healing diet that is low in carbohydrates and high in healthy fats as described in this article.
2. Don’t Eat Late at Night: Finish your last meal at least 2-3 hours before bed.
3. Use Apple Cider Vinegar: Have 1-2 tbsps of ACV in 4oz of water about 10 minutes before each large meal. Apple cider vinegar has natural acetic acid that helps to reduce the pH of the stomach environment and it also activates the vagus nerve which turns on the production of stomach acid, bile and pancreatic enzymes to digest food more effectively.
4. Only Eat 1 Solid Food Meal Daily: Drink green drinks and smoothies during the day. These are easier on the digestive system. One good quality solid food meal daily along with several protein shakes or smoothies and green drinks will help the digestive system to heal.
5. Use Digestive Enzymes: Taking a good digestive enzyme supplement to help the body to digest food more effectively and reduce stress on the entire digestive system.
6. Consume Fermented Foods Everyday: Have a few tablespoons of organic kimchi, saeurkraut, pickles, coconut milk yogurt or kefir or fermented raw, grass-fed dairy each day. The unique probiotics and enzymes within these foods help to improve your microbiome and enhance HCL production.
7. Consume Fermented Drinks & Tonics: This includes apple cider vinegar, coconut water kefir, fermented grass-fed whey and kombucha. Drink 2-4oz daily before a meal or meals to improve digestion and HCL production.
8. Use Lemon and Ginger: Make green drinks with a whole lemon or lime and ginger. Both of these have key nutrients that enhance HCL production.
9. Reduce Stress on the Digestive System: Be sure not to try to eat solid foods when you are under stress. Stress reduces the secretion of digestive juices and enzyme production. I teach people to only consume raw and liquid foods in small quantities during the stressful periods of the day. Enjoy your larger meal with healthy proteins, good fats and veggies at a more relaxed time of day (for many this is in the evening).
10. Use a Hydrochloric Acid Supplement: Improving stomach acid production is one of the biggest factors in improving someone’s health. HCl (hydrochloric acid) supports nutrient absorption and helps maintain a healthy gastric pH, which, in turn, supports healthy gastric ecology.
It is good to look for a betaine HCL product that also contains the protein degrading enzyme pepsin which is also produced within the stomach. You can find products with just those 2 ingredients or you can find products that use glutamic acid, bitter herbs like gentian root that help to stimulate stomach acid production and in some cases you will find betaine HCL combined with ox bile and pancreatic enzymes.
All can be helpful and it is a good idea to trouble shoot and see what dosage works best for you. Start small and gradually work your way up. Here is a helpful article on how to troubleshoot challenges in your digestive health.