At first, let’s clear one common misconception about acid reflux: acid reflux is not necessarily that you have too much gastric acid but rather acid is in the wrong place. The majority of people suffering from acid reflux have rather hypochlorhydria (lack of or too little stomach acid) than hyperchlorhydria (too much stomach acid).
Acid reflux is a common gastrointestinal complain with symptomology of heartburn, a burning pain in the lower chest. It’s driven by stomach acid flowing back up to the esophagus (the food pipe). It can happen for example when increased intra-abdominal pressure overpowers the lower esophageal sphincter (LES, a ring muscle), as seen in people with hiatal hernia or obesity. The esophageal sphincter acts as a valve preventing stomach acid, stomach content from backing up into esophagus. When this system fails we may experience the symptoms of acid reflux. Noteworthy, reflux of gastric contents into the esophagus is normal physiology. However, when reflux (occurring frequently) leads to symptoms, esophageal mucosal injury, or both we talk about gastroesophageal reflux disease (GERD).
Heartburn is a common symptom and some patients perceive this as angina-like chest pain. Functional heartburn has the same symptoms without signs of reflux. Some people experience regurgitation which is a rise of gastric content into the mouth with sour/bitter tasting, without associated nausea or retching. Other symptoms of reflux may include hoarseness, cough, and asthma as well as pharyngitis, sinusitis, pulmonary fibrosis, recurrent otitis media, and sleep apnea. Some individuals will also experience bloating, burping, difficulty swallowing, hiccups, or nausea.
Interpret these symptoms as your body sending you signals that there is something going on. Do not “treat” them with anti-acids and over-the-counter drugs (H2 blockers, aginate drugs, or proton pomp inhibitors), it may help relieving the symptoms however will not address the underlying cause.
How to fix acid reflux?
At first try to find the underlying cause. Sometimes your own detective work will be enough and sometimes you may need testing to find out what’s behind it. One of the most effective ways to reduce acid reflux is to invest in healthy eating habits. If your diet is based on fast foods, just change it and start eating real foods. If you are overweight, start working on losing extra weight, a professional or a supportive community will help you in achieving this goal. Common drugs used for acid reflux do not treat this condition, they just manage the symptoms.
- Eat healthy foods. If you want your digestive system to heal, a healthy diet is a must. Make your own meals by using fresh, real foods and by skipping processed foods. Go back in thinking about cooking before the convenient foods existed, what would you eat them? Home-made soup or the instant powder soup? There is a difference not only in taste, but also in nutrient vs crap content. Reduce consumption of grains (especially refined and especially wheat), sugar, and refined oils. Also avoid CRAP: processed foods, alcohol, sodas, artificial sweeteners, fried foods, spicy foods, and in addition chocolate and coffee.
- Have on your menu bone broths, healthy fats (avocado, coconut oil, olive oil), vegetables (green leafy vegetables, cucumbers, asparagus, artichokes), fermented foods and drinks (pickles, sauerkraut, kombucha, kefir, yogurt, kombucha), wild fish (salmon, sardines), meat (grass-fed beef, free range chicken), healthy starches (squash, sweet potato, red beet), nuts (almonds), parsley, ginger, fennel, apple cider, aloe vera, and raw honey for some sweetness. Eat simple and healthy meals consisting of real foods, it will help your digestive system to do its job – to digest. Replace pasta, rice, bread partly or entirely with vegetables.
- Drinking chamomile or ginger tea, or cabbage juice may help to relive acid reflux symptoms.
- Avoid large meals. Don’t overeat. Don’t eat 2-4 hours before going to bed, especially heavy to digest meals.
- Use adequate hydration. Some people experience that as little effort as increasing their daily water intake can resolve acid reflux. Try it out!
- Improve gastric acidity. Eat bitters, bitter foods and herbs to promote gastric acid production and digestion.
- Chew your food well and eat slowly. Eat in a relaxed environment, eat mindfully without rushing. Take the time to chew your food properly (20-30 times before swallowing).
- Take right supplements. Consider taking digestive enzymes, HCL with pepsin, probiotics, magnesium, zinc, or apple cider vinegar. Try slippery elm bark tea or chew on the bark, it has been used for generations to relief acid reflux.
- Be active by enjoy moderate exercise, something you like doing.
- Sleep with your head and upper body slightly elevated.
- Consider stress management activities such as yoga, psychological therapy, relaxation, exercise, mindfulness if you feel like stress is overtaking your life.
- Consider chiropractic adjustment, osteopathic care or acupuncture.
What can hide behind acid reflux symptoms?
- Eating unhealthy. Eating too much. Typical western diet rich in simple carbohydrates (sugars and starch), processed foods, and little vegetables promotes dysfunction of the digestive system and as a consequence acid reflux may occur. If you suffer from acid reflux, portion matters – do not over eat and stop eating before you are full.
- Obesity. Obesity is commonly associated with acid reflux and GERD. The access weight can put extra pressure on the valves and sphincter causing stomach acid release.
- Hiatal hernia. Hiatal hernia is an abdominal abnormality observed when the upper part of the stomach and lower esophageal sphincter (LES) move above the diaphragm. In this scenario, acid can move up into the esophagus causing acid reflux symptoms. The diaphragm is a muscle helping to keep gastric acid in our stomach. Consider osteopathic or chiropractic care.
- Overtraining. High impact exercises and overtraining can put extra pressure on your abdomen triggering acid reflux.
- Wearing tight-fitting clothes, lying down, bending over.
- Smoking cigarettes. Smoking increases acid production therefore avoid it if you suffer from GERD or acid reflux.
- Certain medications and supplements such as antibiotics, muscle relaxers, blood pressure drugs, ibuprofen, potassium and iron supplements can affect the functioning of the digestive system and cause acid reflux.
- Helicobacter pylori gastric infection. Infection with H. pylori can manifest itself with heartburn. If you suspect it may play a role in your complaints, get yourself tested.
- Low magnesium. Low magnesium can influence muscle tension and impair the function of the esophageal sphincter by not retaining the acid in the gastric cavity.
- Chronic cough, stress, sensitivities to gluten or other foods can also contribute to acid reflux.
- Digestive issues. Think of reduced saliva causing decreased digestive buffering, poor digestive esophageal motor function causing reduced food clearance, poor gastric emptying causing increased refluxate.
- Aging and underdeveloped GI tract as by babies may also promote acid reflux/GERD because digestive tract does not work optimally.
- Pregnancy. During the pregnancy growing fetus can put extra pressure on the esophageal valve and this may promote the release of gastric acid and symptoms of heartburn.
If your symptoms do not subside after adapting your eating habits and lifestyle, please seek medical help to properly evaluate the underlying cause. Long-term acid reflux (GERD) can lead to Barrett’s esophagus, manifested as esophageal scarring and constriction which leads to swallowing disorders.