Welcome back to my on-going blog series on gut health! I’ve been studying it intimately for close to a year now, and with every new piece of information I’ve learned I’ve wanted to find some way to share it with you guys. If you’re not caught up yet, start with my first post, The Forgotten System, which will really open your eyes to the power of a healthy gut. Afterward, peruse my library of gut-focused posts here. Today’s topic focuses on reflux and stomach acid, and what happens when it becomes imbalanced. If you’ve ever experienced a burning sensation in your throat after eating spicy food, then you’ve already felt this imbalance. So, if you or someone you know is looking to understand their reflux, heartburn, or GERD, let this be your go-to guide. Are you ready? Let’s get started!

Reflux, Heartburn, GERD- What’s the difference?

Let’s begin with differentiating reflux, heartburn, and GERD:

#1) Reflux, or Acid Reflux, is when stomach acid flows upward into the esophagus. Normally, a reflux is meant to occur as the body’s way of getting rid of something. Think vomiting or burping. But with reflux, this isn’t always the case.
At the lower end of the esophagus is a sphincter called the lower esophageal sphincter, which either opens up in order to allow food or water to enter, or closes once those things have made it in. With Acid Reflux, the lower esophageal sphincter is opening even when there isn’t any food or water coming in, or if you’re not throwing up or burping. Because it’s now opened up, your food starts coming back. This, in a nutshell, is reflux. [1]

#2) Heartburn is a symptom of Reflux, and actually has nothingto do with your heart. Instead, it’s your esophagus’ way of telling you that something is going wrong. When your food comes back during reflux, it had already started getting broken down by the hydrochloric acid in the stomach. So, when it returns, it’s covered in this acid, which triggers the acid-sensitive nerve endings in the esophagus. As a result, you’re experiencing the burning sensation that’s associated with heartburn.

As a side note, other things can also cause heartburn. These include ulcers, which are erosions in the lining of the GI tract, along with stress, which causes what medical professionals refer to as Functional Heartburn. Heartburn is also a symptom of a condition known as gastroparesis when digestion becomes extremely slow and the stomach fails to empty as efficiently as it normally should. [2]

#3) Finally, there’s GERD, which stands for Gastroesophageal Reflux Disease. This is when reflux becomes chronic-you’re experiencing it constantly on a daily basis. Other symptoms of GERD include frequent belching, indigestion, heartburn, regurgitation, stomach upset, and trouble swallowing. The final sign and symptom of GERD is an inflamed esophagus. People with GERD often feel less pressure in their lower esophageal sphincter but are constantly experiencing Reflux. During GERD, the sphincter has no choice but to remain open and relaxed. [3]

Causes & Solutions

So what causes reflux, heartburn, and GERD? There are numerous culprits but understand that no two cases are ever the same. With each possible cause, I’ll be offering a suggestions on how to approach them. (Reminder: this is only meant to serve as general advice. If your issue is very intense or chronic then please work with a qualified medical professional!):

• Problems with the lower esophageal sphincter:

Sometimes, surgery is needed to correct this. The lower esophageal sphincter can also be weakened by a number of things, including smoking, NSAIDs (like Advil), fried processed foods, and alcohol. [4]
At least with diet, it would behoove you to replace the processed, fast foods with whole foods like vegetables, nuts and seeds, fruit, legumes, and whole grains (if tolerable and/or plant-based), and animal proteins from eggs, meat, poultry, and fish. Dairy may not be appropriate for you in regard to reflux or GERD (see below).

• Foods:

Several foods can trigger reflux and heartburn. These include carbonated beverages, mint and peppermint, citrus, tomato, chocolate, coffee, onions, and spicy foods. High-fat foods and non-fermented dairy are other known triggers. [5]
Foods that can help with reflux include oatmeal, yogurt, green vegetables, melons, and bananas. [6]  Aloe Vera, Licorice tea, Fennel, Ginger, and Chamomile are all soothing herbs for reflux. You may also consider supplementing with herbal Digestive Bitters to support healthy enzyme, bile, and acid secretion, which can help to calm and settle the stomach. With medical supervision, you can also supplement with Betaine HCL and Pepsin for healthy acid production. Be very careful when using it though, since it can actually cause more harm than good in some cases. An alternative would be 1-2 tablespoons of Apple Cider Vinegar in 8 ounces of water before meals. [7]

• Stress:

This may be what’s causing the sphincter to open up and send your food right back. Remember to eat your meals in a calm, relaxed manner. Stressful eating or anxiety during mealtimes can cause stress as well as ulcers, which in turn cause reflux. [8] (Learn to manage chronic stress here, or consider adopting a regular meditation practice.)

• Dysbiosis:

Dysbiosis, or imbalances, in the microbiome. There are three possible types of infections or overgrowths that can cause reflux: candida, SIBO, and H. Pylori. [9] If you suspect that this might be the underlying cause of your reflux, I recommend you work with a doctor to get the proper diagnosis and treatment. Avoid self-diagnosing on the internet withDr. Google. The key phrase here is to test and not guess. Otherwise, you’ll be wasting time and money!

• Tight fitting clothing:

Sometimes, the clothes you wear might be hindering your ability to digest. Clothes that are tightly fitted around your abdomen can cause enough pressure on your stomach to trigger reflux. Try wearing loose, casual clothing around meal times.

• Overeating:

Having too much food also places excess pressure on the stomach. It’s never good to over-do things, so if you’re prone to eating more than your body can handle and are experiencing symptoms, consider adjusting your portion sizes. Another thing you can do is consuming smaller meals that are spread throughout the day. [10] (Read my post on Overeating for more tips!)

• Posture:

It may sound like basic advice, but you’ll be surprised at how sloppy people can get with their posture. Remember to sit up straight and avoid slouching whenever you’re eating food. On top of that, avoid lying down after meals for 1-2 hours to allow your food enough time to digest. This also prevents it from going “back” during a reflux. (If fixing poor posture is something you struggle with, then I highly recommend you do my Postural Therapy series!)

• Too little, or too much, stomach acid:

In certain cases of reflux, the individual is dealing with an imbalance with their natural stomach acid production. They can have too little acid, or too much. While there are at-home tests you can perform yourself, the most accurate reading comes from a doctor. They’ll examine your condition through what is known as the Heidelberg Test. [11]

• Excess Weight:

As a disclaimer, this final cause is not the by all, end-all of triggers for reflux. I’m definitely not bullying anyone for their weight. However, I am going to be objective and admit that there is some research that suggests having extra weight puts excess pressure on the stomach, thereby triggering reflux. [12] So please have an open mind! Cleaning up your diet, making exercise a habit, controlling stress, and getting plenty of sleep are all sure to help you achieve a healthy weight!

Alright guys, there you have it. Another in-depth look into a common gut-related ailment. As you can see, a lot of imbalances come from our habits, so if we can strive to improve ourselves every day, the healthier we’ll be in the long run!

Sources:

[1] https://www.medicalnewstoday.com/articles/146619.php
[2] https://www.medicalnewstoday.com/articles/9151.php
[3] https://www.webmd.com/heartburn-gerd/guide/reflux-disease-gerd-1#1
[4] https://www.webmd.com/digestive-disorders/picture-of-the-esophagus#1
[5] https://www.webmd.com/heartburn-gerd/features/heartburn-foods-to-avoid#1
[6] https://www.aarp.org/health/conditions-treatments/info-2017/foods-help-acid-reflux-fd.html
[7] https://www.healthline.com/health/gerd/melatonin
[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3576549/
[9] https://www.verywellhealth.com/gerd-and-sibo-are-they-connected-1945210
[10] https://www.webmd.com/heartburn-gerd/causes-of-heartburn
[11] http://www.drhirani.com/digestion/the-heidelberg-test-for-stomach-acid/
[12] https://www.webmd.com/heartburn-gerd/features/no-heartburn-diet#1