You eat a meal, maybe even drink some soda along with it and about an hour later, you’re in pain. The burning, can’t-get-away from it feeling has hit you and hit you hard. Naturally, you think, you have way too much stomach acid and now it is time to take some Tums. Case closed, problem solved.
As it turns out, 44% of Americans have heartburn monthly, 10-20% have it weekly and 10% suffer from it daily. Not surprisingly, PPI’s (Proton-pump Inhibitors) generate the third-highest sales of all drugs sold worldwide. At one point, PPI’s were only be used for 8-12 weeks, but now, sometimes people are left on them indefinitely. (They even give them to babies and kids! Another blog post for another day…)
But, what if those suffering didn’t have too much stomach acid, but instead too little?
As it turns out, it is incredibly rare to have too much stomach acid. It takes a lot of resources to make sufficient stomach acid, let alone, more than enough. But, if that stomach acid goes somewhere it shouldn’t…well, it burns. The stomach has the potential to reach an acidity level of 1.5-3 and there is no other location in the body, whatsoever, that likes that acidity. So, anytime the chyme (the food now mixed with your gastric juices) goes into the esophagus where it isn’t supposed to, it is going to burn. But, think about this for a moment, why would your food go back up? The body is intelligent, and does use gravity to its benefit. The food should ONLY go down.
When digestion is working well, the food hits the stomach and the gastric juices are released. These gastric juices have a couple of important jobs. First, they must sterilize the food. This is your first line of defense against any outside pathogen. Second, they break down the food, particularly proteins, into a fine paste to prepare it for travel through the intestines. Third, the gastric juices help break down certain minerals to make them more absorbable, including calcium, magnesium, zinc and iron. The high acidity level of the stomach is actually really necessary and even desirable.
The high acidity level actually triggers the body to move the chyme south. Not north.
Once the food has been thoroughly mixed with the gastric juices and reaches a specific acidity level, the pyloric sphincter opens and the food travels down into the duodenum, the first part of the small intestine. So, how do you end up with food and burning in the esophagus?
If the chyme in the stomach never reaches its appropriate acidity level, then the chyme doesn’t get triggered to move south.
Think about it this way, do you have an overstuffed closet in your house? Overstuffed drawer? Can you close the drawer or closet doors? That might be very simplified, but you get the idea. When your stomach isn’t triggered to release food down into the duodenum at regular intervals, the food needs to go somewhere. When this happens the lower esophageal sphincter can malfunction and allow food to go back up. Ouch!
But, too much food in the stomach isn’t the only reason the esophageal sphincter can malfunction and allow for acid reflux. Here are some other possibilities to rule out:
- High Stress – When your body is under high amounts of stress, digestion, frankly, gets put on the back burner. To your body, stress is life or death, regardless of what the actual stressor is. The body responds to the stressor by ‘turning off’ certain functions to focus its energy on handling the stressor. Digestion, in these situations is not a critical need to immediate survival and therefore your body produces minimal gastric juices for digestion.
- Food Allergies/Sensitivities – Dairy, gluten and eggs are big culprits here. When we continue to eat foods that our body is not happy about it, they become stressors on our body and then lead us back to point 1. Doing an elimination challenge for a month to see how your body responds is the simplest and most economical way to determine if this is the case for you.
- Sugar – Sugar is a stomach irritant, so anytime you are struggling with a digestive issue, the sugar needs to be eliminated to allow your stomach time to heal. Soda also depletes stomach acid, even if it is ‘sugar free’ so it should also be eliminated.
- High carb/High Processed Food Diet – The gastric juices in the stomach produces are produced under a feedback loop system. Proteins require gastric juices and a high acidity level to break them down appropriately, when you eat high carbs and high processed foods, your body begins to make less and less stomach acid.
- Hard Alcohol and Caffeine– Both hard alcohol and caffeine can relax the esophageal sphincter and allow food to travel north, so if this is something you struggle with, I’d eliminate these two for a trial period.
- Pathogens – We all have a variety of gut bugs living inside us, some more favorable than others. When given the chance the more nasty bugs can proliferate and cause havoc. H. Pylori is one of those bugs that in a healthy digestive system creates no problems, but in a weak one, it can dominate the landscape and lead to acid reflux. (But, please note, H. Pylori isn’t the problem itself! You still need to figure out why your digestive system allowed for it to proliferate.)
- Hiatal Hernia – A Hiatal Hernia is when the stomach gets pushed through the diaphragm and into the thoracic cavity. Not super comfortable. Sometimes these are asymptomatic, but the most common symptom is acid reflux. The solution is a quick trip to your chiropractor. Often just one adjustment is needed. A simple fix that is very worth checking out.
Like many digestive issues, there are many avenues to rule out to figure out why you are struggling. There may be a time and a place for very short-term use of a PPI, but it doesn’t resolve why you are struggling with heartburn. Chronic Heartburn, left unchecked can lead to bigger problems down the road to include leaky gut, candida or another gut imbalance, malabsorption of nutrients which can lead to brittle bones, imbalanced brain chemistry and so much more. It is worth it to take the time to get to the root cause of why you are having heartburn.
If you’ve struggled with heartburn, what have you found to help you resolve it?
Wright, J.V., Lenard, L. (2001). Why Stomach Acid is Good For You. Maryland: M. Evans.
Lipski, E. (2012) Digestive Wellness 4th Edition. McGraw-Hill.