About one-third of Americans experience acid reflux at least once a month. Acid reflux is a common condition in which stomach acid flows backward up the esophagus (tube that connects the mouth to the stomach). It occurs when a ring of muscle at the bottom of the esophagus called the lower esophageal sphincter (LES) doesn’t function properly. Normally, the LES remains closed except during swallowing. But in people with acid reflux, the LES becomes weak and relaxes, allowing acid and stomach contents to flow back up the esophagus.
Symptoms of acid reflux usually last for a few hours after a meal and then go away. They include heartburn, trouble swallowing, feeling that food is stuck in the throat, and a bitter or sour taste in the mouth.
If you experience acid reflux more than twice a week, it is a more serious condition called gastroesophageal reflux disease or GERD. If left untreated, GERD can lead to problems such as inflammation of the esophagus and a precancerous condition called Barrett’s esophagus.
Mechanism Behind Acid Reflux
Normally, when you eat, the presence of food in the stomach triggers a hormone called gastrin, which controls the amount of gastric juices that are secreted. Hydrochloric acid (HCL) is one of the main components of gastric juices. For proper digestion, enough acid will be produced to lower the stomach pH to around 1.5-2.5, a very acidic condition. This kills harmful microbes, triggers the release of the protein-digesting enzyme, and allows for proper nutrient absorption.
Typically, acid reflux is believed to be caused by excessive stomach acid production. However, in 95% of the cases, the opposite is true.
Acid reflux is related to low stomach acid. When you are stressed, the body’s natural response is to suppress the digestive system which results in a decline in stomach acid production. Your body also makes less stomach acid as you get older. That’s why acid reflux is more common in the elderly than the young. When there is not enough acid, the undigested food tends to remain in the stomach longer. The longer it stays, the greater the chance of the LES relaxing and the occurrence of acid reflux.
Conventional Treatments
Since conventional doctors generally blame excessive stomach acid for acid reflux, medications for acid reflux aim to either raise the pH (reduce acidity) of the stomach, inhibit, or completely block stomach acid production.
Antacids
These over-the-counter (OTC) drugs (Alka-Seltzer, Maalox, Mylanta, Rolaids, Tums) use different combinations of either magnesium, calcium, or aluminum and hydroxide or bicarbonate ions to help neutralize stomach acid (reduce acidity) and temporarily relieve symptoms.
H2 blockers
Available both OTC and by prescription, these drugs (Tagamet, Pepcid, Zantac, Axid) provide short-term relief by suppressing production of stomach acid.
Proton Pump Inhibitors (PPI)
Available by prescription, these drugs (Nexium, Prevacid, Prilosec, Protonix,) completely shut off the proton pumps in the stomach that produce stomach acid.
Why Acid Reflux Drugs Do More Harm Than Good
Without doubt, these drugs can provide short-term relief. When you neutralize or inhibit the stomach acid, you take care of the acid reflux temporarily as there is no more acid to cause problem. However, these drugs merely mask the symptoms and do not address the underlying cause of your problem. Why do you have acid reflux in the first place?
- When you block all your stomach acid, how can you digest your foods properly and absorb the nutrients your body needs? Long-term use of acid reflux drugs can lead to vitamin and mineral deficiencies, such as vitamin B12, calcium, and magnesium. A deficiency in B12 can lead to depression, anemia, fatigue, nerve damage, and even dementia in the elderly. A deficiency in calcium and magnesium can raise the risk of osteoporosis and hip fractures.
- When your stomach is not as acidic as it should be, you are creating an environment for bacteria and viruses to grow. Chronically low levels of stomach acid expose you to increased risks of food poisoning, ulcers (caused by a common bacteria called Helicobacter pylori), pneumonia, as well as a dangerous bacterial infection called Clostridium difficile. It may lead to a low-grade overgrowth of harmful small intestinal bacteria that causes irritable bowel syndrome and symptoms like bloating, gas, abdominal pain, and diarrhea.
- PPI can lead to acid rebound with symptoms returning with a vengeance when drug use is abruptly discontinued.
Therefore, if you suffer from acid reflux, you need to be aware of the deficiency of the conventional treatment prescribed by many doctors. While it is relatively benign to use these drugs to relieve an episode of acid reflux, it would be foolish to assume that your problem has been resolved. If you do not address the root cause and merely use the drugs to mask your symptoms, you may end up facing additional and potentially more serious health complications.
Factors Influencing Acid Reflux
- Stress
- Being overweight, extra pounds put pressure on the LES
- Pregnancy
- Hiatal hernia, a condition in which the top of your stomach protrudes above the diaphragm muscle in your chest. Diagnosed by chest x-ray.
- Smoking
- Alcohol and caffeine consumption
- Dehydration
- Eating too large a meal
- Eating too fast, inadequate chewing
- Eating too close to bedtime
- Certain OTC and prescription drugs
- Fatty, fried, and spicy foods
- Dairy products, soda, tomato-based foods, citrus fruits, chocolate, mint, garlic, and onions.
How To Permanently Overcome Acid Reflux
- First and foremost, eliminate the bugs if you have them. Check for Helicobacter pylori, yeast, or other bacterial overgrowth. Please contact a healthcare professional or me if you need to have these tests done.
- Eliminate food triggers. Check for food sensitivities, celiac disease, or gluten intolerance.
- Re-inoculate the gut with healthy bacteria by using a high quality probiotic supplement.
- Take digestive enzymes with each meal.
- Take a hydrochloric acid (HCL) supplement with each meal. You want to take as many as you need to get the slightest burning sensation and then decrease by one capsule. If you have Helicobacter pylori, you need to get rid of it before supplementing with HCL.
- Stay standing up or sitting up for three hours after a meal. Acid reflux is very unlikely to occur in the standing or sitting position. After three hours, it should be safe to go to bed. Make sure your head and shoulders are elevated.
- Eliminate sugar, processed, and junk foods from your diet. Instead, focus on high quality, organic meats and vegetables.
- Optimize your vitamin D levels to boost immunity. Ideally, it should be between 50-80 ng/dl.
- Exercise regularly.
- Last but not least, engage in daily stress reduction and relaxation practices. Remember, stress reduces stomach acid production. Undigested food stays in the stomach longer, increasing the chance of the LES relaxing and the occurrence of acid reflux.