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What you haven't been told about your heartburn

7/13/2019

 
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If you're surprised to hear that up to 1/4 of Canadians experience heartburn on a daily basis (Alimentary Pharmacology 2008), just think of the last family get together or social event you attended - did anyone pass around the TUMS, excuse themselves, complain about eating too much or show signs that their meal didn't agree with them?  Was it you? ;)

Almost everyone that I meet has some kind of digestive symptom - heartburn, bloating, gas, constipation, loose stools - but I want you to know that even though these issues are extremely common they are not normal.  Every time our body speaks to us, through symptoms, it's trying to tell us something isn't right.

Symptoms of Heartburn & GERD
  • ​burning in chest (be sure to check for other causes of this)
  • regurgitation
  • vomiting
  • dry cough
  • sore throat
  • bloating
  • feeling full right after eating
  • trouble swallowing
  • lump in throat

With the high numbers of people experiencing these symptoms, Pantoprazole, a medication meant to reduce acid levels in the stomach and help with symptoms of GERD (gastric esophageal reflux disease), was the 5th most commonly prescribed medication in 2011 (Canadian Family Physician 2017), and that's not including the other medications that could be prescribed like ranitidine, esomeprazole (Nexium), or over the counter medications - which are probably the most common way people treat their heartburn.  The recommended course of treatment for a medication like this is a 4 week protocol, but the reality is that I see a lot of people continuing to take antacids for YEARS at a time, way longer than their intended use.

The problem with prolonged use of antacid type medications is that they impair digestion and nutrient absorption (especially magnesium and B12)  in the long run. You could have loose stools or an increased risk of hip fractures.  They also increase your risk of infections (C. difficile and H. Pylori).  You see, the stomach works best at a pH of about 2-3.  At this level of acid, enzymes can break down proteins and intrinsic factor can bind vitamin B12.  With insufficient acid levels (as what occurs when taking an antacid) bacteria, viruses and parasites can escape the environment unscathed and take up residence in your body.  Not good.  

Of course, the damage caused by acid to the esophagus is important to avoid - uncontrolled GERD causes cellular changes that increase the risk of esophageal cancer so it's a very bad idea not to deal with your reflux.  What I'm saying though, is that there is another way to manage heartburn in a way that allows your body to actually prevent and heal from it altogether.

Your body will be well when given the right tools.  The problem is that we don't listen to the signs of struggle, and if we do, we don't know what to do besides use band-aids.

The first thing to consider when it comes to digestive issues is to eliminate the triggers, and this is something you may have heard of before.  If triggers aren't dealt with, you will be fighting an uphill battle.

Common Heartburn Triggers
  • alcohol
  • caffeine
  • tomatoes
  • citrus fruits
  • food sensitivities (as identified by an elimination diet or IgG test - often gluten, dairy)
  • being overweight (pressure on the area)
  • structural changes (like a hiatus hernia, pregnancy)
  • smoking
  • high fat, processed foods (eg. French fries, bacon)
  • chocolate
  • peppermint
  • high carb, low fibre diets

Helpful Lifestyle Strategies
  • elevate bed 4-6 inches
  • stop eating 4 hours before bed
  • chew your food well
  • allow time to eat, try not to eat on the go
  • weight loss
  • prepare your own food - the first step of digestion is smelling and thinking about food, allowing digestive juices to be released
  • ginger (teas are great)
  • eat until you are about 80% full - often we overeat because it takes time for the "full" signal to reach the brain
These strategies are helpful while your body takes the time it needs to heal, but not all of them are the cause of your symptoms.

Mind blowing truth:  your stomach needs to be at its ideal pH in order for the lower esophageal sphincter (LES) to keep the top of the stomach closed.  Most heartburn is actually from not having enough stomach acid, not the reverse.  So in reality, taking medications that inhibit or neutralize acids will temporarily help the burning feeling, but they will not address the cause of heartburn and can actually make it worse in the long run.

Steps to Heal Your Heartburn or GERD
Once triggers have been eliminated, and structural issues like a hiatus hernia or other issues have been ruled out with diagnostic testing, it's time for the real healing to begin.  Consult your Naturopathic Doctor about which of these treatments will be best for you.
    1.  Remove triggers (see above, plus...)
          
- keep a journal of your diet and digestive symptoms in order to determine your unique triggers
          - eradicate infections (eg. H Pylori bacteria) or bacterial overgrowth
          - change up your diet - fewer carbohydrates and more vegetables, prebiotic foods
          - watch the artificial sweeteners and other chemicals - hard to digest

     2.  Support the LES (keep the top of the stomach closed) and digestive environment
          - zinc 
          - melatonin 3-6 mg at bedtime
          - digestive enzymes, often containing betaine HCL (remember, heartburn is often from not enough stomach acid...     ask for help with this)
          - bitters - herbs that stimulate digestion

    3.  Heal the tissues and replace nutrients
          
- DGL (deglycyrrhizinated licorice) - available as chewable for on-the-go relief
          - aloe vera juice
          - marshmallow root tea
          - L-Glutamine 
          - mastic gum
             (I often use a product that contains all of these in one powder or capsule)
          - Vitamin B12
          - Magnesium (the type I use depends on other patient health concerns)
          - probiotics


In a 2006 study (Journal of Pineal Research), people who took a combination of B vitamins, melatonin, betaine, and methionine had 100% resolution of GERD symptoms in 40 days.  How amazing is that?

Keep in mind that everyone has their own unique makeup so it's important to work with a professional to guide you through your best treatment plan.  If you're ready to listen to your body's messages, let the healing begin, and really understand what's going on in your body I'd love to meet with you.

Have a great day,
Dr. Christa
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    Dr. Christa Reed Kruger is a Naturopathic Doctor, health enthusiast, and loving mom with a passion for helping people to become well and stay well.

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