If you experience ongoing, chronic acid reflux and indigestion or heartburn, chances are you have Gastroesophageal reflux disease (GERD).
The naturopathic approach to GERD
Conventional medicine will have believing that GERD results from high levels of stomach acid, which travels up into the oesophagus. What Doctors fail to explain is why that acid is travelling out of the stomach in the first place.
Naturopathic practitioners address the multiple causes of GERD in order to eliminate symptoms for good. Unlike conventional medicine, we see GERD resulting from an underproduction of stomach acid and lack of good bacteria in the gut. Without adequate levels of both, food is unable to be broken down in the stomach and intestines – leaving it stuck uncomfortably in your stomach to sit there for who knows how long. Eventually this produces symptoms such as:
Regurgitation
This occurs when there is not enough acid to break down the food you eat. Because of this, the acid sometimes travels up the oesophagus, leaving a burning sensation in the throat as well as a bitter taste in the mouth (this sometimes tastes like vomit).
Heartburn/ indigestion
This feels like a burning pain in your stomach that moves up to your oesophagus and throat. Sometimes it feels like there is just a big lump of food sitting in your stomach as well, which makes things uncomfortable.
Chest pain
This occurs as the acid splashes and irritates the oesophagus.
A sore throat, cough and/or horseness in your voice
All which make you sound like you’re getting a cold but are in fact caused by stomach acid seeping in and irritating the oesophagus. Asthma may also be triggered when nerves in the chest constrict your breathing tubes to prevent stomach acid from getting in.
A lot of saliva in your mouth
These symptoms could also be Water Brash, a condition linked to GERD. Basically it’s your body trying to wash the acid out of your oesophagus.
Symptoms are worsened when you lie down or bend over
Thank you gravity.
Other factors that exacerbate GERD that you may not know about
Smoking
Smoking slows digestion, and reduces stomach acid and saliva levels (which is your body’s natural defense against excess stomach acid). It also weakens the LES muscle that needs to be working to stop the acid coming up and directly inflames the oesophagus.
Being overweight
Especially around the belly. Those extra kilos put pressure on the digestive tract, creating a backflow of acid by relaxing the LES muscle. Interestingly, excess body fat may also release chemicals that interfere with the normal digestion.
Chronic stress
Many individuals have normalised the physical response to chronic stress in order to get on with their day. Stress directly impacts the nerves around your stomach, making them constrict so the food cannot travel down properly. It causes you to hold your breath, preventing the body from relaxing and allowing the food to travel thru. Lastly, stress hormones are slow the release of stomach acid and hinder the stomachs’ ability to empty itself.
Magnesium deficiency
In my experience, nearly everyone I encounter is Magnesium deficient due to stress and the poor quality of Australia soils. Magnesium is needed to relax the sphincter at the bottom of your stomach that then allows the food to travel down.
Other causal factors
- Lying down after eating
- A Helicobacter pylori infection in the stomach
- Drinking liquids throughout meals
GERD and heartburn medications are not the answer
Over-the-counter medications such as Mylanta or Quickeze, and acid-suppressing medications such proton pump inhibitors (PPIs such as Nexium) reduce stomach acidity, hence create a bigger problem. PPIs work by stopping your stomach’s acid-producing pumps thus reduces stomach acid even further. This is exactly the opposite of what you need when you are experiencing symptoms – you need MORE acid to break down the food sitting in your stomach (as described above). Reducing stomach acid also reduces your ability to absorb nutrients (particularly minerals) and ability to fight off potential food-based pathogens.
Heal GERD for good by following the three R’s
1. Eliminate factors that reduce stomach acid and promote bacterial overgrowth.
Certain foods should be avoided with GERD as they contribute to bacterial overgrowth in the gut thus suppress stomach acid production. These include:
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- Carbohydrates such as all grains, legumes and starchy vegetables like potato.
- Artificial sweeteners.
- High fructose foods including honey, apples, mango, high fructose corn syrup and agave syrup.
- Fructo-oligosacchride foods (prebiotics) such as bananas, onions, garlic, asparagus, barley, wheat and leeks.
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Other foods may also irritate the gut this trigger GERD symptoms:
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- Chilli and other spicy foods.
- Tomatoes.
- Coffee and other caffeinated beverages.
- Alcohol.
- Citrus fruit and fruit juices.
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You might also be surprised to know that Peppermint (which many people take for acid reflux in the form of tea) relaxes the upper sphincter between the stomach and oesophagus. This may in fact worsen symptoms as it provides an open path for stomach acid to travel upwards into the oesophagus.
The GAPS diet and low FODMAP diet are easy to follow and have proven popular in the treatment of GERD:
This diet offers specific carbohydrate options that do not feed the bacteria in the gut.
FODMAPs foods are specific carbohydrates that cause wind, heartburn and reflux in those suffering from SIBO (Small Intestine Bacterial Overgrowth).
2. Stimulate stomach acid and assist digestion with supplementation
As per above, GERD symptoms are caused by a lack of the stomach acid required to break down food. The short cut to finding out whether you are low on stomach acid is to take specific supplements and wait to see if your symptoms improve or not. These include:
- Betaine Hydrochloride capsules (preferably containing pepsin and/or gentian.
Betaine Hydrochloride assists digestion by providing constituents of the gastric acid, pepsin and hydrochloric acid required to break down protein. NB: This supplement should never be taken in conjunction with anti-inflammatory medications such as ibuprofen (e.g. Nurophen), aspirin, corticosteroids (e.g. prednisone).
- Digestive enzymes
Preferably containing protease, amylase, cellulose and lipase. These compounds break down and digest fats, proteins, carbohydrates and plant foods containing cellulose.
- Bitters
Bitters have been used around the world for eons to stimulate digestion. They do so by stimulating bile flow, and the production of pepsin, gastrin, HCL and pancreatic enzymes. Bitters can be shop bought and are easy to take in a small dose in 20ml of water. My preferred brand is Flordis Iberoglast, which is available at most health food stores.
Alternatively, other bitter herbs can me designed specifically for you and made into a tincture by a herbalist. Or you may like to drink bitter herbal teas instead, some of which include dandelion, fennel, gentian root, goldenseal root, hops, milk thistle, wormwood and yellow dock.
3. Heal and seal the gut
Restore the gut with beneficial gut bacteria
GERD occurs when there is a state of dysbiosis in the gut (i.e. when the bad bacteria out number the good bacteria by a lot). Thus restoring the gut with a healthy population of good bacteria is key in the healing process.
The best ways to boost your gut with healthy bacteria include:
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- Taking a practitioner-only, broad spectrum probiotic. Always on an empty stomach and preferably in a powder form to allow for bigger, more therapeutic doses.
- Eating fermented foods that are rich in good bacteria. Some of these include sauerkraut, pickles, organic miso soup, natural yogurt, kefirs and kombucha.
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Restore the damaged lining of the gut
When it comes to healing GERD, it is imperative to address the damaged mucosal lining of the gut as it protects the stomach from it’s own acid. This process involves removing dietary irritants (listed above) and again taking specific therapeutic supplements and superfoods. Some of these include:
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- L-Glutamine
- Deglycyrrhizinated licorice
- Slippery Elm bark
- Prebiotics and probiotics (as per above)
- Zinc
- Activated B Complex (particularly activated B9 & B12)
- Aloe Vera juice (always check there are no added sugars)
- Homemade bone broths
- Fermented vegetables (that provide natural probiotics)
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What if you have tried all of this and you still have GERD symptoms?
If you are leading a clean lifestyle, have followed the guidelines above yet you’re still experiencing regular GERD symptoms, a trip to reputable physician is warranted. Sometimes GERD symptoms are a mechanical issue that can only be corrected with surgery. Some of these potential issues may include:
- Hiatal hernia
- Tissue damage in the oesophagus
3 alternative quick fixes for when you’re having a reflux attack
- Take 1 teaspoon of organic sodium bicarbonate (baking soda) mixed in a fresh glass of water. NB: avoid using this remedy for more than a week straight.
- Take 20 drops of Flordis Iberoglast in a small amount of warm water.
- As much as I am not a chewing gum advocate, it does increase saliva production, which can reduce acid levels in the oesophagus. Most health food stores sell a variety of stevia-sweetened gums which should always be your first choice.