Heartburn, acid reflux and GERD

Heartburn, acid reflux and GERD often go hand-in-hand with autoimmune and other inflammatory conditions. If you suffer from these painful disorders, I have great news for you. You can heal these conditions easily and permanently. Even if you take antacids or proton pump inhibitors, you can wean yourself off of your medication and prevent recurring painful and destructive symptoms by eliminating the root causes of your condition.

Many people think that heartburn, acid reflux and GERD are caused by excess stomach acid. It appears the opposite is true. Many medical experts now believe these conditions are caused by low stomach acid (a condition called hypochlorhydria), and typically accompany other conditions such as leaky gut, gluten intolerance, high carbohydrate diets and/or bacterial overgrowth in the intestines.

You might wonder how low stomach acid could cause that terrible burning sensation in your chest. The gateway to the stomach is the lower esophageal sphincter (LES). When it’s working properly, it keeps stomach acid in your stomach where it belongs, and out of your esophagus where it burns. If the LES becomes loose, weak or subject to abdominal pressure, it allows acid (even low acid) and undigested food to escape the stomach and burn the esophagus.

A class of drugs called proton pump inhibitors (PPIs) such as omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix) and esomeprazole (Nexium) are designed to protect the lining of the esophagus by significantly reducing stomach acid. But reducing stomach acid comes with its own risks:

• Stomach acid kills potentially harmful bacteria in our food and helps to break down large proteins that might later be absorbed into the blood through the GI tract.

• Low stomach acid retards the absorption of certain nutrients like B vitamins (particularly B12), folic acid, calcium, iron and zinc.

• Low stomach acid interferes with iron absorption and can cause iron deficiency anemia and low ferritin (iron reserve protein). Low ferritin is associated with hair loss.

• Low stomach acid can cause vitamin B12 deficiency related anemia.

• Studies have shown that people with low stomach acid absorb less thyroid hormone.1

Many people are unaware that PPI’s are designed for short-term therapy. For example, the directions for one popular brand reads: “Use as directed for 14 days to treat frequent heartburn. Do not take for more than 14 days or more often than every 4 months unless directed by a doctor.” Sadly, many people live on these medications for years, which put them at risk for dysbiosis, nutrient deficiencies, osteoporosis and bone fractures.

One study demonstrated that people taking PPIs, even those who didn’t suffer from heartburn or GERD to begin with, developed symptoms after they were given PPIs for two months and then suddenly stopped.2 In other words, PPIs create dependency and can give you heartburn, even if you didn’t have it before!

Self-Healing Program for GERD

You can heal your heartburn, acid reflux and GERD problems, and help reverse your autoimmune condition at the same time, by eliminating the foods that cause the problem in the first place. I have found that the easiest way to accomplish this is by following the “Eating for Your Good Genes” and “Sensitivity Discovery Program” for 30 to 90 days. In fact, every single one of my clients who suffered from heartburn, acid reflux or GERD noticed an immediate (typically within one week) improvement in their symptoms, once they cut out irritating substances, grains and starchy carbs, and began eating healing foods!

More good news! Excess body weight often makes GERD symptoms worse. Some people only experience GERD above a certain body weight.Eating the right foods will help you lose weight and reverse GERD at the same time!

Things to avoid if you have heartburn, acid reflux or GERD:

• Stressful situations – Never eat when you’re rushed or stressed

• Grains (especially gluten) and starchy carbs

• Coffee and caffeinated beverages

• Alcohol (including beer and wine)

• Fried and processed foods

• Chocolate

• Citrus fruits and juices

• Tomatoes

• Carbonated drinks

• Fructose

• Artificial sweeteners

• Anything that triggers your symptoms, for instance, some people have trouble with spicy foods, certain meats, fried foods and mint.

• Poor food combinations such as fruit and meat together

Things to include:

• Peaceful environments – especially when eating!

• Non-starchy veggies

• Healing fats – especially coconut oil

• DGL – Deglycyrrhized licorice

• Aloe

• Zinc

You can follow my GI self-healing program like everyone else but avoid:

• Prebiotics

• Soluble fiber

While I have found betaine HCL with pepsin is beneficial for most people, I don’t suggest it for those suffering from GERD who take PPIs or other acid-blocking medications. They simply negate each other. Betaine HCL with pepsin therapy may be added once your GERD is under control, and you have weaned yourself off of acid-blockers. Begin with one capsule, and increase to two if you can tolerate that dose without developing a warm or burning sensation in your stomach. If you still experience burping, bloating and gas after taking two capsules for a while, you may consider upping your dose if you can do so without the burning sensation.

Caution! Betaine HCL with pepsin should NEVER be taken along with NSAIDs like ibuprofen, aspirin or corticosteroids like prednisone. These medications can irritate and even damage the delicate lining of the GI tract. Adding betaine HCL to these medications can put you at risk for gastric bleeding or an ulcer.

During the healing process you can benefit from supplementation with zinc, digestive enzymes and probiotics. Taking enzymes with meals assists in breaking down foods so the body can absorb nutrients. Probiotics restore the balance of good bugs in your GI, thus eliminating the problems caused by (bad) bacterial overgrowth. See my recommendations for good probiotics and digestive enzyme supplements in this chapter under the heading “Supplements to Heal your Gut.”

Traditional remedies that I’ve also found helpful are apple cider vinegar, lemon juice or tinctures of bitter herbs, 15-20 minutes before a meal. Avoid drinking a lot of fluids with meals as this dilutes the stomach acid. Hydration is important but is best between meals.

Homemade bone broth soup helps restore the mucosal lining of the stomach. Bone broth contains short peptides called glyprolines that protect the lining of the stomach and help heal ulcers.3 The glutamine in bone broth fuels and protects the cells of the intestinal lining.4 Bone broth also contains plentiful minerals and other healthful constituents. I have found this to be the top GI healing food. An extra bonus is that your hair and nails will grow in thick and strong!

Deglycyrrhizinated licorice (DGL) helps protect from the damage caused by NSAIDs like aspirin and ibuprofen and is also effective at healing ulcers without reducing stomach acid.5 You take one to three 380-400 mg tablets of DGL 20-30 minutes before a meal. Ginger is another great digestive aid. It contains an enzyme called zingibain, which digests protein, and stimulates the activity of other enzymes like lipase.

GERD and the Stress Connection

Stress affects more that just your mind. In fact, studies have documented the link between stress and heartburn, acid reflux and GERD.6 The research shows that stress, particularly prolonged intense stress, make the symptoms of these uncomfortable disorders worse. The scientists were surprised by one of their findings; even though stressed-out people experienced a worsening of their symptoms, their stomach acid wasn’t any stronger.7

The researchers speculated that stress makes low-level symptoms feel much worse; in other words, everything feels worse when you are stressed out! While that is certainly true, I think this finding reinforces the alternative view that GERD is not caused by excess strong stomach acid. The studies also show that exhaustion, which is certainly a common form of stress, also makes these conditions worse.8

It’s easy to connect stress with heartburn, acid reflux and GERD, in fact many of us feel a pit in our stomach when we’re stressed out. Adding insult to injury, stress often inspires unhealthy coping mechanisms such as the overuse of over-the-counter painkillers, alcohol and smoking, which contribute to the development of ulcers, GERD and other GI conditions.

In Chapter 15, of The Thyroid Cure I review some techniques to help reduce stress. But just as a reminder, try to reduce the stress in your life and avoid eating when you are stressed-out or rushed. You can improve your digestion by chewing your food thoroughly. Gobbling your food down can trigger an acid reflux attack. Chewing your food well assists the digestive process by mixing your saliva with the food and breaking it down into smaller pieces. Not only that, eating slower gives you time to enjoy your food and gives your body a chance to recognize that you’ve had enough to eat.

The key to healing heartburn, acid reflux and GERD is eating the right foods and eliminating the foods that cause inflammation and bacterial overgrowth. Seriously, if you eat well for long enough, you WILL get better. The body is funny that way. If you give the body what it needs, it will bounce back from just about anything. It is a mistake to ignore the body’s natural ability to heal itself.

References:

1. Centanni M, Gargano L, Canettieri G, et al. Thyroxine in goiter, Helicobacter pylori infection, and chronic gastritis. N Engl J Med. 2006;354(17):1787–1795.  http://www.ncbi.nlm.nih.gov/pubmed/16641395
2. Reimer C, Søndergaard B, Hilsted L, Bytzer P. Proton-Pump Inhibitor Therapy Induces Acid-Related Symptoms in Healthy Volunteers After Withdrawal of Therapy. Gastroenterology 1 July 2009 vol. 137 issue 1 Pages 80-87.  http://www.gastrojournal.org/article/S0016-5085(09)00522-8/fulltext
3. Medical News Today Online. Gelatin Treats Ulcers. August 2006 http://www.medicalnewstoday.com/releases/50126.php
4. Hering NA, Schulzke JD. Therapeutic options to modulate barrier defects in inflammatory bowel disease. Dig Dis. 2009;27:450–454. http://www.ncbi.nlm.nih.gov/pubmed/19897959
5. Russell RI, Morgan RJ, Nelson LM. Studies on the protective effect of deglycyrrhinised liquorice against aspirin (ASA) and ASA plus bile acid-induced gastric mucosal damage, and ASA absorption in rats. Scand J Gastroenterol Suppl. 1984;92:97-100. http://www.ncbi.nlm.nih.gov/pubmed/6588541
6. Naliboff B, Mayer M, Fass R, et al. The Effect of Stress on Symptoms of Heartburn. Psychosomatic Medicine May 1, 2004 vol. 66 no. 3 426-434 http://www.psychosomaticmedicine.org/content/66/3/426.full
7. Bradley LA, Richter JE, Pulliam TJ, et al. The relationship between stress and symptoms of gastroesophageal reflux: the influence of psychological factors. Am J Gastroenterol 1993; 88:11-19. http://www.ncbi.nlm.nih.gov/pubmed/8420248
8. Naliboff B, Mayer M, Fass R, et al. The Effect of Stress on Symptoms of Heartburn. Psychosomatic Medicine May 1, 2004 vol. 66 no. 3 426-434 http://www.psychosomaticmedicine.org/content/66/3/426.full

Michelle Corey, C.N.W.C., FMC, is a Wellness Recovery Specialist, Certified Nutrition and Wellness Consultant, researcher and author. Michelle studied holistic nutrition at Clayton College of Natural Health and completed a comprehensive 2-year practical program at Academy of Functional Medicine and Genomics. Since reversing her autoimmune condition, Michelle has helped hundreds of people reverse autoimmune and other chronic conditions. She is currently an advisor to the Academy of Functional Medicine and Genomics and the Functional Medical University. She is a member of the Institute of Functional Medicine and the National Association of Healthcare Advocacy Consultants. Michelle and offers Functional Mind-Body healing retreats, workshops and online courses.