Heartburn is one of the most commonly reported symptoms, affecting 60 million people at least once per month and about 15 million people daily. The burning sensation in the chest that often accompanies heartburn is caused by acid traveling up the esophagus. This problem is often treated with medications that neutralize stomach acid, but what if the real root cause of heartburn isn’t high stomach acid?
Functional medicine can help identify the true cause of gastroesophageal reflux disease (GERD) and provide solutions to improve stomach acid levels. Diet and lifestyle changes are an important part of functional medicine treatment for GERD, and can help or eliminate symptoms for many people.
In the public and the media, the notion that heartburn is brought on by high stomach acid is still prevalent, but there are thousands of articles in scientific literature that show that GERD and heartburn are not caused by high stomach acid.
While conventional medicine directs the public to focus on lowering gastric acid secretions to “cure” acid reflux, this approach neglects to acknowledge that heartburn and GERD tend to increase with age, while stomach acid levels generally decrease. If stomach acid levels decrease with age, but the incidence of heartburn goes up, it stands to reason that something other than high stomach acid is to blame for acid reflux and GERD.
The Root Cause of GERD
The root cause of GERD is actually the malfunction of the lower esophageal sphincter (LES). This is the valve that connects the esophagus to the stomach. We have established that ANY amount of acid making its way up to the esophagus is bad. Unlike the stomach, the lining of the esophagus has no protection against acid. If the LES is working properly, it keeps acid in the stomach and out of the esophagus so digestion can proceed as normal. But, if the doorway (the LES) that separates the stomach from the sensitive esophagus is malfunctioning, acid from the stomach gets back into the esophagus and damages its delicate lining.
I am a visual learner, so here is something I was taught by one of my colleagues long ago about how our bodies work. When we eat, food enters the mouth and once you begin swallowing, the food enters the esophagus (the muscular tube that carries food and liquid from your throat to your stomach). There is a muscular valve that opens and closes, connecting the esophagus to the stomach. There is another valve at the bottom of the stomach, the pyloric sphincter, that connects the stomach to the small intestine. These two “doorways”, or valves, are very important in gut health.
Why Stomach Acid Levels Matter
I am going to make an analogy that your stomach is like an oven. When food enters the stomach, your stomach acid heats it up. This heat slams the doorway (the LES) closed. If there isn’t enough stomach acid or if the “oven” doesn’t get hot enough, the valves don’t close. If the valve at the top doesn’t close, the acid leaks upward to the esophagus and gives us that heartburn feeling. If the lower valve remains open, bacteria can leak into the small intestine. If the stomach acid is decreased, the overall pH of the stomach rises, and bacteria begin to proliferate.
In the spirit of making analogies, let’s pretend that the small intestine is like the kitchen. You can imagine that it cannot be good to have bacteria leaking into the “kitchen,” because this is where our body absorbs most of the nutrients from the food we eat and passes them on to other parts of the body to store or utilize the nutrients. Once the small intestine is done with the food, it then arrives in the large intestine (or what we can call the “garbage”), where the waste is removed by way of a bowel movement. The importance of these doorways depends mostly on the amount of stomach acid we produce.
Natural Approach to Relieving GERD
If you are dealing with high levels of acid in your system, there are multiple things you can do to restore healthy acid levels in your stomach:
- REDUCE factors that decrease stomach acid and promote bacterial overgrowth, such as limiting certain carbohydrates such as FODMAPs, following a low FODMAP diet, limiting high-fiber foods that can increase abdominal bloating, or discontinuing or avoiding probiotic use for the time being.
- REPLENISH enzymes that aid in digestion and prompt gastric secretions, like HCL with pepsin.
- RE-ESTABLISH beneficial bacteria and a healthy intestinal lining. Once stomach acid levels are on the rise, you can re-inoculate your digestive system with healthy bacteria from probiotic foods or supplements, prebiotic fiber, bone broth, or glutamine supplements.
While antacids may provide temporary relief for acid reflux, they do nothing to address the root of the problem, which is often insufficient gastric acid. If you are looking for a long-term solution to your heartburn or acid reflux, restoring healthy levels of stomach acid is key!
If you’re looking for natural, long-term solutions to your digestive issues, functional medicine can help you get to the root of the problem and support your body in restoring health. Contact us today for a consultation.
