Today we’re continuing the ‘burning discussion’ on acid reflux. Called by many names, acid reflux is one relatively new condition which is on the rise mostly due to our culture’s lifestyle habits, particularly overeating and increasing weight gain. The excess belly fat creates both structural ‘blockage’ of acid flow and fuels inflammation lending to more digestive drama.
This is Part II of the Acid Reflux topic, so if you haven’t read ‘Fire In The Hole’, I encourage you to begin there as this discussion builds from that post, mostly that acid reflux is not a condition of TOO MUCH stomach acid, but rather a situation of TOO LITTLE stomach acid.
In fact, once you understand the physiology of how and why, you’ll likely recognize the long-term implications of treating this issue of TOO LITTLE stomach acid with conventional means, namely Proton Pump Inhibitors (PPIs) might not be the best choice for most of us.
Let’s jump in and talk about how it could be that too little acid could result in acid reflux? The answer is fairly simple. Our stomach is designed to work optimally at a pH of 1-3. When the food enters the stomach, it causes the pH to rise (become less acidic). This rising pH causes the stomach to release more hydrochloric acid. As the stomach becomes acidic again, the valve at the opening of the stomach (the esophageal sphincter) will close to prevent the acid from escaping back up. It is this action of the esophageal sphincter, in response to rising acid levels that prevents acid reflux. Now let’s look at another scenario. If the stomach does not produce enough acid in response to food intake, the esophageal sphincter will remain open. An open esophageal sphincter allows what little acid that exists in the stomach to rise up into the esophagus, thus causing the burning sensation associated with heartburn. So, you can see that there exists a possibility that your acid reflux medication could be worsening your issues or explains why they might not be working for you. That’s the beauty of science in action. That’s a Functional Medicine approach to acid reflux.
Now that we’ve covered another cause of acid reflux, it’s time to test out the theory. There is a simple litmus test of whether a person could be experiencing hypochlorhydria (low stomach acid) as the cause of their acid reflux. I recommend they perform a trial of taking 2-3 tablespoons of apple cider vinegar right before their meals. Yes! That’s right! We add a mild acid to the stomach (the vinegar) with a meal. If this works to reduce/eliminate acid reflux, and it does so about 85% of the time, we initiate a therapeutic path to retrain the stomach to produce its own hydrochloric acid. I just want to be clear, the apple cider vinegar is just a test to determine if the issue is low stomach acid (hypochlorhydria). If it helps improve symptoms, it is an indication that we likely have identified the real root cause of the acid reflux problem. Apple cider vinegar is a not a long-term remedy, but an old-fashioned, natural ‘lab test’ of sorts. Some of my patients do use it to help with those occasional bouts of heartburn.
Caution: There are situations where it is not appropriate to test with apple cider vinegar. Anyone with the following diagnoses should not attempt the vinegar test: hiatal hernia, erosive esophagitis, peptic ulcers, or Barrett’s esophagitis. These conditions could be worsening by adding an acid to the mix.
It would be an incomplete discussion if I didn’t address another common cause of acid reflux and related symptoms…Food sensitivities. You might be wondering, “Haven’t I heard this tune before?” Yes, I talk about food allergy/sensitivity often, but that’s because we eat very often. And if we continue to eat foods that irritate our immune system, our body is going to let us know about it. Sometimes it’s through chronic sinus congestion, eczema, headaches or even acid reflux. I discuss how to determine possible food allergies/sensitivities in several online lectures at LivingWellnessUniversity.com.
So, if you’re one of the 22 million people suffering with acid reflux, I recommend you seek out the root causes of your symptoms and work to improve them through lifestyle modification and a thoughtful (and sometimes supervised) application of common sense and science!
If you’re interested in learning more about this topic, visit our Education Beyond Medication online medical community, LivingWellnessUniversity.com to watch the following Dr. Saxena Speaks! educational videos which also relate to this topic:
- Acid Reflux: It Keeps Coming Up!
- Heal Your Gut, Heal Your Body
- Digestive Rehabilitation
- Allergies: It’s Not Just Snot
- Testing Yourself for Food Allergies