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Let's talk about heartburn, GERD, reflux, and their connection to low stomach acid.

Updated: Nov 29, 2021

Hello my friends! Welcome to Ponder's first official blog post. Today I am talking about something that, prior to my education in holistic nutrition, had afflicted me for as long as I can remember: #heartburn and #acidreflux.


If you are anything like me (a self appointed #hypochondriac) you have done deep google dives every time you feel sick, or your body doesn't feel right. I understand how #healthanxiety and worry can lead to these searches. You just want some relief!

I had been to many medical practitioners about the pain at the top of my stomach. I would explain how the discomfort would occasionally radiate to my chest. After tests for ulcers and an ECG came back normal I would be told again and again it was just heart burn and instructed to take a tums or Pepto, or shrugged off as just having an "anxious stomach". I cant tell you how many times I wanted to say "Excuse me Dr, did you not hear me? I have chest pains and I'm pretty sure I'm dying..." BUT for fear of looking crazy I left their office unsatisfied.


I would often fall back in to google searches after appointments like these. No where in my searches did I read about low stomach acid leading to the symptoms I was experiencing. On the contrary it was often touted that too much stomach acid was the likely culprit, suggesting antacids and PPI's to alleviate my reflux-related woes. So I did as the doctor ordered and continued on my regime of antacids.


Now, for a time, these remedies worked. I used to take Tums like they were candy and when that stopped working I switched to Pepto - which also worked great! Until it didn't. I was confused. During this time in my life I was high stress, low sleep, and had to carry a nice little medicine bag of antacids with me to every outing for fear of how what I may be eating or drinking could cause discomfort and distress. Not to mention the Tums I kept in my desk at work and in my bathroom at home... I had a seemingly unsolvable problem.


Lets fast forward... I enroll in the holistic nutrition program at CSNN eager to learn. We dive deep into the #physiology of the human body and the intricacies of #digestion. My teacher is doing a wonderful job explaining the steps of digestion, from entrance to exit. Explaining how each step is an essential cog in the machine. Then we start to discuss heartburn, reflux, and GERD. I've got my notebook ready, my pink highlighter is brand new and I'm ready to tear into the textbook... then... she says.... "Contrary to popular belief, acid reflux and heartburn symptoms are often caused by too little stomach acid.. not too much"

HUH? Dr google was so soo wrong about this. And quite frankly, he usually is folks.. don't believe everything you read on the internet. At first I was skeptical. How had I not heard this before? But as we continued learning it was light bulb moment after light bulb moment. It was truly transformative! By implementing dietary and lifestyle changes based on the idea that my stomach acid was low, and not high, brought me great relief. I was able to ditch my secret stash of antacids and live without fear of discomfort around eating.


I write the rest of this blog post dedicated to the anxious and the uncomfortable. Those who scour the internet looking for answers that they have been unable to find elsewhere. To those who love the idea of understanding the intricacies and mechanisms of your body and why it does the things that it does... read on my friends..


Now, to explain: There is a valve at the top of your stomach that allows the food you eat to enter your stomach after you swallow. It is called the Lower esophageal sphincter, or the LES. When correctly functioning the LES lets the food in and then closes up tight. It does this by communicating with your autonomic nervous system (when thinking autonomic think automatic - these acts are done without you having to think about them like breathing or your blood pressure) the autonomic nervous system knows when to close the LES by signals it gets from sensors on its surface that measure acidity levels in the stomach. So when the acidity level in the stomach is low or insufficient the LES stays open causing the stomachs acid and contents to re-enter the esophagus causing discomfort and reflux symptoms like burning and pain. Sometimes in extreme cases the stomach contents or acid can make their way to the airway due to its close proximity to the esophagus and contribute to difficulty breathing and chest pains.









So lets review...

  1. The LES opens and closes to let food into the stomach.

  2. The LES contains sensors that measure the acidity of the stomach contents.

  3. These sensors send messages to your autonomic nervous system.

  4. When there is adequate acidity in the environment the autonomic nervous system closes the LES.

  5. When the LES does not close the stomach acid and its contents can re-enter the esophagus leading too symptoms of heartburn, GERD, or reflux.


So now that we have established the mechanics behind low stomach acid and its relation to heartburn, GERD, and reflux symptoms, lets get into some of the contributing factors that lower your stomach acid in the first place:


High stress levels. Either around meal times or chronic daily stress.


During a stress response a hormonal cascade happens that prepares us to fight or flee. In times of old our fight or flight response was designed to protect us from a predator in our path. In short, it takes the energy away from our internal organs, turns off our digestive processes, and sends our energy and blood flow to our limbs so we can fight, or RUN! now a days the stress response is less directed at literal predators but our nervous system honestly cant tell the difference! Daily life stressors or long term trauma means we are in a constant state of #fightorflight (which I plan to talk about in detail another time) and this leaves our digestive system impaired.


Eating on the run and overeating.


To build off my first point not taking the time to sit down and eat all but guarantees we are staying in a state of stress. On top of this eating on the run promotes rushing and inadequate chewing. Chewing is such an imperative step in our digestive process and poorly chewed food becomes food that is more difficult to digest adding stress to our already stressed digestive system. This also promotes the release of additional stress hormones creating a vicious cycle. Overeating adds pressure to both our LES and digestive system.


A poor diet high in refined sugar, processed foods, trans fats, and low in fiber.

Refined sugar, processed foods and unhealthy fats all promote a stress response and inflammation of the intestinal system. The higher the inflammation, the higher the stress hormones in our bodies (I am sensing a pattern here...)

Fiber is essential to ensure our bowels move along at a healthy pace which reduces inflammation and stress. It also works like a vacuum binding up toxins and wastes within our intestinal tract which lowers inflammation.


Overuse of antibiotics and common pain killers.

Antibiotics have been long studied to damage the healthy bacterial balance in our intestinal system. Healthy gut bacteria create a barrier along our intestinal wall to reduce the incidence of leaky gut and harmful pathogens latching to the intestinal wall. They also help to digest our food for us. All of which decrease inflammation, toxins, and stress in our bodies.

Common pain killers like Advil and other NSAIDS have been shown to damage the lining of our stomach which contributes to decreased stomach acid levels.


Long-term use of antacids or proton-pump inhibitors.


Antacids lower your stomach acid, it’s that simple. They are designed for an environment of high stomach acid. Not only that, but the ingredients found in many over the counter antacids bind to the minerals (like iron, zinc, and calcium) in your digestive tract making them even harder to absorb which worsens the under-active stomach cycle. The main job of a proton-pump inhibitor is to stop the production of acid in our stomach.


Now that you know some of the factors that can reduce your levels of stomach acid I just want to drive home why stomach acid is so important. Some of its main roles are:

  • Digesting of proteins into essential amino acids. These amino acids build our digestive enzymes, all facets of our immune system, our neurotransmitters and "happy chemicals", and more.

  • To sterilize the stomach; killing any yeast, fungus, or bacteria that enter our digestive system through the food we eat.

  • To stimulate the rest of the digestive organs (like the pancreas and gallbladder) to release the enzymes and bile they need.

  • To absorb many important minerals such as calcium, magnesium, zinc, copper, iron, and more.

It should come as no surprise that a disfunction in your stomach acid production can therefore contribute to many other mental and physical health concerns. Minerals and proteins are needed for all of our systems to function. But our brains, endocrine glands, skin and immune system especially! I am hoping that some of the puzzle pieces are falling together for you and I have offered at least one "ah ha!" moment like I had in school.


So now that you're reading this, nodding your head, letting out some audible "uh huhs" or "Mhmms" Now what? Luckily, with some support, your stomach can be up and running optimally again. Lets talk through some baby steps. Keep in mind some are short term fixes, others a little longer. I offer these so you can pick and choose what fits best for where you're at in your journey.


Before I get into what you can do to help I want to make it VERY clear that expecting yourself to do all of the things on this list is unrealistic. I give many options so you can decide what will work best for your particular circumstance. So pick one, two, or a few and give them a try. If you are unsure, overwhelmed, or are simply not certain where to start I would be happy to work together to create a plan for you. Click the contact and bookings at the top of this page, or the button below to reach out.




Now, To support stomach acid production:

  1. Start your morning with a glass of warm lemon water.

    1. Lemon water helps to ignite your digestive organs first thing. It "gets your motor running" as it were. It will also add hydration into your day.

  2. Practice mindfulness around meal times. This will reduce stress hormone activity and help to prevent over eating. This can look like:

    1. Taking 5 deep breathes before you begin eating. Inhale for 4 counts and exhale for 8 counts

    2. Putting the fork down between bites.

    3. Chewing food 50 times, or until almost liquid.

  3. Incorporate apple cider vinegar into your diet

    1. Apple cider vinegar increases the acidity in the stomach environment. A shot of ACV can also be taken when you are experiencing acute heartburn.

    2. Personally I love using ACV when I am marinating meat for dinner or as a salad dressing! (See the resources below for a yummy salad with ACV incorporated in its dressing!)

  4. Supplement with a digestive enzyme that includes HCL.

    1. Adding a digestive enzyme to your routine is probably my number one suggestion if you are under stress. Its easy, accessible, and adds support for your entire digestive system. Supplemental enzymes contain what your body makes naturally to break down your food (and may be struggling to make right now) By ensuring the enzyme has HCL, or Hydrochloric Acid (a.k.a stomach acid) it will offer that acidic environment your body needs, therefore increasing nutrient absorption reducing post-meal digestive complaints

  5. Add fermented foods to your diet.

    1. Kimchi, Yogurt, Kombucha, Kefir, Miso, Tempeh!

  6. Incorporate Zinc foods into your diet.

    1. Zinc is an essential ingredient in stomach acid production.

    2. Pumpkin seeds, Whole grains like Rye and Oats, Red meat, Oysters, Eggs.

  7. Add a Probiotic supplement to support your microbiome for better digestive health.

  8. Remove or reduce foods and habits that irritate the stomach lining.

    1. Alcohol, Caffeine, Refined sugars and grains, and deep fried or fast foods.

  9. Reduce your overall stress. I include this point last as it is the most important but also the most difficult given the increased stress of our modern world. Some stress reducing activities that I love:

    1. Sleeping long, or sleeping in! A great way to help your body restore and reset.

    2. Mindfulness practices like deep breathing, meditation, or yoga.

    3. Going for walks in nature, or getting outside in general!

    4. Journaling out all my stressy thoughts before bed.

    5. Relaxing into my current favorite show or video game.

Stress reduction is unique to each person. So lean into what gives you joy and offers a sense of calm. You deserve it!


I have put together a special link with the supplement recommendations noted above and tip sheets for breathing exercises, mindfulness, and more. Feel free to take advantage of the 15% off within the link, or simply use it as a frame of reference when you are at the supplement store. I know how overwhelming that wall of supplements can be!


As always before beginning a new supplement please read through the precautions and contraindications noted on the bottle and speak with your Doctor or health care provider/Nutritionist to ensure it will not interfere with any medication you are currently taking or any conditions you may be afflicted with.


Click button below for access


And as promised, one of my favorite fall recipes:


Thank you so much for taking the time to read through my first blog post. I hope that I was able to offer you the relief I needed few years ago. To the anxious ones, the hypochondriacs, and the people who are told to just "relax and not worry about it" or have been told "there is nothing wrong on your tests, you just have anxiety" these blogs are for you!


In love and health,

Nicole



***DISCLAIMER****

The information included in this blog post is restricted to consultation of the subject of nutritional matters intended for general nutritional well being and do not involve the diagnosing, prognostication, or prescribing of remedies for the treatment of any disease or any licensed or controlled act which may constitute the practice of medicine in the province of British Columbia.


Resources: Guide to symptomatology 1st Edition - CSNN Publishing 2019.

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