ACID REFLUX (HEARTBURN): CAUSES AND SOLUTIONS
June 20th, 2013 by Lyne Quesnel, ND
What is it?
When it functions properly, the muscular barrier between the esophagus and the stomach opens to let food into the stomach and then closes to avoid letting stomach contents back up into the esophagus. However, when this barrier does not work properly, it may open prematurely allowing stomach contents to go back up into the esophagus during digestion. This is when acid gases travel up the esophagus and eat away at the lining and causes pain near where the heart is located. This is why it is known as heartburn or acid reflux.
A doctor may examine you to determine an acid reflux diagnosis. But to be certain, an endoscopy may be performed.
Who is affected?
- 50 YEARS AND OVER: people aged 50 years and over are the most affected although it may happen at a younger age;
- 50% OF ADULTS: nearly half of the North American adult population suffers from heartburn occasionally and 30% of them suffer from it at least once a month;
- DIABTICS: they are particularly affected;
- SMOKERS: they are particularly affected;
- ANXIOUS, STRESSED OR NERVOUS: people who tend to be anxious, stressed and nervous are also particularly affected;
- HEAVY EATERS: they are often affected because overeating and heavy meals, greasy or acidic foods and swallowing too soon increase the risks;
- ALCOOL, CAFFEINE, COLAS: are factors that contribute to reflux;
- HIATAL HERNIA: people who have previously suffered from a hiatal hernia are more likely affected. This problem is often the origin of acid reflux.(A hiatal hernia (or hiatus hernia) is the protrusion of the upper part of the stomach into the thorax through a tear in the diaphragm);
- WEAK ESOPHAGEAL SPHINCTER: represents a high risk factor;
- PROFESSIONAL ACTIVITIES: people whose work activities require that they bend over often are more at risk;
- BILE: people who suffer from troubles with the biliary functions;
- OBESITY AND PREGNANCY: 2 factors which create occasional acid reflux due to the increased pressure inside the abdomen. Liquid stomach contents rise into the esophagus.
What are the symptoms?
- HEARTBURN (pain in the thorax area);
- ULCERATIONS: unlike the stomach lining, which can tolerate high concentrations of acid, the reflux of acid and stomach contents into the esophagus irritates the esophageal lining and can sometimes cause ulcerations;
- REGURGITATIONS: reflux of foods (behind the sternum) towards the esophagus that sometimes rise towards the mouth in the form of acidic regurgitation with a sour taste;
- COUGH, INFLAMMATIONS: occasional cough and chronic inflammation of the pharynx.
Which good habits can help?
Current knowledge does not allow for prevention of this disease but we can decrease the symptoms with certain habits:
- SLEEPING POSITION: for sleeping, elevate the head of the bed by 10 to 15 cm by placing a few books or pieces of wood under the mattress. Pillows are not sufficient. The incline helps avoid the reflux of acid into the esophagus, especially during the final months of pregnancy;
- PRESSURE ON THE ABDOMEN: many manage to relieve their heartburn by loosening their belt, thereby reducing the pressure on the interior of the abdomen. Too tight, a belt does tend to push up liquids from the stomach to the esophagus;
- LYING DOWN: avoid this position as it allows for acid reflux into the esophagus. Stay sitting after a meal, do not bend down or go lie down as these positions increase pressure on the stomach, which tends to create reflux;
- TOBACO: avoid tobacco because each time that you smoke a cigarette the production of gastric acid increases. Smoking also weakens the muscle barrier between the esophagus and the stomach that should normally prevent reflux. Stop smoking and avoid smoke filled places. Nicotine also weakens the esophageal sphincter and increases acid production;
- ALCOHOL: limit alcohol consumption to 1 glass of wine or beer occasionally because alcohol relaxes the esophageal sphincter;
- STRESS: Relax because as per Dr Klein, stress stimulates acid production in the stomach. Good relaxation techniques and many natural products (Herbacalm, Magnesium) will help decrease tension and balance your metabolism. A calm and quiet atmosphere should reign, especially during meal times.
How can we help ourselves with your meals?
Certain modifications to your nutritional habits can also bring relief:
- BALANCED DIET: adopt a diet based with vegetables, fruit, whole cereals, balanced proteins, starches, fruits and vegetables rich in fibre and avoid all fried, fatty or sugared foods as these are longer to digest and slow the passage of food through the stomach as well as enabling excessive production of gastric acids;
- QUANTITY: a heavier load on the stomach will increase the risk of reflux into the esophagus. Take lighter meals on smaller intervals rather than rich heavy meals and take your time eating. Avoid heavy meals especially at the end of the day;
- ALCOHOL ET CAFEINE: reduce the amount of alcohol, caffeine and coffee in all forms. Coffee relaxes the esophageal sphincter, even when decaffeinated, it increases acid levels. So do colas, tea and other sources of caffeine. Sparkling beverages can irritate the lining of the esophagus, bubbles in colas swell in the stomach and are just as hard on the sphincter as a heavy meal;
- ACIDIC FOODS: reduce the amount of foods containing tomatoes (they relax the esophageal sphincter) and other acidic foods (see list in the following pages);
- EATING: avoid eating at least 2 to 3 hours before bedtime;
- SPICES: there is no proof that spicy foods (except for black and cayenne pepper) create heartburn; but if you have the impression that you are not digesting properly after a spicy meal, you may as well avoid that spice;
- CHOCOLATE: to be avoided altogether if you suffer from heartburn because chocolate near exclusively contains fats and caffeine that provoke the esophageal sphincter to open and increase reflux;
- CALM: A calm and quiet atmosphere should reign, especially during meal times.
Is there room for natural supplements?
Certain home remedies can help to temporarily sooth symptoms by neutralizing acids, but they are not recommended. That is the case, for example, with water to which baking soda was added, colas or milk. The fats, proteins and calcium contained in milk increase acid secretion in the stomach and if taken on a regular basis, these home remedies aggravate the situation by adding gases and fluids in the stomach, increasing pressure and causing reflux. Furthermore, their high alkaline level cause a rebound effect since the stomach tends to then produce extra acid. Taking baking soda also increases the amount of sodium in the diet, which can increase blood pressure.
- ANTI-INFLAMMATORY PLANTS: eat plants with anti-inflammatory (mucus), sedative (spasms) and calming (stomach irritation) properties. HERBACALM contains all of these properties. This formula will also help calm stress and help to relax;
- ALKALINISING SUPPLEMENT: try to neutralize your pH level by avoiding foods that are too acidic and by adding natural or mint flavoured CHLOROPHYLL to your daily glass of water, you will lighten digestion as well as tone, purify and alkalize your body;
- MINT: it sooths certain symptoms of gastritis and the esophagus. It has an ancient reputation in traditional practice for soothing gastric troubles and heartburn, a reputation supported by many scientific tests. A recent study also showed that 5 drops of mint essential oil diluted in 10ml of water helps to decrease the intensity and the length of contractions in the esophagus;
- PROTECT THE MUCUS: red elm extract and Aloe Vera Gel act as a bandage for the gastric and intestinal tract. They protect the mucus from acidity and also help digestion. Liquorice protects the mucus in the esophagus and has an anti-inflammatory effect, the SYRUP and ALOE VERA formulas are perfectly adapted to these needs;
- CALCIUM: calcium (carbonate) fights gastric hyperacidity, it has an alkalinizing effect that helps to counter the acidifying action of gastric acid. Commercial antacids often contain calcium carbonate. CALCIUM-ACTION is perfectly formulated to calm symptoms of gastric acidity.
- ANTACIDS: over the counter antacids used to neutralize gastric acid are not ideal solutions. They provide short term relief but don’t solve the problem because they do not reduce the acidity. It is important to know that these products contain chemical components;
- MEDICATIONS: many medications sold with or without a prescription such as aspirin, antidepressants, non-steroidal anti-inflammatory analgesics, some heart and blood pressure medications, medications against asthma, antalgics and sedatives aggravate heartburn because they provoke the production of digestive acids. If you take medications, advise your doctor.
When to consult a health professional?
- PAIN: when heartburn becomes a chronic issue and when your stomach becomes sensitive and anything you eat makes you sick. If you have pain or a hard time swallowing. In this case, your doctor will evaluate if you have an ulcer or a hiatal hernia;
- MAY BE AN ULCER: if you suffer from heartburn before meals or have frequent stomach pain, without any apparent reason or present for 2-3 timez a week for more than a month, it may be an ulcer;
- COUGH, ASTHMATIC BREATHING: if you have a cough, have difficulty breathing and often feel like you need to rinse your mouth;
- MAY BE A HEART ATTACK: if you have difficulty swallowing, pain in your left arm, a presence of blood in vomit, blood in the feces or black stools, shortness of breath, pain in the neck and shoulders, feel lightheaded and dizzy. These symptoms may be a precursor to a heart attack;
- VOMITTING AND STOMACH PAINS;
- UNEXPLAINED WEIGHT LOSS;
- RUSTY VOICE, especially in the morning;
- ZENKER’S DIVERTICULUM: an illness, known as Zenker’s Diverticulum, may also interfere with the digestive process says Bruce Luxson, doctor and professor of gastroenterology at the faculty of medicine of the University of St-Louis, in Missouri. This illness creates a pouch in the esophagus where some food may be retained instead of progressing towards the stomach. If you lie down for a couple of hours after eating, the pouch empties itself by regurgitation. In other words, this food never makes it to the stomach because it has been held prisoner in the esophagus.
LIST OF ACIDIC AND/OR ACIDIFYING FOODS:
To be avoided or taken in moderation: even if they are not originally acidic, they produce acid during metabolism:
- BEVERAGES: fruit juices (except mango juice), alcohol, beer, wine, spirits, liquors, coffees and black teas, colas and/or industrial sugars, soya milk, almond milk;
- OILS AND FATS: butter, heated, hydrogenized, or refined oils and fats, avocado oil, olive oil, sunflower oil, canola oil, linseed oil, corn oil, sesame oil, safflower seed oil, cooking fats, animal fats, fatty foods, fast food;
- VINEGARS: apple vinegar, commercial vinegars, white vinegar;
- PROTEINS/MEAT: fish, shellfish, deli meats, lard, beef, clams, rabbit, coquille Saint-Jacques, venison, lamb, oysters, salmon, tuna, carp, lobster, pork, shrimp, turkey;
- DAIRY PRODUCTS: cheese from cows, melted cheese, goat cheese, cheese from sheep, fermented cheese, liquid whey (originally basic but becomes acidic), butter, fresh cream, non-skimmed yogurt;
- FRUIT (the less they are ripe, the more they are acidic): cranberries, acidic cherries, mandarins, oranges, grapefruit, acidic apples, rhubarb, prunes and all oleaginous fruits, dried apricots, dried prunes;
- VEGETABLES: white asparagus, artichokes, Brussel sprouts, watercress, rhubarb, tomatoes and onions, sauerkraut, spinach, leeks, potatoes;
- GRAINS AND NUTS: peanuts, hazelnuts, cashew nuts, pecan nuts, except almonds and Brazil nuts, Tahini;
- PEAS AND LEGUMES: black beans, white beans, chick peas, green peas, Lima beans, soya beans, rice milk, lentils, red beans, kidney beans, pinto beans;
- CEREALS: refined sweetened cereals, rice cakes, barley, oats, rye, wheat, wheat cakes, buckwheat, quinoa, spelt, hemp seeds, amaranth, corn, all rice, Kamut, wheat germ;
- MEAL (FLOUR): white pastas, spaghetti, noodles, macaroni, white bread, pastries, rice;
- OTHERS: sugar, salt, honey, products containing aspartame and/or sugar derivatives, sweets, syrup, saccharin, fructose, cocoa and chocolate, lard, conserves and conservatives (dextrose);
- CHEMICAL PRODUCTS: pesticides, herbicides, medications, psychedelic drugs.
LIST OF ALCALINE AND/OR BASIC FOODS:
To be taken without moderation, these foods contain basic components and little or no acids:
- BEVERAGES: chlorophyll, mango juice, fresh fruit juices, vegetable juices, green juices, mineral water, tea, goat milk, maternal milk, organic milk, green tea, ginseng tea, Land Art plant extracts;
- VINEGARS: apple cider vinegar;
- PROTEINS/MEAT: chicken breasts, pumpkin seeds, sunflower seeds, tofu, tempeh, millet, almonds, linseed, squash seeds, germ seeds;
- FRUITS: bananas, chestnuts, pears, yellow apples, red apples or apple pears, cherries (non-acidic), raisins, Honeydew melon, pineapples, watermelons, dried raisins, grapefruit, nectarines, peaches, all berries, tropical fruits, avocados, cantaloupe, dates and figs, limes, oranges, pears, tangerines, lemons (even though they are originally acidic, once digested they return to an alkaline Ph level);
- VEGETABLES: marine vegetation, fermented vegetables, dark and/or vegetables rich in chlorophyll, edible flowers, garlic, seaweed, asparagus, eggplant, beats, broccoli, cabbage, celery, watercress, mushrooms, carrots, pumpkin, cucumbers, squash, zucchinis, Brussel sprouts, cauliflower, mustard leaves, green beans, barley herbs, wheat herbs, lettuce (romaine, leaf lettuce, Boston lettuce), alfalfa, onions, peas, dandelion, parsnip, peppers, potatoes, leeks, radishes, wild plants;
- GRAINS AND NUTS: soya seeds, soya derivatives, barley, almonds, Brazil nuts, chestnuts, coconuts, pumpkin seeds, sesame seeds, sunflower seeds;
- GERMINATIONS: germ seeds, sprouts, sunflowers, alfalfa, soya (germination provokes alkalinisation);
- OTHERS: Stevia, sea salts, curry, cinnamon, mustard, miso, ginger, tamari and all herbs.
- OILS AND FATS: cold pressed vegetable oils, olive oil and tahini;
- DAIRY PRODUCTS: milk, skimmed yogurt, soft goat cheese, Quark cheese, fresh white cheese, maternal milk;
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