It’s estimated that roughly one quarter of the North American population experiences acid reflux (heartburn) either daily or more. When people think of acid reflux they think of excess stomach acid (HCl) and the obvious solution then, is to take an antacid. How many of you remember your parents or know someone who sleeps with a pack of antacids beside their bed? Or how many of you have gone to your pharmacist or doctor about the problem and have been told to take an over the counter antacid like Gaviscon, Maalox or Rolaids?
You would probably be confused then if I told you that the majority of the time, the problem doesn’t actually stem from too much stomach acid. In fact, taking antacids regularly can actually make it worse.
Symptoms of acid reflux are typically related to the cardioesophageal sphincter (the valve that separates the esophagus and the stomach) opening when it shouldn’t. This may be due to GERD, a weakened cardioesophageal sphincter, a hiatal hernia and other physical stresses like pregnancy, surgery or obesity. The causes that are least recognized by conventional medicine but which I want to dive into in this post are digestive issues like hypochlorhydria (too little HCl or stomach acid), hyperchlorhydria (too much HCl or stomach acid, but usually actually rooted in hypochlorhydria), food sensitivities and dysbiosis (when you have too many bad gut bacteria and too few good bacteria).
So let’s talk about low HCl (hydrochloric acid, also known as stomach acid), which is often the root of the other digestive problems. Low stomach acid can arise from regular overeating, eating foods to which you’re sensitive, a diet high in processed and packaged foods, chronic stress, and aging. All of these can affect normal HCl production.
HCl is very important! It helps break down food, especially protein, and keeps the stomach sterile. When you have low HCl, bad bacteria can proliferate and protein or other undigested foods can putrefy and create gases that cause bloating and discomfort after meals. These gases rise and open the cardiac sphincter where they irritate the esophagus. It creates the sensation of rising HCl, even though it’s not just stomach acid going up. So when you take antacids you just neutralize stomach acid further which will just increase the amount of microbes (bacteria) in the stomach, cause discomfort and create a never ending cycle of antacid abuse.
Another thing to note is that for people who have been tested and actually do produce too much stomach acid, the problem may still have been caused by low HCl in the first place. Your gut lining is a mucous membrane which, just like your respiratory pathways, releases histamine whenever it gets irritated (think hay fever and a runny nose). Microbes in the gut, (a common one being H. pylori), can irritate the stomach and cause histamine release, which also stimulates stomach acid production.
It’s important to start by addressing the root of the problem which, for most people, actually stems from low HCl. In this case, dietary changes and some digestive support are often enough to help people resolve acid reflux for good.
Digestion starts with the sight and smell of foods. Try not to eat when rushed or stressed and instead thoroughly chew and think about your meal.
For most people this includes caffeine, processed foods, cigarettes and alcohol but everyone is different, so I recommend taking note of foods that are triggers for you.
For most people, just drinking water is actually just as effective as over the counter antacids. Unfiltered, raw apple cider vinegar helps stimulate stomach acid production to enhance digestion and it helps prevent the growth of unhealthy bacteria.
While you can’t go wrong with whole, nutrient-dense foods, I also recommend incorporating fermented foods like kefir, yogurt or traditionally fermented vegetables, bone broth, bitter leafy greens like arugula, kale or mustard greens and raw honey. Click here for a sauerkraut recipe.
The combination of these three ingredients is both soothing to the digestive tract and promotes good digestion.
Click here for my 5 unconventional tricks to manage stress.
Click here to read the article, Portion Control 101: How Not To Overeat.
Probiotics help to competitively inhibit bad bacteria and promote better digestion. We expand on this topic here: Are Probiotics The Answer For Everything?
Digestive enzymes like pancreatin, papain and bromelain can be helpful, along with hydrochloric acid and pepsin. However if you do go the supplement route you want to take this under the guide of a practitioner, because there can be risks if you are taking any anti-inflammatory medications like aspirin, ibuprofen, advil, etc or if you have a history of ulcers. Dosage varies and again you should work with a practitioner to know how much to take.
Digestive bitters can also stimulate your body to produce digestive juices (stomach acid) on its own. A great one is St Francis Digestive Bitters and you can take this before you eat a meal.
If you struggle with chronic acid reflux, have been taking antacids for years, or if you’ve tried all of this and the problem has not resolved or has gotten worse, you may need more guided support from a nutritional practitioner.