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Acid reflux (heartburn): causes and solutions

Why do I get heartburn or gastric acid reflux?

In order to understand the causes, it is first important to know how this part of your digestive system works.

Normally, when we swallow food or liquids, they pass into the mouth and through the esophagus until they get to what is known as the lower esophageal sphincter. The sphincter is a muscle in the shape of a ring that opens and closes the passage.

This sphincter plays a crucial role as it opens to allow food to pass from the esophagus to the stomach. It then closes to prevent the gastric acid in the stomach from going back up into the esophagus.

Unfortunately, when this sphincter is not functioning properly, that is, if it does not close tightly enough to seal off the stomach, there is a higher risk that acid content from the stomach may back up into the esophagus during digestion. This phenomenon causes heartburn,which often feels like a burning sensation in the chest area. This is also known as Gastro-esophageal Reflux Disease (GERD).

It is possible to get a Gastro-esophageal Reflux Disease diagnosis through a clinical exam with a doctor. To be certain, they may also request an endoscopic examination.

Who is affected by heartburn and what are the risk factors?

  • 50 YEARS AND OLDER: people over the age of 50 are most affected, although heartburn may also appear at a younger age. It is starting at age 50 that a decrease in the tonicity of the sphincter tends to occur.
  • 50 % OF ADULTS: nearly half of the adults in North America suffer from heartburn occasionally; 30% of them suffer from this at least once a month.
  • OBESITY: excess weight increases the pressure inside the abdomen. This increases the risks for acid reflux into the esophagus.
  • ALCOHOL, CAFFEINE, CARBONATED DRINKS: drinking these on a regular basis provokes acid reflux.
  • HEAVY EATERS: they are the most affected because eating heavy meals or overeating, eating fats, acidic foods and swallowing too quickly all increase the risks.
  • PROFESSIONAL ACTIVITIES: people that work in a profession which requires them the bend forward often are also at a higher risk.
  • PREGNANCY: during the final months of pregnancy, women regularly suffer from acid reflux. As the fetus grows, it takes up more space and creates extra pressure on the stomach.
  • ANXIETY, STRESS, AND NERVOUSNESS: people who are stressed or generally anxious are also more likely to be affected.
  • DIABETICS: they are more likely affected.
  • SMOKERS: they are more likely affected.
  • HIATAL HERNIAS: people who have been treated for a hiatal hernia are commonly affected. This problem is actually quite often the origin of Gastro-esophageal reflux disease. (This hernia is a when a part of the stomach passes through an orifice in the diaphragm).
  • WEAK ESOPHAGEAL VALVE: represents an acute risk factor.
  • BILE: people who suffer from biliary functions.

What are the potential symptoms of heartburn?

  • A burning sensation is pushing up behind the sternum. Doctors call it pyrosis.
  • Acid regurgitations that leave a sour taste in the mouth.
  • A hoarse voice, especially in the morning.
  • A chronic sore throat.
  • A chronic cough or frequent hiccups.
  • Nausea.
  • Dental problems (loss of enamel).
  • Ulcers

Which lifestyle habits may help to prevent or reduce heartburn?

Current knowledge does not allow us to prevent the onset of the disease, but we can alleviate symptoms and decrease the frequency by observing the following recommendations:

  • MEALS: eat smaller meals and fewer fats. Reduce portions. Further, in this article, we will elaborate on meals and which foods to choose.
  • SLEEP POSITION: when sleeping, raise the top section of your bed by about 10 to 15 cm using a few books or boards slipped under the mattress, at the head of the bed. Pillows are not enough. The incline will help to prevent the gastric acid from coming back up into the esophagus, especially during the final months of pregnancy for women.
  • REDUCING THE PRESSURE ON THE ABDOMEN: many people can relieve heartburn by loosening their belt, thereby reducing the pressure inside the abdomen. A tight belt will have the tendency to push liquids from the stomach back up into the esophagus.
  • LYING DOWN: avoid lying down as this makes it easier for gastric acids to flow back up into the esophagus. Stay seated after a meal, do not bend over and do not lie down, these positions increase pressure on the stomach which provokes reflux.
  • TOBACCO: avoid tobacco, because each time you smoke a cigarette, the production of gastric acid increases. Smoking also weakens the muscle at the end of the esophagus which normally prevents gastric acid from backing up. Stop smoking and avoid areas with smoke. Nicotine relaxes the esophageal sphincter and increases acid production.
  • ALCOHOL: limit the amount of alcohol that you consume to one glass of wine or beer every now and then, as alcohol relaxes the esophageal sphincter.
  • STRESS: Relax! According to Dr. Klein, stress promotes the production of acid in the stomach. Good relaxation techniques and many natural products (B-Complex Zen, Magnesium) will help to decrease tension and stabilize your metabolism. Calm and relaxation are important, especially during meals.

How to improve your eating habits?

Modifying some of your dietary habits can help to relieve heartburn.

  • BALANCED DIET: create a diet with variety which is slow in fats. Add vegetables, fruit, complete grains, and avoid any foods that are fried, fat or sweet, as these tend to slow digestion which will then slow the passage of food through the stomach, on top of producing increased amounts of acid. Also, choose leaner cuts of meat.
  • QUANTITY: eat less, because the more you fill your stomach, more the gastric acids will tend to back up into the esophagus. Take smaller meals at regular intervals rather than large copious meals and take your time to eat. Avoid heavy meals, especially at the end of the day.
  • ALCOHOL ET CAFFEINE: reduce your alcohol and caffeine intake, in all forms. Coffee irritates the mucous as it promotes increased acid production, the same goes for tea, soft drinks and other sources of caffeine.
  • CARBONATED DRINKS AND SPARKLING WATER: all sparkling beverages inflate the stomach and are just as harmful to the sphincter as eating heavy meals.
  • ACIDIC FOODS: if you suffer from heartburn, you should also avoid tomatoes and tomato juice as well as citrus and their juices (orange, lemon).
  • MEAL TIMES: if you eat during the evening, do so at least 2 hours BEFORE going to bed.
  • SPICES: foods containing spices (curry, peppers, etc.) may increase the pain associated with acid reflux. If you have heartburn after a spicy meal, it is best to avoid this type of food.
  • CHOCOLATE: to be avoided in case of heartburn, as chocolate contains nearly exclusively fats and caffeine, which both tend to increase the frequency of acid reflux.
  • CALM: calm and relaxation are important, especially during meals.

Choose natural supplements

Certain home remedies may help to relieve the symptoms of heartburn by neutralizing acidity temporarily, but most are not recommended. This is the case for milk. Drinking a glass of milk will provide temporary relief of the pain, but the fats and proteins, and especially the calcium contained in the milk will then increase the secretion of acid in the stomach. It is best to opt for more durable solutions, and this is where many natural supplements may come into play.

  • DRINK ALOE VERA GEL: Aloe Vera is a plant which is known to relieve the sensation of heartburn, but it will also promote (accelerate) the repair of damaged mucosae. Drinking Aloe Vera gel also protects the mucosae. Land Art’s Aloe Vera Gel is highly recommended. 
  • ANTI-INFLAMMATORY PLANTS: consume plants with anti-inflammatory properties. Curcuma, devil’s claw and even Aloe Vera may reduce inflammation. This allows your body to get into repair mode.
  • CHLOROPHYLL: avoid consuming foods that are too acidic, and add a daily dose of CHLOROPHYLL in your water, this will aid digestion.
  • LICORICE (Glycyrrhiza glabra): the internal use of licorice root is already used by the European Commission to treat ulcers in the stomach and the esophagus. Licorice facilitates the formation of mucus, which covers the walls of the stomach and protects it from the gastric acid. This plant is regularly recommended by Naturopaths to treat heartburn due to the protective effects on the mucosae and its anti-inflammatory properties. However, no other clinic has yet proven its efficiency.
  • MARSHMALLOW, MALVA, ELM, MULLEIN, NOPAL, PLANTAGO: due to their high content of pectin and mucilage, these plants have traditionally been used to relieve the irritation of the mucosae that line the digestive tract. They act by protecting the tissues against the aggressions of the acids. However, no clinical study seems to have been conducted up to date to prove this use.

Medication for heartburn

  • ANTACIDS: antacids used to neutralize gastric acid are not a good solution as they only offer temporary relief. Their calcium content has a double effect: it temporarily buffers acidity but also immediately provokes the secretion of new gastric acids. Rather than attempting to relieve symptoms on a short-term basis, it is preferable to adopt a holistic approach and act on the cause of the problem, and the overall factors that may help to reduce the frequency of the problem.
  • PROTON PUMP INHIBITORS (PPI): these medications, such as Losec, Prevacid or Nexium act directly on the natural mechanism that produces acid in the stomach. However, there is the risk of reducing too much acid in the stomach and thereby considerably decreasing the quality of our digestion. Gastric acid plays an essential role in digestion. Also, reducing the levels of gastric acid too much leaves us vulnerable to external bacterial contaminations. The gastric acid acts as the main barrier against bacterial contaminations within our digestive system; with its high acidity, it kills many bacteria that enter our digestive system.
  • OTHER MEDICATIONS: many medications sold with or without a prescription, such as aspirin, antidepressants, nonsteroidal anti-inflammatory painkillers, certain medications for the heart and high blood pressure, medications for asthma, painkillers, and sedatives can aggravate heartburn and acid reflux. If you take any of these medications, consult your doctor to verify this.

When to consult with a healthcare professional?

  • SEVERE AND FREQUENT PAIN: when your heartburn becomes a chronic situation, and your stomach becomes so sensitive that everything you eat makes you sick. If you have difficulty swallowing or if it is painful to swallow. In this case, your doctor should investigate the causes and establish a plan of intervention with you.
  • RISKS OF AN ULCER: if you suffer from heartburn before meals or have that burning sensation with no apparent reason for two to three times a week for over a month, it may be an ulcer.
  • COUGH, ASTHMATIC RESPIRATION: if you are bothered by a persistent cough, have asthmatic breathing difficulties and constantly feel like you need to rinse your mouth.
  • RISK OF A HEART ATTACK: if you are having a hard time swallowing, pain in your left arm, the presence of blood in vomit, blood in your stools or black stools, shortness of breath, pain in your neck and shoulders, and dizziness. These symptoms may indicate an impending heart attack.
  • VOMITING AND STOMACH PAIN.
  • UNEXPLAINED WEIGHT LOSS.
  • HOARSE VOICE, especially in the morning.
  • ZENKER’S DIVERTICULUM: an illness known as Zenker’s Diverticulum may also disrupt the digestive system, according to Bruce Luxson, doctor of medical science, assistant professor of the faculty of gastroenterology at the University of Saint Louis, Missouri. With this illness, food gets held in a sac within the esophagus instead of making its way down to the stomach. If you lie down for several hours after a meal, the sac empties itself by sending the food back up towards the mouth. In other words, food doesn’t get to the stomach very easily because it becomes trapped in the esophagus.

LIST OF FOODS TO AVOID OR EAT IN MODERATION:

  • BEVERAGES: fruit juices, alcohol, beer, wine, spirits, liqueurs, coffee and black tea, soft drinks and sweetened beverages, milk, soy milk drinks, almond milk drinks.
  • OILS AND FATS: butter, heated oils and fats, hydrogenated fats, refined fats, avocado oil, olive oil, sunflower seed oil, canola oil, linseed oil, corn oil, sesame oil, safflower oil, fried foods, animal fats, fatty foods, fast food.
  • VINEGAR: white vinegar, wine vinegar, apple cider vinegar, etc.
  • DAIRY PRODUCTS: milk, cheese, ice cream and yogurt in moderation.
  • ACIDIC FRUIT: such as cranberries, oranges, grapefruit, apples and clementines.

References:

Les médecines de la nature, Éditions Reader’s Digest.

Aliments santé et aliments danger, Éditions Reader’s Digest.

La pharmacie verte, Éditions Modus Santé, Symptômes, causes et guérison, Éditions Modus Santé.

Guide pratique de la phytothérapie, Éditions HM.

Les extraits d’herbes, Éditions La Bécassine bleue.

Bien se soigner, Éditions Carnets de santé.

Le guide des vitamines et suppléments, Éditions Modus Vivendi.

http://www.canalvie.com/sante-beaute/sante/index-des-maladies/brulure-d-estomac-1.1201529

https://sante.canoe.ca/channel/sante-digestive/brulures-destomac-et-indigestion/les-symptomes-des-brulures-destomac

https://sante.canoe.ca/condition/getcondition/rgo-reflux-gastro-sophagien

https://www.journaldemontreal.com/2016/02/14/8-astuces-contre-les-reflux-gastriques

https://www.passeportsante.net/fr/Maux/Problemes/Fiche.aspx?doc=reflux_gastro_oesophagien_pm

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991651/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4254461/

http://gut.bmj.com/content/early/2015/12/09/gutjnl-2015-310376/


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