How to manage reflux naturally!

A common complaint we see in clinic is acid reflux, also known as heartburn. This is where the acidic contents from your stomach move up into your oesophagus... Not fun. If you want to eat again without the fear of reflux, read on!

Signs and symptoms of reflux include:

• Burning in the chest or oesophageal region

• Chest pain

• Difficulty swallowing

• Regurgitation of food or sour liquid

• Sensation of a lump in your throat

• Chronic cough

   

Reflux can be caused by a number of factors, including:

Poor lower oesophageal sphincter tone: Think of the lower oesophageal sphincter like a door. When you swallow, a circular band of muscle around the bottom of your oesophagus relaxes to allow food and liquid to flow into your stomach. Then the sphincter closes again. If the tone of these muscles are too weak, they are unable to close when they need to. This allows the stomach secretions to come up into the oesophagus.

Hypochlorhydria (low stomach acid): Often reflux is misunderstood as being caused by over-acidity. Rather, it may result because of low stomach acid, or hydrochloric acid (HCl). In this scenario, the oesophagus ‘door’ doesn't get the message to close because there is not enough acid in the stomach. The result? Reflux.

Delayed gastric emptying: is when your food stays in the stomach for too long. This can be a side issue to having low stomach acid as the food takes longer to break down and clear the stomach.

Stress: decreases the production of HCl. When your body is in fight or flight, it is not focusing on digesting (rest & digest), and as a result, less HCl is produced.

Helicobacter pylori (H. pylori): is a cause AND effect of reflux. If you have H. pylori, it can cause reflux. Likewise, H pylori can overgrow in a higher pH environment, meaning when the stomach is not as acidic as it should be, the likelihood of having a H. pylori overgrowth is higher. If you do experience chronic reflux, it's important to rule this out.

Diet: fatty foods, chocolate, coffee, alcohol, spicy foods and acidic foods may be problematic for some people. Eating too much may also contribute to reflux.

Others: obesity, certain medications, & aging can all contribute to reflux.

The most common medication for reflux is a protein pump inhibitor, or PPI, which works by blocking acid production in the stomach. The problem with blocking acid production is that often the reflux is caused by low acid in the stomach to start with! PPIs also change the pH of the stomach which may allow opportunistic bacteria to grow. Lastly, long term PPI use may cause deficiencies of folate, B12, iron, zinc & calcium.

So what can we do about it??

To reduce the occurrence of reflux by working on the root cause, try the following:

• Chew well and eat slowly! Allow plenty of time for your stomach to prepare for the food that’s coming.

• Bitter foods: help to improve our digestive fire. Try having raw bitter foods at the start of a meal such as rocket, witlof, radicchio, and bok choy.

• Don't eat when stressed. Our ability to produce hydrochloric acid is low at this time.

• Avoid trigger foods: such as coffee, chocolate, alcohol, fatty foods, spicy foods, and acidic foods (eg. citrus & tomato).

• Manage weight: if that is a contributing factor.

• Avoid overeating. If you're feeling full, pack the remaining food away for a snack later.

• Avoid eating within 3 hours of bedtime.

• If you're a smoker: and are experiencing reflux, now is the time to quit.

• Ensure adequate daily protein: of approximately 1gm per kg of body weight .

• Glutamine & amino acid formula: 5g twice daily.

• Betaine hydrochloride: 400-800mg with per meal.

• Mucosal protecting herbs: licorice, marshmallow, slippery elm, and chamomile.

• Bitter herbs: gentian, globe artichoke, dandelion root.

If you’ve had chronic reflux for years, it's important to rule out Barrett's oesophagus which can result due to the cells of the oesophagus becoming damaged. See a health professional if this is you.

If you are experiencing signs of reflux and would like individualised support, please get in touch by booking in a Discovery Call here

References
Hechtman, L. M. (2012). Clinical naturopathic medicine. Australia: Elsevier Health Sciences.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991651/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502218/