(And why acid blocking medications aren’t solving the problem)
That uncomfortable burning sensation in your throat or chest, or regurgitation of food after you’ve eaten, that’s heartburn.
Sometimes heartburn presents with very obvious symptoms. Other times it can just feel like you are having chest pain ranging from mild to severe. In other cases, there is not burning feeling, but you may notice excessive burping, bad breath, a chronic cough that is not asthma, or even post nasal drip or sinus congestion. These can be signs of silent reflux, where you are having the acid reflux but not noticing the burning or pain symptom.
Tired of reaching for tums?
Very often when we have heartburn, we are prescribed a medication to lower our stomach acid. This is based on the theory that stomach acid must be too high which is causing the reflux. In truth though that is the only the rarest of case, and most cases of reflux come from a different cause.
The number one cause being LOW stomach acid.
What! How can that work? Well, there is a sphincter at the bottom of your esophagus, into your stomach. The trigger to close this sphincter really tightly is actually having stomach acid that is high enough. So, in order to fix the reflux, we often usually have to build that acid back up. And it is important we do so, because it actually is necessary for many other body processes.
Having enough stomach acid is important for how your whole digestive tract works, and a lot of other body processes too.
First, we need adequate levels to digest our foods to a certain point so that they can’t be fermented by bacteria in the gut. Second, we need those levels high enough so that we control populations of certain bacteria and yeasts in the gut. Third, the level of stomach acid triggers the release of other factors that aid in absorption of certain nutrients, as well as trigger the release of digestive enzymes from the gallbladder and pancreas to process different parts of our foods.
There are other causes of heartburn as well.
One is a reaction to a food that you are eating. Another is dysbiosis, or inappropriate levels of certain bacteria or yeast in the wrong areas of the digestive tracts.
And finally, it could be a hiatal hernia, which is very common.
That is where a small portion of the top of the stomach is shifted out of normal position and basically comes up through the hole in the diaphragm where your esophagus comes through. This causes a mechanical disruption of the sphincter being able to close properly (imagine two sides are stretched too far apart). These hernias are common after pregnancy, weight improper lifting techniques, and with activities that have us bending over while working with an increased pressure within the abdomen (think gardening etc). The good news is that all of these things can be treated easily and effectively, and that you can get off of your reflux medication with proper guidance.