Breathing Fire

Imagine the repercussions on an assembly line if one worker didn’t show up on time. Instead of the product moving along to the next station for further processing, you’d get a backlog on the conveyor belt. You’d also get a poorly packaged product that would cause other problems down the line.

The digestive tract and its components really aren’t that different from an assembly line. Each organ along the tract plays a role in breaking down the food we eat, harvesting nutrients, feeding our microbes, and giving the system a good cleanse as waste leaves the building.

Acid reflux is a sign that the digestive system’s conveyor belt is not operating smoothly. Instead of gastric contents passing from the stomach into the small intestine as they should, food and stomach acid can regurgitate, or reflux, into the esophagus. Reflux not only causes irritating symptoms but also paves the way for other health concerns down the line.

Symptoms of acid reflux

Acid reflux commonly causes burning in the chest, which we colloquially call heartburn. But reflux can also present as chest pain, food regurgitation, bitter taste, chronic cough, asthma, throat clearing, hoarseness, a lump-in-the-throat sensation, belching, and trouble swallowing.

If you experience reflux regularly, it might be classified as gastroesophageal reflux disease (GERD). Having symptoms at least twice per week for four to eight weeks may indicate GERD.

But other health conditions may mimic reflux symptoms, so it’s a good idea to inform your physician of your symptoms so that you receive an accurate diagnosis and treatment.

Long-term effects of reflux

Whereas occasional reflux may resolve on its own without lasting effects, GERD negatively affects quality of life, requires treatment, and is associated with increased risks of other health concerns. Those with GERD have an increased risk of painful conditions that can lead to permanent damage to the esophagus, as well as an increased risk of esophageal cancer.

GERD usually responds well to treatment with proton pump inhibitors (PPIs), which reduce stomach acidity. However, long-term PPI use is associated with an increased risk of bone fracture, renal disease, pneumonia, and nutrient deficiency.

Not all acid is bad

In the conveyor belt of the digestive tract, stomach acid plays a vital role. We need stomach acid to facilitate digestion; absorb iron, calcium, and vitamin B12; and kill harmful micro-organisms.

Long-term PPI use can cause a state of hypochlorhydria (low stomach acid), which weakens digestion, impairs nutrient absorption, and increases susceptibility to intestinal infections. A low-acid environment in the stomach has been identified as a contributor to small intestinal dysbiosis, which can lead to disease in the gastrointestinal tract.

Strangely enough, low stomach acid can also cause heartburn! In this case, treating with acid-lowering medications is not helpful. However, supplementing with betaine HCl can improve hypochlorhydria caused by PPI use.

Although research in this area is limited, there are anecdotal reports that drinking a teaspoon of apple cider vinegar before a meal may be helpful for low stomach acid.

Causes of reflux

The food we eat and how we eat it play a role in reflux. Irregular mealtimes, large portion sizes, and eating before bed are associated with GERD symptoms. Acidic foods such as tomato, orange, or grapefruit; coffee and tea; foods that are spicy, fatty, or fried; carbonated beverages; and chocolate can trigger GERD.

Lifestyle patterns also affect reflux. Tobacco smoking is a contributing factor in GERD. Smoking also reduces the production of saliva, which helps protect the esophageal mucous membrane from acid. Alcohol consumption can trigger reflux episodes and aggravate acid-related esophageal injury.

Other lifestyle factors that contribute to GERD include obesity, vigorous exercise, exercise right after a meal, or lack of regular exercise.

GERD is more common in women and is associated with aging and stress.

Natural reflux support	Benefit
probiotics	can improve heartburn and reflux in GERD
turmeric	may be helpful in reducing mucosal damage from reflux
apple cider vinegar, licorice, calcium carbonate, and papain	may improve symptoms of heartburn and acid reflux, based on a study, when combined and taken as a chewing gum

Diet and lifestyle

The positive thing about the correlation between reflux, diet, and lifestyle is that we have the power to do something about it! Making diet and lifestyle changes now can help manage reflux in the long term.

Embrace regular mealtimes and be mindful that you don’t make a habit of overeating. Minimizing acidic, spicy, and fried foods in the diet can also reduce reflux episodes.

Schedule moderate-intensity exercise a good distance away from mealtimes and bedtime. For sleep, lie on your left side and raise the head of the bed to reduce nighttime reflux.

Mind-body practices

Diaphragmatic breathing exercises also reduce reflux symptoms and PPI use, while improving quality of life. Breathing into the abdomen rather than the chest trains the diaphragm and strengthens the lower esophageal sphincter to prevent reflux.

Integrative care

Acupuncture can be used to improve quality of life among those with GERD, with research showing that, when used alongside conventional medical management of reflux, acupuncture can provide more effective results than medication alone.

Hypnotherapy, which encourages a state of deep relaxation, has also shown positive results in providing relief for those suffering from reflux.

Natural digestion support	Benefit
peppermint	reduces pain in irritable bowel syndrome (IBS) and diffuses esophageal spasms
bananas	may have anti-inflammatory effects in the gut, suggests preliminary research on resistant starches, including green banana flour
chamomile	may be helpful in the treatment of oral inflammation and ulceration
ginger	may prevent gastric ulcers induced by nonsteroidal anti-inflammatory drugs