###Managing Heartburn -By Dr. Isaac Eliaz on 07/24/2010
Summertime means picnics, barbecues, and celebrating the warm weather with friends and family! However, if you suffer from heartburn, barbecued meat and high-fat snack foods may trigger this uncomfortable condition.
The exact cause and therefore the best treatments for heartburn and acid reflux are complex and debatable.
In order to digest food, the stomach releases hydrochloride acid (HCL). Between the stomach and the esophagus is the lower esophageal sphincter (LES) muscle, which opens to allow food into the stomach, and then closes to keep the stomach acid from flowing back up the esophagus. If this muscle becomes weak or doesn¡¯t function properly, stomach acids can move into the esophagus, creating the burning sensations of heartburn.
Acid reflux is often considered a problem of too much HCL. However, having too much stomach acid is very rare. In fact, stomach acid levels decline as we grow older. For most it's not an issue of excess stomach acid – as most of us have low to normal levels – but of keeping the acid from rising into the esophagus.
Although it¡¯s still unclear exactly what causes the LES muscle to weaken, one theory is that the stomach becomes overburdened with the task of digesting food because it does not have enough stomach acid. Without sufficient stomach acid, the food is not being broken down and nutrients are not being effectively delivered to the duodenum, the first part of the small intestine that attaches to the stomach. Nutrients are then not delivered adequately into the small intestine where they can be absorbed into the bloodstream.
The stomach continues to fill with acid, pepsin, and bile, working hard to break down all the food present. This causes the stomach to expand and become overwhelmed, pushing the gastric juices up, essentially backing up into the esophagus, resulting in acid reflux and symptoms of heartburn.
Other causes of acid reflux are linked to the nervous system. Certain factors may cause abnormal nerve or muscle function in the stomach. These abnormalities can cause impaired motility, which is the inability of muscles to act spontaneously. In this case, the stomach muscles do not contract normally, which causes delays in stomach emptying, increasing the risk for acid back up. Abnormalities in the esophagus itself can account for a large percentage of symptoms. Smoking has also been linked to weakening of the LES muscle.
Over the counter heartburn medications and proton pump inhibitors (PPIs) work by turning off many of the ¡°acid pumps¡± in the stomach¡¯s acid-producing cells. However, proton pump inhibitors like Prevacid, Prilosec and Nexium seriously impair your digestion by significantly reducing the amount of acid in your stomach, impairing your ability to properly digest food. Stomach acid also serves an important purpose for immunity because it kills food-borne pathogens. By reducing your levels of stomach acid with heartburn medication, you increase your risk of food poisoning. Helicobacter pylori, the bacteria responsible for most ulcers and inflammation of your stomach lining, is also a contributing cause of the symptoms of acid reflux. When you suppress the production acid in your stomach, you minimize your body¡¯s ability to kill this dangerous bacterium. Chronic use of OTC heartburn medications can thereby turn into an aggravated cycle as the integrity of your stomach¡¯s environment becomes steadily compromised.
Studies have also shown that low stomach acid disrupts calcium metabolism and iron absorption, and may contribute to osteoporosis and iron deficiency anemia. To further complicate the problem, your overall health may worsen because you aren¡¯t getting all the important nutrients from your food. Clearly, normal levels of stomach acid are vital to good health and should not be compromised or reduced.
###Treatment Tips
This summer, try to avoid or minimize high fat meats and deep-fried foods, which tend to sit in the stomach longer. Don¡¯t eat large meals; instead, opt for small meals and snacks. Also avoid acidic fruit, especially tomato products like ketchup and salsa. Try not to overdo it on alcohol, caffeine, or carbonated beverages. Eat your main meal earlier in the day when you are more active, have a lighter meal in the early evening and do not eat before bed.
If you are a loyal antacid user, decrease the dosages and frequency slowly instead of quitting immediately. After you have reduced or stopped medication, try an over the counter betaine hydrochloric supplement. If you have a current ulcer, you should not take hydrochloric acid. It is best to do this under the supervision of a knowledgeable health care practitioner. Normalizing your stomach acid will enable your body to better digest your food, and will help protect your stomach from H. pylori bacteria, as well as bring relief from your heartburn symptoms. An alternative method to try is deglycyrrhized licorice (DGL). This demulcent herb heals and soothes the esophageal lining. The use of ¡°bitter¡±, and herbal tincture containing a combination of bitter-tasting herbs is an ancient folk remedy for signaling your entire digestive system to make the appropriate juices and enzymes in anticipation of a meal. Bitters can be found at your local health food store. Take a small amount 10 minutes prior to your meals. Over time this will retrain your entire digestive system to a normal natural secretion pattern.
In addition, to improve and strengthen your overall digestion, I recommend including zinc, enzymes and herbs known for digestive health benefits. It¡¯s best to use an integrated formula, complete with enzymes such as Amylase, Alpha-galactosidase, protease, phytase, invertase, and lipase, as well as deglycyrrhizinated licorice and ginger. I also suggest adding probiotics to your daily routine. Probiotics contain good bacteria that may improve your digestive health.
Eating our favorite summertime foods doesn¡¯t mean that we have to suffer for it! By focusing on strengthening your stomach environment with herbs and supplements, weaning yourself from heartburn medication when necessary, and moderating acid producing foods, the indulgences of summer can be enjoyed without remorse. And with the hot summer sun out, remember to drink lots of water |