Indigestion: Understanding Reflux and Heartburn

Gastro-oesophageal Reflux Disease (GORD) is a common condition experienced by up to one fifth of the population. People with this condition may experience the feeling of ‘heartburn’ or ‘reflux’, as well as possibly a number of other symptoms. These feelings occur when contents from the stomach, including stomach acid, travel back upwards through the gastro-oesophageal sphincter into the oesophagus. Medication for this condition is consistently in the top ten most commonly prescribed drugs.

 

How it works

On its journey through our digestive tract, food must go through a series of processes that break it down to enable it to be absorbed and used by the body. The first step is its mechanical breakdown in our mouths- chewing. Also our saliva has enzymes in it that start to break down some of the foods. After the mouth, food travels down the oesophagus into our stomachs, where it hits the most incredible acid bath imaginable! In an ideal world, the acid is strong, it breaks down our chewed food into even smaller parts. Alongside the hydrochloric acid is pepsin, an enzyme which also starts to break down proteins foods down. Then the food travels downwards and out into the small intestine, where the acidity of this mixture triggers the release of further digestive secretions. So the stomach’s role is so important, not just for the breakdown of the food, but for everything else that follows. If there isn’t a strong enough acid, or the food isn’t broken down effectively, it makes all the rest of the processes that follow far less efficient. Stomach acid is also important for killing any bugs that might come in with the food, and so plays an important role in our immune system.

 

High Acid or Low?

Although many people assume that heartburn and reflux are due to ‘too much acid’, in actual fact sometimes there is too little acid, or in other words, the stomach acid and secretions are not as acidic as they should be. As we age our gastric (stomach) acid production can decrease, making it harder to digest and break down certain foods. If we aren’t breaking foods down, or they don’t agree with us, our stomach may just send it back – reflux!

 

Why does it hurt?

‘Heartburn’ really is like a burn, an acid burn, and the associated pain and damage to tissues is directly related to the presence of acid. But the acid itself isn’t the real problem. We need strong acid for good food digestion. The problem is that the stomach itself has layers of mucus and in a balanced state protects itself from the acid. When it is out of balance, it becomes less protected and can become inflamed and raw. In a worst case scenario an ulcer can develop. Also, if the sphincter becomes weak and acid is often coming back up into the oesophagus, these tissues become damaged and can become raw and scarred.

 

Suppressing Acid Production

Medications that seek to suppress or reduce acid production provide immense relief and allow the tissues to heal without the constant acid exposure. These can be useful when taken short-term, but what effect might reduced acid have over longer periods?

 

The effects of reduced acid production may include the reduced absorption of certain essential minerals (magnesium is just one that has been documented in the research). Potentially, with digestive function compromised, further digestive issues may arise (bloating, bowel irregularities, food sensitivities etc). Another possible outcome could be reduced immunity as bugs don’t get effectively killed off by the acid environment.

 

A Special Note: Reflux in Babies

You may be reading this because you are the concerned parent of a baby who has been medically diagnosed with reflux. This can be incredibly distressing as babies can experience so much pain and discomfort with this condition. Almost all the tips below can still apply. Slippery Elm powder can be a useful adjunct to treatment, as can baby-specific probiotics. Identifying any foods that may be triggers via the breast-milk is key. Laying babies on their left side is useful as the sphincter opening is usually on the right side. Also feeding frequently and for shorter periods can help if there is too much force with a fast flow of breastmilk. Car seats can be a difficult place for a refluxy baby to be, so reduce time spent in transit if possible!

 

Simple Tips for Supporting Your Stomach

  • Stop, sit, breathe, look, smell, listen, feel and then eat. The brain is actually the first digestive organ that must be engaged, as it tells the rest of the body to get ready for action! Don’t eat at your desk or in your car. Savour your food.
  • Chew food well. Really well. And then chew it again.
  • Enhance natural digestive function by eating or drinking bitter foods or herbal bitters before meals.
  • Keep portions small and manageable.
  • Support digestive function with Apple Cider Vinegar.
  • Identify foods which exacerbate your indigestion – you might just be surprised! The commonly known triggers are spicy foods, alcohol, coffee, and fried foods. Lesser known triggers are potatoes! But this is highly individual and should be assessed on an individual basis.
  • Learn how to breathe deeply; diaphragmatic breathing can make a remarkable difference to reflux symptoms.
  • Lose weight if you are overweight.
  • Check your stress. Stress is a major contributor to poor digestive function and reflux specifically.
  • Elevate the head of the bed or use extra pillows at night- do note however that this in no way treats reflux it simply may reduce discomfort
  • Avoid smoking
  • Don’t eat too late at night
  • Try not to drink while eating. If you want to drink, take small sips as large volumes of fluid will place extra pressure on the stomach
  • Don’t drink gassy drinks while eating due to the pressure that the gas puts on the stomach and oesophagus
  • Don’t lie down directly after meals. If one suffers with reflux then try to go for a walk after meals. Don’t lie down for an hour after eating.
  • Herbal medicine seeks to improve sphincter tone and function, and heal and soothe the gastric lining, without reducing acid production or digestive function. See your naturopath or medical herbalist for tailor-made support.
  • As a naturopath friend of mine once said to me: Most of the time, heartburn and reflux is due to poor practises around eating, just understanding simple plumbing can help a lot!”

 

Using natural approaches to support and improve digestive function has the benefit of not only eliminating unpleasant symptoms of reflux and heartburn, but also improving the absorption of nutrients and general health and well-being overall.

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