What You Need to Know about Acid Reflux, Heartburn and GERD

This is a long one, so make yourself comfortable and read on…

Acid reflux is becoming common even at a younger age group. Acid-blocking drugs such as PPIs like Nexium and Prevacid and H2 Blockers like Ranitidine (which was recalled last April 2020, FYI) are one of the most prescribed medications around the world. With the addition of stress due to the pandemic, there is a drastic increase in the incidence of people experiencing acid reflux.

Why are we suffering from reflux? What is the cause? Why are we seeing it as “normal”? What can we do to heal ourselves from it?

First, definitions…

Acid reflux, heartburn and GERD are sometimes used interchangeably but are they really the same?

Acid reflux is a condition wherein the acid from the stomach flows backward into the esophagus leading to what you may know as heartburn, a common symptom characterized by a burning pain or discomfort. GERD or Gastroesophageal reflux disease is a diagnosis given to you when acid reflux progresses and worsens for a longer duration. While acid reflux may not sound that serious at first, it can lead to worse complications if not dealt with.

What are the Symptoms of Acid Reflux?

This is not a definitive set of symptoms but here are some common ones that you may be experiencing.

• Sore throat and/or hoarse voice

• Persistent dry cough

• Heartburn (mild to severe that can be mistaken for a heart attack)

• Chest pain

• Sensation of a lump in the throat

• Bad taste in the mouth

• Difficulty swallowing

• Asthma

What Causes Acid Reflux?

In Functional Medicine, we like to ask “What’s causing this symptom?”

Like any other diseases, it is usually not due to one cause alone but a number of them, accumulated for a long time until your body has filled up its rain barrel.

There are primary of root causes to consider:

• Chronic stress. Being stressed for a long time affects your nervous system making it difficult for your stomach to process the food properly. This is why our mother’s would tell us to stay seated when we eat our meals, not keep on walking around because we digest our food well when we relax and enjoy our meal. When you are in stress like being angry or worried about something, notice how your gut respond, maybe a bit of bloating or indigestion.

• Food sensitivities. The common ones are dairy, gluten and food additives. When the gut is leaky and particles enter the lining, it causes the body to go into a vicious cycle of symptoms. These can be detected by doing an Elimination Diet or a Food Sensitivity Test. It is best to be guided by a trained healthcare practitioner.

• Nutrient deficiency. An example is Magnesium. The loss of this mineral can be due to stress and medication. Magnesium is important in the relaxation of the lower esophageal sphincter. Lacking in magnesium allows the food and acid to go up.

• Bacteria and yeast overgrowth. If you have been taking antibiotics, chances are your gut microflora has been imbalanced leading to more bad bugs growing inside. They ferment the food you are eating, producing gas leading to bloating and reflux. Eating a lot of sugar and processed food can also cause this.

• Overweight or obesity. There’s a lot of correlation between poor gut health and weight gain. This is also linked to dysbiosis or imbalance of the gut microflora.

 Other factors that can also cause acid reflux:

• Aging

• Hiatal hernia

• Eating right before bed

In terms of food triggers, here are some that are common:

• Fried and processed foods

• Spicy foods

• Citrus foods

• Tomato-based foods

• Alcohol

• Caffeine (yes, sad to say this can cause acid reflux :( )

What can I do if I have Acid Reflux?

Again, deal with the root of it. As mentioned previously, there are a lot of things that you need to check with and it isn’t just taking an acid blocker or an antacid, which can cause all sorts of problems. While it does give you instant relief, it also adds burden to your body.

Acid blockers may cause:

• Bloating

• Overgrowth of bad bacteria, yeast and parasite

• Prevent mineral absorption such as zinc (decrease immunity, wound healing, etc.)

• Prevent vitamin absorption such as B12 (leads to neuropathy, memory problems, etc.)

Because Functional Medicine is medicine by cause and not by symptom, it is encouraged that you explore changes that will target the root cause.

• Fix your food and eating habits- This may sound simple but can be very difficult to some. But frankly, if you want to be free from acid reflux, start by removing food triggers such as fried foods, spicy foods and citrus foods. Set a relaxing vibe before each meal. Take deep breathes to relax your nervous system and help your gut to digest your food better.

• Remove food allergens- Set at least 2 weeks to remove food allergens such as gluten and dairy. It is also encouraged that you do food journaling to take note of what you ate and how you felt after.

• Adjust eating and sleeping time- Instead of lying in bed and sleeping right after eating, allow your food to digest first. Do not eat 3 hours before bed.

• Support with specific supplements- There are a number of supplements that can support your gut. Glutamine and aloe helps by coating the stomach lining and digest your food better. Deglycerized licorice (DGL) helps to coach the stomach as well and prevent acid reflux. Digestive enzymes help break down food. Magnesium, zinc and probiotics have shown to help acid reflux.

• Do testing- There are a number of specialty lab tests that will help you identify and confirm the problem. You would need to work with a Functional Medicine healthcare practitioner for this. You can test for H. Pylori, food sensitivity, bacterial overgrowth, yeast overgrowth and parasites.

What is Silent Reflux?

Is this the first time you’ve heard of it? It is also called Laryngopharyngeal Reflux (LPR). It happens when acid from the stomach goes to the esophagus and makes its way into the larynx (voice box) and throat. It is called silent reflux because it does not cause the same burning sensation you would feel with a heartburn and often go unnoticed for some time.

Symptoms may be so mild that you may overlook them. Since the acid makes it way to the larynx and throat, symptoms can show up as:

• Sore throat

• Hoarseness

• Chronic cough

• Difficulty swallowing

• Shortness of breath

While I do not want you to get paranoid with these symptoms, I also want to encourage you to have it checked and see if any of these symptoms will reduce when you try some eating and lifestyle changes as mentioned previously. What you do not want is to let it pass and having to deal with a full-blown myriad of symptoms. The process to reverse them is more complex and will likely to take a longer time.