When you are diagnosed with heartburn, the pain is bad, and you want relief now. So, when your doctor prescribes an antacid, you naturally want to race to the pharmacy to get your prescription filled.
Before you start popping those pills or chewing those tablets, did you know that antacids can cause osteoporosis?
Let’s talk about the difference between heartburn and acid reflux and GERD, what causes them, how to eliminate them, and how to improve digestion naturally.
You Need Your Stomach Acid
Stomach acid is necessary to digest your food, assimilate proteins into usable amino acids, activate digestive enzymes in your small intestine, keep the bacteria from growing in your stomach and small intestine, and help you absorb important nutrients like calcium, magnesium, and vitamin B12.
When you suppress the amount of acid in your stomach, you are increasing your risk for
- bone fractures
- iron deficiency anemia
- vitamin B12 deficiency, which can lead to depression, anemia, fatigue, nerve damage, and even dementia, especially in the elderly
- food poisoning
- irritable bowel syndrome
- protein deficiency (which leads to muscle wasting and weakness)
Mother Nature makes your stomach acid for a reason. Stomach acid (hydrochloric acid) makes the calcium (all minerals actually) soluble so that it can be absorbed in your intestines. If your stomach produces too little stomach acid (hydrochloric acid), or your stomach acid is blocked by antacids, then calcium (all minerals) from food or supplements cannot be absorbed.
Antacids inhibit the absorption of calcium regardless of the brand, whether prescription or over the counter. TUMS is NOT your friend, and even though it is made with calcium, it can actually make your bones weaker. To learn more about the effects of Calcium on your bones, please read my comprehensive report Important facts that can make or break your bones HERE
How Things Work
You have two stomach valves where food enters and exits, the IN valve (lower esophageal sphincter also known as the LES) and the OUT valve (pyloric sphincter). When you swallow food, it passes through the IN valve and enters the stomach where stomach acid is released along with the powerful digestive enzyme pepsin to break down proteins and inhibit bacterial growth. The food is churned in the stomach with the acid and enzymes until it reaches a low enough pH that it activates the OUT valve to continue the digestive process.
In normal digestion, the lower esophageal sphincter (LES) opens to allow food to pass into the stomach and closes to prevent food and acidic stomach juices from flowing back into the esophagus. But if the LES is weak or relaxes inappropriately, the stomach’s contents can flow back up into the esophagus causing the sensation of heartburn, but it is actually acid reflux. This condition is referred to as Gastroesophageal Reflux Disease (GERD).
Is Heartburn the Same Thing as GERD?
Medical websites make it very complicated to understand. There are references to heartburn, acid reflux and GERD.
Let me unravel the mystery for you.
Heartburn is also called acid indigestion and usually feels like a burning chest pain beginning behind the breastbone and moving upward to the neck and throat. It may feel like food is coming back into your mouth and it may give you an acid or bitter taste. The burning, pressure, or pain of heartburn can last as long as 2 hours and is often worse after eating.
Heartburn, acid reflux and GERD are the same because each one is caused by stomach acid that has gotten past the LES into the esophagus and is causing a burning sensation.
The Burning Is Not in Your Stomach
If you will notice, I keep referring to acid burning in the esophagus and not in the stomach. Most people think that heartburn is a burning in their stomach. But, to feel a burning sensation in your stomach, you would have to have problems with your stomach lining such as an ulcer.
This is because your stomach is naturally protected from stomach acid by mucous. If you did not have this coating, then every time you ate, you would experience a burning in your stomach.
Your esophagus on the other hand, is NOT protected by this mucous so what most people call “heartburn” is the splashing up of hydrochloric acid (HCl) into the esophagus.
Symptoms of acid reflux/heartburn and GERD include:
- Burning pain in your chest
- Irritation in your throat
- Acid taste in your mouth
- Bad breath
- Chronic cough
- Difficulty swallowing
If the Burning IS in Your Stomach
The 3 most probable causes of an actual burning sensation in your stomach.
- Stomach cancer
The symptoms of gastritis and ulcers are very similar. Both can cause a dull ache or burning pain in the upper abdomen. Other symptoms include nausea, vomiting, loss of appetite, and belching or bloating.
A Peptic Ulcer is an open sore in the lining of the stomach or duodenum (upper intestine) and gastritis is an irritation or inflammation of the stomach lining.
Both ulcers and gastritis are most commonly caused by overuse of alcohol or anti-inflammatory medications (such as aspirin, ibuprofen, naproxen and prednisone) and/or H pylori infection.
You Want to Eliminate Acid Reflux/GERD
If a person experiences acid reflux on a regular basis, the acids will irritate the esophagus which can advance to scarring, ulceration, inflammation and hemorrhaging. It may even lead to esophageal cancer.
This is why you don’t want acid reflux and why your doctor prescribes an antacid as a quick fix.
But, in most cases, antacids are the wrong approach. You need to get to the root of the problem, not just put a band-aid on it.
NOTE: If you are taking a prescription antacid do not quit cold turkey.
Heartburn and GERD, A Rising Problem
More than 60 million North American adults experience heartburn at least once a month, and more than 15 million adults suffer daily from heartburn. Recent studies show that GERD (Gastrointestinal Esophageal Reflux Disease) in infants and children is more common than previously recognized and may produce recurrent vomiting, coughing and other respiratory problems.
So, what is causing all this acid indigestion?
The most common causes that your doctor will likely cover are:
1. Hiatal hernia.
Any time an internal body part pushes into an area where it doesn’t belong, it’s called a hernia.
A hiatal hernia is a structural problem that occurs when the lower esophageal sphincter (LES) and stomach wall below it partially bulge up through the opening in the diaphragm. Normally, the diaphragm muscles serve as an extra barrier for the LES. In a hiatal hernia, the diaphragm encircles and impinges on the upper stomach wall, weakening the LES and allowing the acidic contents of the stomach up into the esophagus.
Research shows that the larger the hernia, the greater the acid reflux. Some people can have a hernia and never experience symptoms, but persistent heartburn is a common complaint of hiatal hernia patients.
2. Pregnancy or Weight Gain
The pressure of a growing fetus or increased abdominal fat can push up on your stomach, putting added pressure on the LES which can allow stomach contents including stomach acid into the esophagus.
Certain medication such as Fosomax (given to women with osteoporosis) can actually cause heartburn).
Less serious side effects of Fosomax may include:
- mild heartburn, bloating;
- mild nausea, vomiting, or stomach pain;
- diarrhea, gas, or constipation;
- mild joint pain or swelling;
- swelling in your hands or feet; or.
- dizziness, eye pain, headache.
What if you had osteoporosis and were given Fosomax, then you developed heartburn so you were given an antacid? As a result, you were not able to absorb calcium/magnesium which are needed to build bone. In the end, your osteoporosis would get worse, not better!
This may seem absurd, but trust me, in over 35 years of practice, I have seen scenarios like this (and worse), occur hundreds of times.
The medical advice you could be given should help, but it won’t be the “cure”.
- Lose weight.
- Check your medication to see if it is the culprit. Work with your health care practitioner to find natural solutions if the medication needs to be discontinued.
- Don’t lie down within three hours of eating, as that is when acid production is at its height. Gravity helps keep your stomach contents down where they belong so if you lie down after a meal, you lose this assistance and the acid can potentially splash up into your esophagus.
- Certain foods and beverages have been found to weaken the LES such as chocolate, peppermint, fatty foods, tomatoes, coffee, and alcoholic beverages. These should be reduced or eliminated.
- Eat smaller meals and chew properly. **I can’t stress this enough.
- Take an antacid (this could be over the counter or one may be prescribed). **this is the only advice I DON’T AGREE WITH.
If you look at the “real” causes of heartburn and take appropriate action, you will eliminate it entirely.
Top 5 Real Causes of Heartburn and GERD
You may need to address anywhere from 1 to 5 causes. I suggest working through the list starting at number 1.
#1. Candida Overgrowth
Novels could be written on the topic of Candida Yeast Overgrowth (also known as Candidiasis). So here is what you need to know in a nutshell.
You have good bacteria, bad bacteria and yeast in your guts. The good bacteria should keep the bad bacteria and yeast under control, but the following allow for Candida yeast to over grow:
- Antibiotics by prescription or antibiotics in your food
- Birth control pills
- Steroids such as cortisone or prednisone
- A diet high in refined foods and sugar
- A weak immune system
Candida is a toxic and tenacious yeast that will take over your guts at every opportunity. It will consume your nutrients and dump toxins in your bloodstream. This can give you numerous symptoms that cannot be traced by any laboratory tests. One of those symptoms is heartburn (NOTE: not all people with Candida will have heartburn and not all people with heartburn have an overgrowth of Candida).
To find out for free, if you have Candida and if you do, what you should do about it, go to our online Health Solution: Is It All In Your Head? Or Is It Candida?
If you have Candida, you will absolutely need to follow the protocol I outline in my e-manual to eliminate the overgrowth. If you are on heartburn/reflux medication, do not attempt to wean off your medication until you are well into your Candida program.
The entire Candida program, including step-by-step e-manual is available HERE through our online store.
Stress contributes to reflux in many ways.
- Clearly, food is supposed to go down, not up, when you eat. That’s why there are two main valves, or sphincters, that control food going in and out of your stomach. When you’re stressed, the valve on the top relaxes and the valve on the bottom tightens up. This may result in acid traveling back up your esophagus.
- Under stress you lose copious amounts of magnesium. Magnesium helps the sphincter at the bottom of the stomach relax, allowing the food to leave the stomach. (See next about magnesium).
There is lots to be done about stress. For more details refer to chapter 10 in my book “Get Off the PMS and Perimenopausal Roller Coaster, Learn 9 Natural Fast Track Solutions to Balanced Hormones.” My book is available HERE (shipping in Canada is free).
In my book, I have covered many ways to calm your nerves while in the middle of a stressful time and how to recover after a wave of stress.
Our favorite overall product that both helps calm your nerves while in stress and helps you recover from stress is Rhoziva (the only brand of Rhodiola that we recommend).
Rhodiola acts like a hormone thermostat, especially as it pertains to cortisol, one of our main stress hormones. We believe that cortisol is usually, if not always, out of whack when you’re stressed out and exhausted.
If you have read my hormone book, you know that cortisol levels are either too high when they should be low or not high enough when we need more. Getting your cortisol back in rhythm when you’re compromised is crucial and Rhodiola literally helps balance the cortisol levels in your body, raising or lowering it as needed.
Rhoziva is an adaptogen which refers to the unique ability of this herb to help you adapt to the stress in your life. It does this by “normalizing” or “regulating” the adrenal stress response. You can rely on this brand of Rhodiola to be safe and gentle, even with longer term use.
Adaptogens like Rhoziva work best when taken for a minimum of 3 months, and for as long as a year.
#3 Magnesium Deficiency
Low magnesium can cause specific (or all!) muscles to be too tight or to spasm erratically. This includes your LES (lower esophageal sphincter).
Since calcium causes muscle contraction and magnesium causes muscle release, people that are deficient in magnesium will commonly have symptoms such as muscle contraction or spasms like high blood pressure, asthma, constipation, muscle cramps, muscle tension, headaches, menstrual cramps, restless leg syndrome and grinding of teeth or clenching of their jaw (this is usually incorrectly treated with a night guard instead of magnesium).
If you are deficient in magnesium, you won’t necessarily have all the above symptoms. Blood tests are not accurate and so the best way to determine whether or not you have a magnesium deficiency is to complete the questionnaire in my book “Get Off the PMS and Perimenopausal Roller Coaster, Learn 9 Natural Fast Track Solutions to Balanced Hormones” or go here Magnesium Deficiency Checklist and learn more about magnesium.
If you have a magnesium deficiency follow the protocol set out in my book or in my free Magnesium Usage Guide found here https://hormonerollercoaster.com/free-downloads/
For treating the deficiency we recommend using Magnesium Citrate with L-Taurine, found in our online store HERE.
#4 Low Stomach Acid
That’s right! It seems counter intuitive that the cause of too much stomach acid is from too little, but you can get “heartburn” if you are not producing enough stomach acid. One of two things usually happen.
- The food will churn longer and remain in the stomach for hours until it can reach a low enough pH to pass through the OUT valve. As this food churns, its pH is not lowering as much as it should and the IN valve (LES) loosens allowing some of the stomach contents to “splash” up into the esophagus creating a burning sensation known as “heartburn” or acid reflux.
- The stomach may initially respond to low acidity by temporarily releasing more stomach acid (hydrochloric acid) which then can splash up into the esophagus.
Heartburn Is Not the Only Symptom of Low Hydrochloric Acid (HCl)
Even if you don’t have heartburn, you could still have low HCl. In either case, it is important to restore your HCl levels.
Although this is not a complete list, if you have any of the symptoms marked with an asterisk (*) you are VERY likely to have low HCl. If you have more than a couple of symptoms, I would also suspect low HCl.
Symptoms of Low HCl
- Rectal itching
- Chronic or recurring yeast infections
- Loose stool or diarrhea
- Food allergies or food sensitivities*
- Gas, bloating and burping shortly after a meal*
- Acid reflux/heartburn*
- Nausea, especially after taking vitamins and minerals*
- Undigested food in stools*
- Weak, peeling or cracked nails
- Susceptible to parasitic infections*
- Loss of taste for protein foods*
- Coated tongue and/or bad breath
- Unexplained hunger
- Feeling of fullness or food not digesting*
- Foul smelling stools
- Discomfort after rich meals*
Two Ways to Test If You Have Low Stomach Acid
Regardless of your symptoms, if you are over the age of 50, it is worth testing for an HCl deficiency. As we age, our HCl levels decline. The test(s) is inexpensive and easy to do.
**Do not take hydrochloric acid on an empty stomach or if you have an ulcer. Do not open a capsule or chew it because hydrochloric acid in your mouth may harm your tooth enamel.
1A. (If you don’t have heartburn) Take one Betaine hydrochloric acid capsule (available in HERE in our online store) at the beginning of the meal (if you forget, take during or immediately after), if you experience a feeling of warmth behind your breastbone then you don’t need it, however if you feel nothing then your “hydrochloric gas tank” is low and you should continue to take these with each meal.
1B. (If you have heartburn) You can try one capsule of Betaine HCl (hydrochloric acid) capsule at the beginning of a meal. If the heartburn worsens, this is not the cause of your heartburn. Do not take any more HCl. If the heartburn is the same as usual, try 2 capsules at the next meal. If the heartburn is improved with 2 capsules then you are low on hydrochloric acid (stomach acid) and if the heartburn is the same, try 3 capsules. You can keep taking one more capsule at each meal up to 7 capsules as long as you are using our recommended product AND you aren’t causing your heartburn to worsen.
The reason you may need to keep increasing is that if you have heartburn, you likely need more HCl, but the trick is to take enough. For example, if you are low in HCl and the right dosage for you is two capsules per meal and three for a big meal and you only take one HCl capsule per meal, you may not see any improvement.
2. This test only works if you have heartburn. You can also try mixing 1 tablespoon, of pure unpasteurized apple cider vinegar into 6-8 ounces of fresh water, and drink this before each meal. If you feel it worsens your heartburn, do not continue to ingest it. But if it helps, then you are indeed low on stomach acid.
One Way to Restore Your HCl
Taking the appropriate dose of Betaine HCl capsules at each meal will condition the stomach to produce sufficient stomach acid and will return HCl levels to normal (Betaine HCl is the stable supplement form of hydrochloric acid. Our Betaine HCl includes the important digestive enzyme, pepsin. These capsules are safe. Remember your stomach is naturally protected from HCl by mucous).
Once the heartburn is gone, or if you never had heartburn but were low on HCl, you will know when to cut your dosage back as it will cause a warming sensation behind your breastbone.
When that happens, decrease your dosage. Keep taking the lower dosage until you feel a warming behind your breast bone again, then lower your dosage. Every time you feel the warming behind your breast bone, lower the dosage until you are no longer taking any Betaine HCl.
If Experimentation Causes Heartburn
A spoonful of baking soda can help put an end to the gnawing, burning, sensation of heartburn caused by acid reflux because it will immediately neutralize stomach acid. You need about 1-2 teaspoons stirred in a full glass of water. Drink all the mixture at once.
Note: This is not to be confused with a treatment for heartburn but can be used in a pinch if experimentation with apple cider vinegar or Betaine HCl causes heartburn.
#5. Food Sensitivities or Food Allergies
We have discovered that many of our clients with food sensitivities or food allergies stop having heartburn when we ask them to remove the offensive foods.
According to Dr. James Breneman, past president of the American College of Allergists, persistent heartburn from a particular food is a reliable symptom of allergy to that food. He states that addiction to antacids is a common finding in the medical history of food-allergy/sensitivity patients.
Food allergies (or food sensitivity) stimulate histamine release, which stimulates stomach-acid secretion which can then cause heartburn/acid reflux. Most common offenders are cow’s-milk products, gluten-containing foods like wheat, barley, and rye, as well as corn, beef, eggs, soy, and some citrus fruits.
You will know that the burning sensation you feel is caused by a food allergy/sensitivity if the sensation comes soon after you have eaten and not with every meal. However, if you have several food allergies/sensitivities and you eat one of those foods at every meal, i.e. wheat, then you will have heartburn at every meal.
You can either work with your health care practitioner to determine whether or not you have a food sensitivity/allergy, or you can do an elimination diet for two weeks removing either the foods that are repetitive in your diet or removing the foods that are in the above list.
If You Are Currently Taking Medication for Heartburn
Prescription Proton Pump Inhibitors (PPI’s) such as:
- Prevacid (Lansoprazole)
- Dexilant (Dexlansoprazole)
- Prilosec (Omeprazole)
- Aciphex (Rabeprazole)
- Protonix (Pantoprazole)
- Nexium (Esomeprazole)
should not be stopped cold turkey!!!
While taking PPI’s (Proton Pump Inhibitor) the stomach responds by attempting to crank up acid production. When the medications are stopped, the floodgates open and heartburn symptoms return, possibly more severe than previously.
In fact, a study that placed people with no heartburn symptoms on a PPI medication for two months, found that when the medicines were stopped, the patients with no previous history of GERD (gastroesophageal reflux disease) developed symptoms of heartburn within a few weeks!
This effect, sometimes referred to as acid rebound, can also occur after taking antacids such as TUMS: in response to the acid-neutralizing effect of the tablets, the stomach works to replenish its acid supply.
Ultimately, prolonged use of acid-inhibiting medications (even over the counter medications) can induce a state of hypochlorhydria (low hydrochloric acid), perpetuating the cycle of indigestion.
It is important to address the underlying cause of the heartburn and work with your health care provider to wean off your antacid medication.
The information made available in this article is provided for educational or reference purposes only. Nutritional Therapy and/or Coaching is not intended as a diagnosis, treatment, prescription, or cure for any disease, mental or physical, and is not intended as a substitute for regular medical care.
Copyright Brenda Eastwood 2018 – “Eliminate Heartburn – It’s NOT What You Think”.
Would you like to use this article in your E-zine or website? You may, if you include this complete write-up with it: Brenda Eastwood is a holistic health expert who specializes in Women’s Health Issues. Her expertise stems from over 35 years’ experience as a Registered Nutritional Consulting Practitioner. This includes ongoing research, 17 years running a successful private practice, presenting hundreds of seminars and workshops, as well as coaching clients through her unique online Inner Circle program. Today she can reach out to even more women through her Facebook posts and her book “Get off the PMS and Perimenopausal Roller Coaster, Learn 9 Natural Fast Track Solutions to Balanced Hormones”.