Considering I love the gut and all things related I thought I would start the first blog with the beginning of your digestive system or thereabouts, the Oesophagus and a common condition called acid reflux. It’s best known as the nasty burning sensation you experience after certain meals accompanied with a sour acidic taste in the mouth.
So what is it? Acid Reflux occurs when acid or bile flows up into the food pipe and irritates the lining. At the entrance to your stomach is a ring of muscle known as the lower esophageal sphincter (LOS for short). When operating correctly this ring of muscle acts like a valve and should close straight after food passes through. When operating incorrectly it tends to not close all the way allowing acid from your stomach to pass up and into your esophagus
How do I know if I have acid reflux? The symptoms commonly experienced with acid reflux tend to be:
- Burning discomfort in your chest (heartburn) or throat.
- Regurgitation leading to a sour or bitter taste of acid in the throat or mouth.
Why do we get it? There are a lot of causes for acid reflux so here is a list of the most likely.
- A stomach abnormality called hiatus hernia where the upper part of the stomach protrudes up past the diaphragm into the lower oesophageal sphincter allowing stomach acid to pass into the oesophagus. Follow this link for tips to treat hiatus hernia
- Hypochloridia (low stomach acid) – eating food causes stomach acid triggering the sphincter to close. Too little stomach acid can reduce the trigger for the sphincter to close.
- Producing too much stomach acid (it’s all about a fine balance) this can be accompanied with bloating and belching.
- Small intestinal bacterial overgrowth (SIBO) – gas produced by the bacteria travels upwards to be belched out and gas produced in the small intestine can cause pressure on the stomach to push contents back up affecting the LOS.
- Eating large/heavy meals
- Lying down right after a meal – ensure you stop eating minimum 3hrs before retiring to bed
- Being overweight – abdominal fat causes upward pressure on the stomach forcing acid back into the oesophagus
- Food Allergies including wheat, corn, soy and dairy
- Specific foods are known to trigger reflux. They can be problematic in large quantities and therefore avoidance is best until symptoms subside re-introduction in small portions can then be trialed. Further information on this can be found below.
Foods that trigger
- Citrus and tomatoes due to their acidity (do not eat on an empty stomach) They relax the eosophageal sphincter and release the enzyme pepsin
- Chocolate (contains a compound called theobromine a carminative and methylxanthine which increases stomach acid)
- Mint (herb, gum and tea) along with chocolate as they can relax the LOS
- Cheese and fatty food due to slowing down the emptying of your stomach leading to increased pressure on your sphincter (try to avoid consuming at the end of a meal for this reason)
- Garlic and Onion (carminative and contains fructans leading to intestines absorbing water equaling bloating)
- Spicy foods relax the LOS
- Fatty foods relax the LOS
(Again remember that in small portions these may cause you no symptoms. It can be a tolerance issue for many and therefore one food in large quantities or a combination of trigger foods can often be the culprit).
Beverages that trigger
- Alcohol (relaxes sphincter and increases stomach acid production) vodka seems to be a better option if you want to have a drink however spacing drinks with water, diluting your alcoholic beverage with something like ice and ensuring you don’t drink a large amount close to retiring to bed.
- Carbonated drinks (bubbles can rise from the stomach carrying acid)
- Coffee and tea (carminatives)
- Vinegar ( activate pepsin)
- Smoking – delay stomach emptying putting pressure on oesophageal valve
- Being pregnant
- Medications – aspirin, ibuprofen, antibiotics, types of muscle relaxants and blood pressure medications.
Food to consume
- Fruit low in fructans
- Nuts and seeds
How do I reduce its occurrence? Identify and remove the triggers.
How do I reduce the symptoms when they occur and prevent further damage? Soothe irritated tissue and rebuild a healthy mucus lining for the stomach and oesophagus.
- Drink a gruel of x1 teaspoon of slippery elm powder with 1/4 cup cold water until you have a thick paste, add x1 cup of hot water and stir before drinking. Repeat this 1-2 times daily.
- Aloevera juice soothing and settling for the stomach.
- Anti-inflammatory oils – fish and walnuts.
- Sip on fennel, ginger, cinnamon or chamomile tea.
Is stomach acid bad? Stomach acid is important for protein digestion, to kill bacteria and sterilize our food preventing it from travelling further into the digestive tract and for the absorption of vitamin B12, therefore caution should be taken with prolonged use of acid suppressing drugs. Avoiding irritants and healing the mucous lining should be the first line of treatment however prolonged acid reflux can damage the delicate lining of the oesophagus so if a natural approach is not achievable then proton pump inhibitors SHORT TERM should be discussed with your GP.