Understanding Acid Reflux, Heartburn and GERD
The terms acid reflux, heartburn, and GERD (gastroesophageal reflux disease) are similar but not the same. Acid reflux means stomach acid flows back into the esophagus. Heartburn is a symptom of acid reflux. GERD is a severe form of acid reflux.
What Is Acid Reflux?
Acid reflux may cause heartburn, and it may cause damage even without heartburn. The burning sensation or damage comes from acid rising from the stomach and irritating the lower esophageal sphincter (LES), the valve that separates the esophagus from the stomach.
No matter if you call it, heartburn, acid reflux, or GERD ,some 35 to 45 percent of the population experiences heartburn, which is about 116 million people! It’s also the most profitably treated symptom in America.
Because of those numbers, it’s almost considered normal to have reflux and to take drugs for it. However, it is certainly not good, and those experiencing the pain are definitely nowhere near optimal health.
Heartburn can be a sign of other problems and can almost always be treated without acid blockers.
What Are the Symptoms of Acid Reflux?
Acid reflux is generally felt as a burning pain in the middle of the chest, hence the name heartburn. It can also taste sour in the back of your throat, and you might taste regurgitated food. It may also feel like pressure in the chest. In some people, it can be so bad that it is difficult to keep food down and may even result in dental erosion.
Over time reflux can result in damage to the LES, called Barrett’s Esophagitis, and even cancer. If you have chronic heartburn or reflux, then be sure to have a thorough examination by a gastroenterologist to rule out this serious condition. Sometimes this chest pain is confused with heart pain. If you are unsure about the cause of any pain in your chest, be sure to have a thorough exam by your doctor. Learn more about IBS and pregnancy, as heartburn can be a symptom of both.
What Happens During Acid Reflux?
There are several causes of acid reflux, but the common thread is the relaxation of the LES. Once the LES relaxes, acid is afforded the opportunity to rise from the stomach and damage the esophagus, resulting in a burning feeling.
Once the esophagus has been damaged, it is very slow to heal. Antacids, histamine blockers, and proton pump inhibitors only shut down acid production, they don’t promote healing of the LES, nor do they cure the cause of the heartburn. They also are not meant to be used long-term, and come with a host of side-effects.
What Causes Acid Reflux?
It’s commonly believed that heartburn is the result of overeating. And although many Americans overeat, the size of the meal has no scientific correlation with the frequency of heartburn.
Others think too much stomach acid is the culprit, because that is often the implication. However, having too much acid production is very rare. Ironically, the opposite is more likely the case. In most people, stomach acid decreases with age.
In order to cure acid reflux disease, you must remove the cause of the problem and promote the healing process.
The following are the most common causes of acid reflux:
- Food allergies: In my practice I have found a majority of cases of heartburn are caused by food allergies. Unfortunately, these aren’t the kind of food allergies your doctor is likely to diagnose, since they aren’t life threatening.
- Foods: Certain foods cause the lower esophageal sphincter to relax, thus leading to heartburn. These include peppermint, coffee, alcohol, and chocolate.
- Hiatal hernia: This is a physical condition where part of the stomach protrudes through the diaphragm. It can generally be reduced without surgery, though even when present, it is not necessarily the sole cause of heartburn.
- Low Acid Production: Ironically, low stomach acid levels can result in heartburn. This is much more common than increased acid production. This problem can be assessed clinically and is treatable.
- Medications: Many medications cause heartburn as a side-effect, including several acid blockers. Some of the more common medications that cause heartburn are:
- Acid Blockers
- Asthma inhalers
- Nonsteroidal anti-inflammatory medications (NSAIDs), such as aspirin, ibuprofen, and naproxen.
- Antianxiety medications
- Osteoporosis drugs
- Overeating: The stomach is only so big, so eating too much can cause discomfort.
- Pregnancy & Obesity: These are related in that both put pressure on the stomach, decreasing its volume and forcing food back from whence it came.
- Stress: Stress is a small word with big health consequences. Stress can be the sole cause of heartburn, but often it is exacerbating other causes. Regardless, there are nutrients, herbs, and therapies that will help you deal with your stress.
- Smoking: Smoking also causes the lower esophageal sphincter to relax, leading to heartburn.
If you experience heartburn, it’s important to get the proper testing so we can sort through the possible causes and provide you with permanent relief. Even heartburn caused by necessary medications can be treated in a way that is much healthier and more effective than acid blockers.
How to Treat Acid Reflux?
Many people turn to antacids and acid blockers to treat reflux. Those are not the only options.
Up to one-half of GERD patients don’t get complete relief from even the strongest acid-reducing medications, called proton-pump inhibitors (PPIs), and most don’t have any evidence of acid erosion when doctors examine their esophagus with an endoscope. Gastroenterologists have dubbed this condition non-erosive reflux diseases, or NERD.
In order to truly solve reflux and heartburn and eliminate the need for medications that only treat the symptoms, you must first understand what is triggering it. This is the best way to treat reflux. If you ignore the cause and continue to push forward, sooner or later you are guaranteed to suffer the consequences.
Do not settle for this diagnosis. You can eliminate heartburn and reflux and move on with a much healthier life. We recommend finding a doctor who will help you do exactly this.
Also, there are natural treatments for heartburn. These include DGL, D-limonene, and zinc gluconate. These can be very effective and are preferable to medications, but they should be used in conjunction with treatments that eliminate the cause of the problem entirely.
Naturopathic doctors are the most likely to be able to help you, but know that naturopathic doctors are also specialists, and some are much more experienced at working with digestive disorders than others. A good dietitian or Oriental medical doctor may also be able to help.
Depending upon the cause of the problem, you may also benefit from working with a massage therapist who specializes in visceral manipulation. These experts can help to resolve a hiatal hernia without the need for surgery. Some chiropractors provide a broad base of natural healthcare along with visceral manipulation.
The key is to continue to search until you find the right person or team that can help you. Don’t give up until you do.
IBS and It’s Relation to Acid Reflux
A study found a strong correlation between reflux and IBS. But know you don’t have to have IBS to be successfully treated for reflux.
At the IBS Treatment Center, we are not surprised at the relationship between IBS and heartburn. Many of our IBS patients experience reflux or heartburn, and often both the reflux and the IBS are gone once they receive treatment here.
Dr. Wangen is the founder and medical director of the IBS Treatment Center, the award winning author of two books, and a nationally recognized speaker on digestive disorders. He has been on ABC, NBC, and Fox as well as public radio, and was named one of Seattle’s Top Doctors by Seattle Magazine.