What Causes Reflux and Heartburn?

Most people think too much stomach acid causes reflux. Although this can be the case for some patients, the usual root of heartburn has to do with a little band of muscle at the base of the esophagus, called the lower esophageal sphincter (LES).

After you chew and swallow food, it travels down the esophagus and into the stomach, where the food is digested by hydrochloric acid.

Normally, the LES constricts after food passes into the stomach. This prevents the stomach acid from splashing up (or refluxing) into the esophagus.

In people affected by GERD (gastro-esophageal reflux disorder), however, the LES has “flabby” tone and does not fully constrict to close off the lower esophagus. Hydrochloric acid can therefore splash back up from the stomach into the esophagus, causing the burning, pain, and discomfort commonly referred to as heartburn.

Aside from being unpleasant, heartburn can in the long run can irritate the cells in the esophagus and over time increase the risk of developing Barrett’s metaplasia and in turn esophageal cancer.

.

.

The Risk of Prilosec and TUMS

Conventionally, reflux symptoms are treated with medications that either decrease the amount of stomach acid produced – proton pump inhibitors esomeprazole (Nexium), omeprazole (Prilosec) and pantoprazole (Protonix) or H2 blockers like ranitidine (Zantac), cimetidine (Tagamet), and famotidine (Pepcid) – or neutralize the acid after it’s produced (calcium carbonate products like TUMS).

When used in the short term during a “reflux crisis,” these medications put a bandage on the unpleasant symptoms, but do little if anything to address the cause of the reflux. These medications do nothing to address the weak tone of the LES – in fact they can even make it worse!

Furthermore, a long list of problems can develop as a result of long-term suppression of stomach acid. Most importantly:

{1} Infections and Illnesses. You need stomach acid to kill the harmful bacteria, viruses, and fungi that you accidentally ingest. Without enough stomach acid, these bugs can stark wreaking havoc in your body.

{2} Nutritional Deficiencies. Stomach acid is necessary to properly digest the food you eat and assimilate the nutrients. Low stomach acid has therefore been associated with nutritional deficiencies, and can have devastating health effects in the long run. Examples include:

• Skin problems
• Anemia and Fatigue
• Poor memory, depression, learning challenges, and brain fog
• Dementia (yes, really!)
• Osteoporosis

{3} Other Digestive Complaints. Without proper hydrochloric acid to digest the food you eat, the intestines may become irritated while processing the under-digested food particles. This can cause gas, bloating, abdominal pain, and irregular bowel movements.

{4} Worsening of Reflux. Because these medications decrease stomach acid, the further relax the LES, therefore worsening the reflux symptoms and keeping you hooked on those little purple pills.

Treating the Cause of Reflux

Through working with your naturopathic doctor, it is possible to increase the strength and tone of the lower esophageal sphincter (LES) and combat reflux.

Check out part 2 of this series to read about supplements and strategies for overcoming reflux naturally. (Kick TUMS to the curb!)

…And check out my piece on treating reflux in babies.

Get ready to say goodbye to that little purple pill for good.