Heartburn: Suppress or Support Stomach Acid?
By Dr. Nicole Sundene
A serious pet peeve of mine is how we all traditionally deal with indigestion and heart burn with the use of calcium carbonate antacids, proton pump inhibitors, and H2 blockers (histamine receptor blockers).
I understand that at times we need to suppress our stomach acid just to provide some short term relief, or to prevent it from burning our stomach lining and potentially causing permanent scarring to our stomach and esophagus. But, before we make any major decisions regarding inhibiting the natural processes of our digestion let’s first investigate what stomach acid was designed by nature to do for us.
Stomach acid is Hydrochloric Acid (HCL) which is produced to help break down our food for digestion and absorption. HCL is the biochemical “mother” of the digestive process triggering resultant chemical reactions and productions of enzymes as your food moves through your intestines. Certain vitamins, minerals, and macronutrients are unable to be properly metabolized without the aid of HCL. Protein, vitamin B12, iron, calcium, zinc, and most other minerals require an acidic environment for proper activation and absorption.
Now antacids are not designed for long term use, because obviously in the long term we run the risk of being deficient in protein, B12, and minerals.
Some common signs of these deficiencies can be seen as brittle hair and nails, neurological problems, anemia, osteoporosis, and fatigue to name a few. Over the counter antacids neutralize stomach acid rendering it ineffective; while most typical prescription medications for heartburn and GERD like proton pump inhibitors and histamine receptor blockers work different biochemical angles to suppress the production of stomach acid.
An alternative approach to heartburn and acid reflux is to avoid irritating substances, as well as those that cause the esophageal sphincter to relax and allow acid to creep back up such as chocolate, caffeine, mint, spicy foods, orange juice, sugar, coffee, white refined foods, fried foods, and those foods that you may be specifically sensitive to. Herbs with volatile oils such as mint make your esophageal sphincter relax, and thus acid is able to continue to creep up from your stomach and burn your esophagus resulting in “Gastroesophageal Reflux Disorder” aka GERD. Eliminating cigarette smoking and coffee are critical to recovery for anyone with an ongoing acid reflux or active peptic or duodenal ulcer.
Aside from avoiding irritating foods, and foods that relax the esophageal sphincter, you may want to consider investigating foods you may be intolerant or allergic to further with an ALLERGY ELIMINATION DIET.
Stress is an important factor to deal with because it thins the mucous that protects our stomach lining. Without a healthy protective layer of mucous covering the stomach lining, HCL becomes the enemy as it erodes the tissues and results in very painful ulcers. Stress also inhibits our stomach acid production resulting in gas and indigestion. Furthermore the suppression of stomach acid typically results in a rebound effect. Stomach acid will only be suppressed for so long before the body produces more in a natural feedback loop.
The stomach senses a high pH not conducive to digestion and overshoots by producing too much HCL to lower the pH at times when we don’t even need it… like between meals and at night time. Many people under high stress all day long will experience painful night time reflux as their body finally relaxes and has time to make some stomach acid. Unfortunately this is painful and keeps us up all night. Especially when we lack a healthy layer of mucous covering the lining of our stomach.
Eliminating aggravating foods and stressors whenever possible is a great first step towards healing from ulcers and GERD. Once irritating foods have been eliminated one can add in some soothing “demulcent” herbs such as Glycyrrhiza glabra also known as good old fashioned licorice root. Look for the chewable “DGL” chewable licorice tablets at your health food store, Enzymatic Therapy makes a great one. Chew the tablets three times daily as directed 20 minutes prior to meals. DGL means that the component that raises blood pressure in the licorice has been removed but the demulcent properties have remained intact, however I would still use this treatment with caution and monitor your blood pressure daily if you are prone to hypertension.
You can also make teas or powder pastes with Marhmallow (Althea officinalis) and Slippery Elm root (Ulmus fulva). Taken between meals or twenty minutes or prior, these healing herbs will calm down the irritated lining of the stomach and allow the acid to work when it is supposed to work. Aloe vera juice is also a great therapeutic agent for those not susceptible to diarrhea. However the “latex free” form of juice can typically be consumed without incident. Drinking fresh cabbage juice is also a highly researched remedy for healing the mucosa. The amino acid l-glutamine can also be used.
Many people experience chronic gas and bloating which is simply the result of lack of stomach acid from use of antacids or eating too quickly before the body has time to properly build up the digestive juices. Some will resolve with HCL supplementation (please don’t take this without advisement from your naturopathic physician), or by eating green bitters before a meal, a shot of concentrated lemon juice, or even a teaspoon of apple cider vinegar in two ounces of water. If you have active acid reflux or heartburn I would advise against using foods to increase stomach acid until the reflux problem is resolved, and the stomach mucosa is healthy.
All of these things are great quick fixes but they aren’t really addressing the root cause of most digestive upset which is that we are either eating under stress, or we are not slowing down and taking the time to enjoy our food properly. Make every meal an event. Make a point with your friends and family to savor the eating ritual. An average lunch in some European countries is 1-2 hours and an average dinner is 2-4 hours. That is the spirit that we need to embrace in order to truly make the most out of our digestion. Not eating on the run.
REFERENCES: “Biochemistry” Fifth Addition by Berg, Tymozko, and Stryer; “Herbal Medicine From the Heart of the Earth” by Sharol Tilgner
~Dr. Nicole Sundene