The Real Reason Behind Acid Reflux + How To Heal
Acid reflux, or gastroesophageal reflux disease (1) (GERD – the more serious form of acid reflux), is a major problem in the United States, where up to 20% of the population suffers from the burning, gnawing, burping, and other uncomfortable symptoms of acid in the digestive tract above the stomach where it isn’t supposed to be.
Because of the name, as well as the symptoms of this condition, it is a common misconception that acid reflux/heartburn is caused by too much stomach acid, but research shows the rate of heartburn and GERD increases with age, while stomach acid levels generally decrease with age. How could this be? The Journal of American Geriatrics Society found (2) that over 30% of people over 60 years old experience little to no stomach acid secretion, and another study found that 40% of postmenopausal women produce no basal gastric acid. Yet, GERD is common in these populations. So why are so many millions taking acid-suppressing medication to treat this condition?
The research suggests that this is exactly the wrong treatment. There are thousands of studies supporting the theory that suppressing stomach acid does not treat the problem; it only treats the symptoms, and only temporarily. There is evidence to suggest that acid-suppressing medication actually interferes with the body’s natural ability to regular its own acid production, when acid production probably isn’t the actual problem.
So what is? The prevailing scientific theory today is that GERD is caused by a dysfunction of the lower esophageal valve that separates the lower end of the esophagus and the stomach. In other words, the seal that is supposed to keep stomach acid in the stomach has a leak. When the pipe under a sink has a leak, we all know the solution is not to just turn off the water forever. The solution is to fix the leak, and better yet, to figure out why the leak occurred in the first place. In the case of GERD, this valve dysfunction seems to be caused by intra-abdominal pressure.
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As a functional medicine practitioner, it’s my goal to investigate the underlying causes of chronic issues such as acid reflux and GERD, so what I look for in my patients is the underlying cause of the intra-abdominal pressure compromising the integrity of the lower esophageal valve. In simple terms: Why is your valve leaking? I have some theories (which are functional medicine theories as well).
First off, our Western diet, food intolerances, medications, chronic infections, environmental toxins, and chronic stress all contribute to both digestive inflammation and low stomach acid. This confluence of underlying factors increases intra-abdominal pressure, while inflammation could cause damage to the valve and low stomach acid could contribute (3) to a condition called SIBO (small intestinal bacterial overgrowth), because one of stomach acid’s roles is to keep bacteria levels balanced and SIBO is a case of pathogenic bacteria growing out of control. This in turn can lead to poor food digestion due to decreased enzyme secretion, which is compromised by the bacterial imbalance. This in turn can lead to more inflammation.
You can see how long term use of acid-suppressing medications would only perpetuate this vicious cycle, and is an overly simplistic and misplaced solution to a serious problem. In fact, research has shown that acid-suppressing medication can lead to gastric bacterial overgrowth. (4)
Of course, you are an individual and the exact reason for your GERD or acid reflux may be unique to you. That is why a comprehensive functional medicine health history and diagnostic testing can uncover the underlying culprit for individual cases.
After you’ve discovered and removed the source of your problem, there are some effective natural solutions to help heal your digestive tract and valve, and to encourage good overall digestive health going forward:
- You probably need more acid, not less. Taking an HCI or other digestive enzyme supplement will help restore proper digestion and ph levels in the stomach.
- Fermented foods like kimchee, sauerkraut, kvass, and kombucha can help to restore and rebalance your body’s beneficial bacteria levels, so bring more of these into your diet.
- Healing fats like fermented cod liver oil and coconut oil will decrease inflammation, clean your system and promote good digestion. Add more of these to your diet, too.
Every person is different, so a “one-size-fits-all” approach is inadequate to say the least. However, whatever the reason, chances are that acid-suppressing medication is not the solution! Functional medicine can help you to pinpoint your individual health picture.
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- Gastroesophageal reflux disease (GERD) Mayo Clinic https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940
- Krasinski SD, Russell RM, Samloff IM, et al. Fundic atrophic gastritis in an elderly population. Effect on hemoglobin and several serum nutritional indicators. J Am Geriatr Soc. 1986;34(11):800‐806. doi:10.1111/j.1532-5415.1986.tb03985.x
- Bixquert Jiménez M. Treatment of irritable bowel syndrome with probiotics. An etiopathogenic approach at last?. Rev Esp Enferm Dig. 2009;101(8):553‐564. doi:10.4321/s1130-01082009000800006
- Theisen, J., Nehra, D., Citron, D. et al. Suppression of gastric acid secretion in patients with gastroesophageal reflux disease results in gastric bacterial overgrowth and deconjugation of bile acids. J Gastrointest Surg 4, 50–54 (2000). https://doi.org/10.1016/S1091-255X(00)80032-3
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BY DR. WILL COLE
Dr. Will Cole, IFMCP, DNM, DC, leading functional medicine expert, consults people around the world via webcam and locally in Pittsburgh. He received his doctorate from Southern California University of Health Sciences and post doctorate education and training in functional medicine and clinical nutrition. He specializes in clinically researching underlying factors of chronic disease and customizing a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. Dr. Cole was named one of the top 50 functional medicine and integrative doctors in the nation and is the best selling author of Ketotarian and The Inflammation Spectrum.