I Have a Gut Feeling Part 2: Heartburn

What 3 over the counter medicatons for heartburn have recently been shown to increase your risk of death by 50%?

Heartburn, I’m not talking about when your girlfriend or boyfriend dumped you, we are discussing occasional heartburn and gastro esophageal reflux disorder otherwise known as GERD. 60% of the population will experience heartburn each year with about 20% having symptoms weekly. There are approximately 64.6 million prescriptions written for GERD medications in the United States on an annual basis. It’s estimated by the American College of Gastroenterology that the symptoms of GERD result in almost two billion dollars in lost productivity each week of the year.  If you have heartburn symptoms at least two times a week chronically it is GERD. The symptoms include burning and discomfort in the esophagus, throat and or stomach. Most people take over the counter (OTC) drugs like Maalox, Mylanta, Gelusil, Gaviscon, Rolaids and Tums, which act as antacids to neutralize the excess acid. There are other over the counter medications that reduce the production of stomach acid by blocking H2 receptors. These include Tagamet, Pepsid and Zantak. Then there are OTC products that are even stronger and block the production of stomach acid called proton pump inhibitors (PPI’s). These include Prevacid, Nexium and Prilosec. Then there are prescription versions that are even stronger than the ones above.

Proton pump inhibitors have already been linked to dementia, bone fracture and kidney disease. A recent study published in the British Medical Journal Open is even more concerning. The study is entitled, “Drugs to curb excess stomach acid may be linked to increased risk of death”. The authors of the study told ScienceDaily, "No matter how we sliced and diced the data from this large data set, we saw the same thing: There's an increased risk of death among PPI users.” “For example, when we compared patients taking H2 blockers with those taking PPIs for one to two years, we found those on PPIs had a 50 percent increased risk of dying over the next five years. People have the idea that PPIs are very safe because they are readily available, but there are real risks to taking these drugs, particularly for long periods of time." To read more on this subject here are the links, https://www.sciencedaily.com/releases/2017/07/170705113546.htm and http://bmjopen.bmj.com/content/7/6/e015735.

This is just one example of subject of the side effects of OTC and prescription drugs. Many will cover up the symptoms for which they are prescribed but never get to the cause of the problem. This article will stay focused on heartburn but please be aware what is true above is true for many medications.

The common denominator behind all the above drugs is that they treat too much stomach acid. In my 30 years of experience as a chiropractor I find it is more often not enough stomach acid that is the problem! This sounds counter intuitive so let me explain. The purpose of the stomach is to start the process of protein digestion. The stomach makes hydrochloric acid and pepsin which mix with food and get churned by the stomach muscles.

Proteins are made from chains of amino acids that are strung together in series. When we eat proteins from plants and animals our stomach starts the process of breaking down these strings of amino acids into much smaller chains and or single amino acids that can then be absorbed through the intestinal tract to get into the blood stream. The blood stream carries the amino acids to the cells of the body that then rearrange them to create whatever proteins the DNA of that cell requires. This is how we create bone, muscle, neurotransmittors, hormones, enzymes…to heal and repair the body. Let’s get back to the stomach.

Can you guess what happens if there is not enough stomach acid to digest that hamburger you just eat? The beef will sit in the stomach longer then it should and start to ferment which causes the production of a different kind of acid. This is what many people experience as heartburn. The solution in this case is to supplement your meal with betaine HCl with pepsin. This must be taken in the middle of the meal, with food before and after. It is common as we age that the stomach loses its ability to produce enough acid. You can also try taking up to 1 tablespoon of apple cider vinegar with the vail of the mother (raw and untreated) with some good untreated sea salt mixed with 6 ounces of water prior to your meal. If the betaine HCl or the apple cider vinegar make the symptoms worse you probably are one of the people who make too much acid. If this is case for you the next paragraphs will be helpful.

The other half of the equation of heartburn is having a lower esophageal sphincter that does not close correctly. The LES is a ring of muscle at the bottom of the esophagus that should contract after you swallow food and it enters the stomach. It stops acid from entering the esophagus where it will erode the lining.

One cause of the LES not closing is called a hiatal hernia. This occurs when the upper aspect of the stomach passes above the diaphragm where it doesn’t belong. This makes the diaphragm squeeze the LES open and creates heartburn and if left untreated may erode the lining of the esophagus. One self treatment for hiatal hernia is to drink 16 ounces of water or eat a meal and then stand on your tip toes and quickly drop onto your heals. If you have no structural problems you can alternatively jump off a stair step onto the floor. This exercise is to try and drop the stomach below the diaphragm. Chiropractic adjustments to the neck can also relieve stress on the diaphragm due to the fact that the nerves that control the muscle tone of the diaphragm exit the spine at neck vertebrae three through five. There are also three reflex points on the groin, shoulder and neck that help to normalize the function of the LES and ileocecal valve (the valve between the small and large intestine). Stop at our office or email us for a handout on their location. Finally pulling down on the stomach itself can help. This is best accomplished by having the individual lay on their back with the knees bent and feet on the floor or table. Then gentle pressure is applied in a foot ward direction on the area just below the ribcage in the midline.

The other main causes of the LES not functioning are over eating, eating before bed and eating foods that your digestive tract doesn’t digest well. That can vary for each person but most people know what causes their heartburn if it is chronic.  Our office can do blood tests or nutrition response testing (see our website under services) to determine food sensitivity. Thus; eat small meals more frequently during the day, don’t eat and then sleep or nap, and avoid foods that aggravate your condition. Another helpful idea is to raise the head of your bed for GERD or sleep in a recliner for the occasional heartburn symptom. Gravity helps close the LES and move food downward.

If you have chronic heartburn we have found a product called acid blocker to be very helpful in healing the esophagus and preventing the heartburn without side effects. It is taken after the meal and chewed and swallowed with a glass of water. It contains alginic acid and sodium alginic which creates a mucus like barrier on top of the food. It also has healing botanicals for the stomach and esophagus. We had one patient who was on prescription medication for GERD for over 20 years and still had symptoms and started taking acid blocker and working on the reflex points. He was able to stop taking the meds and he had much reduced symptoms when I last saw him.

Other natural remedies for occasional heartburn are ½ to 1 teaspoon of baking soda mixed with up to 8 ounces of water and swallowed. Don’t do this chronically as it is high in salts that can cause other health problems. Ginger tea can help improve digestion and aid in relief of occasional problems. Chamomile tea can also help relax you before bed and aide in lowering the symptoms. Apples and almonds have been shown to help prevent acid reflux.

In conclusion there are natural therapies that can get to the cause of heartburn and GERD. The medications help to cover the symptoms and can have terrible side effects. If you suffer from chronic digestive symptoms we have helped many people heal their conditions. Don’t forget the last blog, 80% of your immune system is in your gut and 80-90% of your neurotransmitters are made in the gut mediated by our gut flora. So listen to your gut feelings, think happy thoughts, eat healthy foods and connect to something greater then yourself.

Chaz Schatzle, DC APC

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