By: Dr. George Stanton
Acid Reflux seems to have become common place in our nation. A review of several studies found the range of GERD prevalence estimates between 18.1%–27.8% in North America.1 That means 1 in every 4-5 people experiences reflux symptoms at least once a week.
There is a myriad of underlying issues that could be causing acid reflux; here are some common reasons we find in our office:
1. Food allergies/Sensitivities– Frequently eating foods that cause a sensitivity reaction will lead to damage and inflammation of the intestinal villi. These microvilli are the hair-like structures that line the intestines, and they are largely responsible for nutrient absorption. Damage to these will not only inhibit nutrient absorption, but send a signal to decrease stomach acid. This is the body’s way of protecting the intestines from too much acid. However, when the inflammation from an ingested food sensitivity is building up in the intestines, the body will create a “push back” per se, and reflux can still be one of the symptoms. Even with decreased stomach acid? You betcha. Read below for more information on how low stomach acid can actually cause reflux.
Typically food sensitivities are due to an underlying issue causing immune chaos; identifying some of these issues can help relieve sensitivities and/or the reflux.
The five most common food sensitivities are (in no particular order): gluten, dairy, corn, eggs, and soy. How much of these do you consume on a daily basis? Are they contributing to your GERD?
2. Gut issues – Something is causing a ruckus in the GI system, and that can decrease bile production, nutrient absorption, HCl (stomach acid) production, increasing food reactions, and inflammation. So, find what is causing the flare up! What could it be? Possible offenders include candida (yeast), bacteria (H. Pylori, SIBO), mold, heavy metals, or even parasites. Yes, parasites. Here in America. These can reduce the amount of bile production which, as you will read next, can cause reflux as well.
3. Bile – Is there enough bile being produced in the digestive tract? Bile helps to emulsify fats and helps shuttle toxins out of the body. When you eat or take pills, there needs to be enough support from the liver/bile ducts to break these things down to be utilized. Sludgy bile will be less effective, and often can lead to abdominal pain – which may be misinterpreted as heart burn.
4. Drainage – How are your drainage systems doing? If you are detoxing, there needs to be a clear path for the toxins to go. If you begin to have reflux symptoms during a detox program, that may be your body’s response to the drainage systems being blocked up. Read more about drainage, detox, and the proper order to support those systems here.
5. Hiatal Hernia – This develops when the stomach has gotten stuck in the opening where the esophagus goes through the diaphragm. The mechanical blockage can be a cause of reflux.
6. Low Stomach acid – Medications that reduce stomach acid decrease our ability to digest food. When what we eat isn’t digested in a timely manner, the build up in the stomach can cause what little acid is still present to float up into the delicate lining of the esophagus. Even small amounts of acid will irritate this tissue and lead to symptoms. The decrease of HCl will also oppress the stomach’s immune defenses and allow for bacteria and other infections to flourish, exacerbating GERD symptoms, along with causing other health issues. And if that wasn’t enough, it has been shown in studies that long term use of antacids such as esomeprazole (Nexium 24HR), lansoprazole (Prevacid 24HR), and omeprazole (Prilosec OTC) can lead to increased risk of heart attack, dementia, and kidney failure.4
7. Alkalinity – The pH (acidity vs alkalinity of the body and digestive tract) have a big role in digestion. Constantly drinking alkaline water will increase the pH of the stomach acid (i.e. making it more “basic” or less acidic). The Stomach acid needs to be at a low pH to break down foods appropriately. See the section on low stomach acid above!
8. Obesity -- Specifically central obesity (around the waist areas) can contribute to GERD. There is a sphincter between the esophagus and the stomach that is controlled automatically by the nervous system. There is mounting research demonstrating an association between central obesity and reflux.2 In a small study, it was shown that a very low carbohydrate diet can improve GERD (possibly by helping to relieve some of the stress of obesity).3 This could also be due to yeast/candida being addressed (very low carbohydrate diets help with yeast/candida overgrowth), if that was a contributing and underlying issue.
9. Old age – Unfortunately, as we age, HCL production in the stomach tends to decrease. This can lead to B vitamin deficiencies (read more here), and also GERD due to food not breaking down properly.
In our office, we offer food sensitivity testing and/or encourage elimination diets to help address food allergies/sensitivities. For all gut issues, we have patients fill out an assessment, and can run lab tests such as Organic Acids testing, Hair Tissue Mineral Analysis (HTMA), and others depending on the individual. See what lab tests are available here.
Typically, by addressing the root causes in the gut, patients experience relief from most or all GERD issues. If you have reflux-type symptoms and can’t get to the bottom of it, let us help!