Do you have a case of heartburn for the holidays?
Heartburn is when you have burning in your chest, often behind or near the sternum or breastbone, that often gets worse when you’re eating, lying down or bending over. Heartburn can make swallowing difficult, or cause partially digested food to shoot up into your mouth.
The full name of this condition is Gastro-Esophageal Reflux Disease, reflux for short. It is a condition where your partially digested food and stomach juices “reflux,” or come back up from your stomach into your esophagus and sometimes even your mouth or sinuses.
You must seek immediate medical care if you have severe chest pain, especially if you also have shortness of breath, or jaw or arm pain. These may be signs of a heart attack.
In order to explore heartburn and other related conditions, we need to do a quick review of digestive tract anatomy and function.
The mouth empties into the esophagus, which empties into the stomach, which empties into the small intestine, which empties into the large intestine, which empties waste via the rectum and anus. We break our food down by chewing, which is mixed with saliva to help break down starch, then the stomach adds hydrochloric acid, the pancreas adds digestive enzymes and the liver adds bile. There are also muscular movements and small sweeping movements in the digestive tract to keep pushing food, bugs and debris downward, and these motions also help to break up and break down food.
If any of these processes break down, heartburn or reflux can ensue.
Common causes of reflux include smoking, pregnancy (it is very hard to prevent heartburn from pregnancy because the baby is pushing your internal organs around), eating large meals or eating late at night.
Food sensitivities, allergies or other food reactions also are very common causes of or contributing factors to heartburn/reflux. The main irritating foods are fried foods, acidic foods (such as citrus and tomatoes), gluten, coffee and alcohol.
Anti-inflammatory medications like Naproxen, Aspirin and Meloxicam can really irritate the gut.
Gut infections can cause heartburn. Helicobacter Pylori, or H. Pylori for short, is a bacteria that can infect your stomach and lead to heartburn and even stomach ulcers.
Post infectious dyspepsia (indigestion): is a common underlying cause of heartburn. If you have had intestinal infections, foodborne illness or “traveler’s diarrhea,” and then you noticed that your symptoms started after this infection, it is not a coincidence!
Hiatal hernias, when a piece of the stomach slides back up into the chest cavity and squirts food and enzymes back into the esophagus, is caused by bearing down or lifting heavy items. Sometimes the risk can be inherited.
Other anatomy issues include loose esophageal sphincter, when partially digested food and acid come back up from the stomach into the esophagus because the opening of the esophagus is loose or floppy.
If the muscular movements in the gut, or small sweeping movements in the small intestine, get injured or impaired, reflux can result. As an example, diabetes can injure the nerves to the gut and cause a paralyzed or slow working stomach (gastroparesis).
Typical heartburn treatments include Tums, Rolaids, Gaviscon and Maalox, which are over-the-counter remedies, and prescription medications that are proton pump inhibitors or acid reducers.
There are some more natural treatments that can help reduce symptoms, like chewable licorice tablets (DGL), ginger root products, digestive enzymes, bitters, baking soda in water, and more.
These approaches may only treat the symptoms. They can give you short-term relief, but treating the underlying causes can give you permanent relief.
Here are some treatments for the common underlying causes of reflux:
Gut infections: Your medical providers should be able to help you get a breath or stool test to rule these infections out. Once they are identified, they can be treated either through herbs or medications when appropriate. I prefer a three-day comprehensive stool test to just one simple stool or breath test to find these infections.
Small intestine bacterial overgrowth (SIBO): If you suspect that you have this condition, you may want to work with a naturopathic doctor to get a SIBO breath test. If you have SIBO, it can be treated with herbs, nutrients, or medications to eradicate it.
Hiatal hernia: There are providers who do a type of abdominal massage that can help to adjust the position of your stomach and could relieve this condition. In extreme cases, surgical measures may be needed.
Medication reactions: If your meds are suspected of causing your heartburn, you might want to try other treatments or work with a naturopathic doctor to uncover why you are experiencing pain and inflammation and improve the pain with diet and lifestyle changes.
Food/drink reactions: You may want to get tested for food allergies or food sensitivities with a naturopathic doctor or allergist. Identifying and eliminating these allergens could better help you to understand which foods trigger symptoms. Stopping eating early in the evening or fasting for a few hours between meals could also help reduce symptoms.
I can’t help but cringe whenever I see the commercials about “fighting back” against your heartburn using over-the-counter medicines when you eat food that causes heartburn. If the body is angry about something you are eating, why wouldn’t we make the choice to listen and not hurt ourselves? We are human after all, but taking medication so we don’t have to experience the reaction is like telling our body to “shut up” when it’s talking to us.
My gut shouts with heartburn when I have coffee, gluten, fried food or too much citrus or acidic foods. I know this and try to make food choices based on this knowledge.
My challenge to you is to listen to your body more often. If you get heartburn, think about what you have had to eat or drink and see if you can detect patterns and figure out what your body is trying to tell you. If you aren’t getting heartburn from food, think about when it started and reflect on whether you had a gut infection, were lifting heavy things, straining to use the bathroom, or the other causes I’ve listed here.
If you need help figuring out the cause of your heartburn or treating it in a more natural way, naturopathic doctors are ready and willing to help!
Dr. Christine Bowen of Everett is a licensed naturopathic doctor, keynote speaker and has been published in the Townsend Letter. In practice since 2005, Bowen specializes in holistic approaches for digestive health and autoimmunity. Go to www.bothellnaturalhealth.com for more information. Connect with her via Facebook drchristinebowen or Instagram @drchristinebowen.