Acid Reflux, Indigestion, GERD, Heartburn, High Stomach Acid, Acidity
Whatever you want to call it, high stomach acid is very common and affects zillions of people.
Is It Really High?
Before we actually accept it is high stomach acid, you need to read about low stomach acid. I know, I know; that sounds the opposite of what you are having but, trust me, the symptoms are exactly the same and LOW rather than high stomach acid is much more common. Even in mainstream medicine, it is a known fact that about 30% of GERD patients turn out to have normal stomach acid levels. In practice, it rarely turns out to be actual high stomach acid. Promise.
If you don’t believe me, try this quick test first. Next time you feel some acid (given that you know you don’t have an ulcer or raw broken skin etc that you could make worse!), try putting a teaspoon of fresh lemon juice in a little water and drinking it. If your acid gets worse, yup; it could be too high. Take some milk of magnesia or your usual antacid to bring it back down. Most often, though, it won’t change or it actually improves. That’s your clue it is probably low. Honest.
One way this low stomach acid thing might cause an over-acidity feeling is because of a problem with the LES. The lower esophageal sphincter (LES) can weaken over time, like any connective tissue. It separates the stomach from the oesophagus and in between meals, it is supposed to be closed to prevent the backflow of food into the oesophagus. However, when there isn’t enough stomach acid, the food isn’t digested properly and this can lead to an overgrowth of bacteria in the small intestine (SIBO). These bacteria feed on and ferment undigested carbohydrates resulting in the feeling of fullness, discomfort, bloating and distension. This then causes an increase in intra-abdominal pressure (IAP), which relaxes the LES and pushes the stomach contents and acid into the oesophagus. And you get the over-acidity feeling. Ugh.
Other factors such as obesity, inflammation (poor diet, smoking, high alcohol intake), high intake of caffeinated drinks, spices, mint and chocolate can all relax the LES too and make symptoms worse.
For more on this whole subject of hypochlorydia, see the Low Stomach Acid page.
Other Causes Of Stomach Acid Problems
Ok, if you’re convinced it is actually high stomach acid, next you need to look at the possible causes of that.
In short, the most common factors I have found clinically have been emotional stress (do not underestimate this one; most people do), a food intolerance reaction (ditto) and H. pylori bacterial infection.
Of course, it can be all three!
Helicobacter pylori infection is very easy to test for, using either a stool test or a breath test or the GastroPanel comprehensive antibody test (see Gut Tests here).
For emotional stress, each time you get the symptoms, note down what you were just feeling. What were you thinking about? Is there a pattern after a few times? Is it linked to a particular emotion eg. fear, anger, frustration, sadness, guilt etc. OK, sounds a bit wacky, but it honestly is a common link.
Re food intolerance, again note down what you ate for the meal before and the meal before that one. Do it several times and see if there is a pattern. Follow the Low GL diet here to remove the most common allergens and see what happens; does it get better? I will eat my hat if it doesn’t improve at least to some degree!
(Ignore the name of the plan by the way; it fits so many needs and I haven’t had time to rewrite it for lots of different health conditions! Suffice to say; it suits most people, not least because it removes the key allergens involved in GERD.)
A Possible GERD Treatment
This is the way I tend to approach it. Obviously look at and deal with any of the factors discussed above. And…
- Lose weight preferably using a low-carb diet like the Low GL Diet if you know you need to. Low carb has been shown to significantly reduce GERD symptoms. Avoid all refined sugars and carbohydrates (e.g. pasta, bread) and eat simple meals based around a source of protein (meat, fish, eggs, legumes) and vegetables. Avoid snacking and eating late in the evening.
- Use healing and soothing herbs that help by coating the stomach lining and regulating acidity. Those might include slippery elm, marshmallow, DGL licorice and aloe vera. This is a good mix.
Slippery elm soothes the throat and lining of the stomach and stimulates mucus secretion. Gamma oryzanol from rice bran oil normalises stomach secretions, has potent antioxidant activity and has an anti-ulcer properties. Marshmallow soothes irritated mucous membranes and has been used as a remedy for ulcers. Deglycyrrhizinated licorice (DGL) increases production of protective mucus and exhibits activity against H. pylori and Aloe vera has a long tradition of use for its wound healing and anti-inflammatory properties.
In addition:
- Strengthen the connective tissue with glucosamine, MSM and vitamin C. I like this one.
- Support bacterial balance with probiotics eg this and antimicrobial herbs such as garlic or cinnamon, for their activity against H.pylori.
- Promote effective digestion with hydrochloric acid (HCL) and digestive enzymes if necessary to reduce carbohydrate fermentation, gas production and bloating. If you have ulcers, gastritis or any other tissue damage in the GI tract, use the soothing herbs above before trying HCL or digestive enzymes.
More Resources …
Rather then reinvent the wheel, I will leave it to a series of articles written by Chris Kesser, which I think are particularly good.
Start with the first article in the series here:
What Everybody Ought To Know (But Doesn’t) About Heartburn & GERD
Next, some simple natural remedies recommended by another physician I really rate: Dr Murray:
Gastroesophageal Reflux Disease (GERD)
Also, he has written this:
Burn Out A Rational Approach To Indigestion
I hope that helps to start you off. Good luck!