What causes heartburn and acid reflux? In this episode of the Thank Gut It’s Fixed Show, I will be discussing the root cause or underlying cause of heartburn and acid reflux. And it’s not what you think or have been told for many years. It’s not the acid. It actually has more to do with what’s happening in the lower part of the gut.

Before we keep going, let’s get some terms clear.

What is Heartburn? What is Acid reflux?

Heartburn is the burning warm sensation under the breastbone. It’s the warm or sour feeling people experience at the top part of the stomach, typically after eating.

Acid reflux is when the content of the stomach exits the stomach, splashes up into the esophagus, and causes the heartburn, pain, and irritation in the upper stomach and chest area. Sometimes, acid reflux can cause sour taste in the mouth and burping. Acid reflux can also cause constant coughing, a feeling that you can’t swallow, lump in your throat, and hoarse voice. It can even lead to asthma and pneumonia. Some people experience these symptoms without the heartburn, and this is called silent acid reflux.

GERD stands for gastroesophageal reflux disease. When acid reflux happens too often, a diagnosis, or a medical term, is given to the symptoms. People get diagnosed with GERD if they have mild acid reflux that occurs at least twice a week, or moderate to severe acid reflux that occurs at least once a week.

LPR stands for Laryngopharyngeal reflux. It’s sometimes called silent acid reflux if the person doesn’t experience heartburn. This can cause serious long-term damage because people don’t even realize that it’s an acid reflux problem. They may not think seek treatment, and the long-term damage can cause to abnormalities in the lining of the esophagus (Barrett’s Esophagus) which can lead to esophageal cancer (more details in the video)

What Causes Heartburn and Acid Reflux?

Conventional medicine believes that the cause of acid reflux is too much acid. If you go to your doctor complaining of these symptoms, you’re most likely going to be given a prescription.
The two types of medications used to treat heartburn and acid reflux are:

1. H2 blockers (Histamine antagonists)
2. PPIs (proton pump inhibitors)

Both types suppress hydrochloric acid production in the stomach.

Low dose versions of some of these medication are available over the counter. In case you’re wondering how Tums fits in the picture, it’s made of calcium salts, which are alkaline. It works by balancing the acid in the esophagus. Basic chemistry lesson: acid+ base = water + carbon dioxide (aka-burp).

The problem with taking over the counter or prescription acid suppressing medications is that they make things worse. Sure, they take the edge off and you don’t feel the pain anymore. But they contribute to the root cause of the problem.

What’s the root cause of the problem then?

Bacterial fermentation of carbohydrates in the stomach and small intestine. If you give bacteria 30 grams of carbohydrates, they will produce 3 gallons (pause—imagine 3 gallons) of gas in your stomach and intestine. That’s enough gas to push the LES muscles between the stomach and esophagus to open.

When you take acid suppressing medications, you make fermentation worse. That’s because these medications slow down digestion, so food sits longer in the stomach to ferment. In additional, when there isn’t as much acid, the pH of the stomach will increase and the environment will become less acidic. That creates a lovely place for bacteria and pathogens to grow and get comfortable in your stomach and small intestine. This can lead to H. Pylori infection or SIBO condition (more on that in later posts).

The bottom line is: hydrochloric acid will not make you get heartburn and acid reflux. You don’t have heartburn because you have too much acid. You have heartburn because the content of the stomach is the wrong place.

It doesn’t matter whether it’s too much or too little acid—any amount of acid in the esophagus will cause a problem. And in fact, it’s not just hydrochloric acid that is refluxing. It’s all the stomach content which also includes the enzyme pepsin and bile salts.

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Is Stomach Acid Beneficial?

YES! These are the 3 main important roles:

1. It activates the enzyme pepsin, which starts the digestion of proteins. It makes protein structures unfold and nutrients bound to amino acids to be released. Without HCL, proteins will not be broken down, and you may not properly utilize the amino acids (important building blocks in the body) from your food. You may not utilize vitamins and minerals attached to the amino acids like calcium, magnesium, or vitamin B12. You may feel too full, have stomach pain, or get constipated if you eat any type of protein.
2. Adequate acid is needed for the mineral iron to exist in a form that is efficiently absorbed. When acid production is reduced, iron absorption is disrupted. Acid suppressing medications lead to iron and vitamin B12 malabsorption. And if you take them long-term, you may develop low iron stores and low ferritin level. Acid blocking medications also interfere with zinc absorption.
3. You need acid to prevent pathogens and bacteria from growing. H.pylori is a type of bacteria that commonly grows in the stomach and causes ulcers and gastric cancer. Low stomach acidity allows H. pylori to grow, and H. pylori will further reduce stomach acid production so it can survive. Reduced stomach acidity increases the risk for developing SIBO (small intestinal bacteria overgrowth).

How to Naturally Treat Heartburn and Acid Reflux?

If you have been following me for a while now, you know I’m not about Band-aid quick fix solutions. Before going into treating heartburn, you have to eliminate the underlying issue, which is fermentation. Here are some of the things I advise my patients who have heartburn, acid reflux, GERD, or LPR to do:

1. Remove acidic foods like citrus fruit, pineapple, berries, tomatoes. It’s a short-term solution to get rid of the pain, but not enough alone.
2. Remove foods that may irritate the esophagus, these include coffee, tea, spicy foods, chocolate, and mint. Still, not enough alone.
3. Reduce bacterial fermentation. Eat a diet low in carbs and sugar. Specifically, remove quickly fermentable foods including garlic, onion, wheat, rye, and barely. Sometimes, I remove all grains and starches.

With my private clients, I use a comprehensive program to heal acid reflux and heartburn once and for all. We aim to naturally combat infections like SIBO and H. pylori. I address problems with gut motility (how fast the stomach moves food down the digestive system) such as gastroparesis and hypothyroidism through food and supplements. We focus on improving digestion and replacing nutrients that are deficient. There are often more foods to eliminate. There are specific supplements that help heal the lining of the esophagus (I prefer to discuss supplements on case by case as functional nutrition must be individualized).

Sometimes food sensitivities can cause heartburn and acid reflux, which is one of the tools I used in my program. If you have heartburn, acid reflux, GERD, or LPR, start with the suggestions above. When you’re ready to go deeper and address the problem from a holistic food-based approach, I’d love to talk. Click HERE to book a Strategy Consultation session so we can map out your own custom healing plan.

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