What is Acid Reflux?

Acid Reflux is when acid and/or contents of the stomach are moved upwards through the sphincter (the valve that separates the esophagus and the stomach) into the esophagus causing various symptoms. Also known as GERDS, Heartburn, call it what you like if you have experienced it, you will know that familiar burning sensation in your chest.

What are the symptoms of Acid Reflux?

The most common symptom is heartburn. However, it can manifest in several different ways such as:

• regurgitation without nausea
• feeling of a lump in your throat
• asthma
• hoarse voice
• a tickly cough for no other reason 
• sour taste in the throat or mouth

Myth of Acidic Stomach

This has been one of my biggest health issues for most of my life. Every visit to the doctor resulted in a prescription for ant-acid (Proton Pump Inhibitor) medication. Once I started looking deeper I found that there is an epidemic proportion of people now taking acid blockers or ant-acid tablets all over the world. I thought this couldn’t be right, I can’t believe there are billions of people out there with excessive stomach acid. So I dug deeper and discovered many causes and it all came back to gut health.

Through education, I have mostly resolved the issues and changed my diet. You can do the same by reading my articles on Gut Health and adapting changes in your lifestyle to improve your reflux.

How much is too much stomach acid?

There is no such thing as too much stomach acid. Your stomach produces about 2 to 3 liters of gastric juice every day. The stomach lining constantly renews itself to prevent the digestive acids from harming it. You should not be aware of any stomach acid due to a protective lining of mucus.

What causes acid reflux?

There are several possible causes of acid reflux. It helps to understand how the stomach works before looking at the possible causes of reflux.

How the stomach works

After chewing your food to form a “bolus”, your tongue pushes it down a tube called the esophagus. This tube squeezes the food down to your stomach through the upper sphincter (valve). In your stomach, strong muscles mix the food with gastric juices that break it down. The food becomes like a smoothie, called chyme (pronounced “kime”).

The muscles in the stomach wall also squeeze to push the chyme toward the pyloric sphincter (pronounced “pie-LOR-ic sphincter”) at the lower end of the stomach. This helps move chyme into the small intestines and onto the next stage of digestion.

Possible Causes of Reflux

The most likely and most common are poor diet, constipation, SIBO small intestine bacterial overgrowth and stress. We examine below a list of the possible causes. This list is not exhaustive and is not an attempt to diagnose your reflux.

Diet and Drinks:

A poor diet can cause gut microbiome imbalance increasing SIBO (small intestine bacterial overgrowth). This increases bloating which in turn slows down or even stops peristalsis. This can back up into the stomach causing reflux.

Excessive alcohol can cause inflammation in the gut allowing acid to escape and further inflaming the esophagus.

Constipation:

Are you constipated? This is a very under-considered cause of reflux in my opinion. If you are constipated, this can have a huge knock-on effect on your digestive system and cause no end of problems including acid reflux. You can read more about constipation here.

Overeating:

A stuffed stomach puts pressure on the sphincter, making it more likely for stomach acid to leak back up.

Hiatal Hernia:

This is a condition where part of the stomach pushes up through the diaphragm (muscle separating chest and abdomen), weakening the sphincter.

Pregnancy:

Hormonal changes during pregnancy can relax the sphincter and increase pressure on the stomach.

Medications:

Certain medications, like aspirin and ibuprofen, can irritate the stomach lining and contribute to reflux.

Stress & Reflux

As with most other things, stress plays a huge role in causing Acid Reflux.  Stress can cause the stomach to stop digesting food properly leaving it to ferment and pushing up through the sphincter.

Stress also has an impact on the Vagus nerve.  Anxiety affects Vagal Tone, the firing of the vagus nerve that controls a whole bunch of processes including stomach acid secretion.  So when you are under high stress or anxious, you’re in a state that will deactivate the vagus nerve, leading to low secretion of stomach acid which you need to digest food.

Medical Conditions:

Diseases like asthma and scleroderma (autoimmune disease) can affect the muscles involved in swallowing and digestion, leading to reflux.

Hypo functioning in the stomach specifically refers to decreased muscular contractions and motility. There are two main terms used to describe this:

• Gastric hypomotility: This is the general term for sluggish stomach muscles that don’t contract as forcefully or as often as they should.
• Gastroparesis: This is a more severe form of gastric hypomotility where the stomach muscles become partially paralyzed, significantly slowing down the emptying of food from the stomach.

As a result, hypo functioning of the stomach can:

• Slowed digestion: Food sits in your stomach for longer than usual, leading to feelings of fullness, nausea, and vomiting.
• Bloating and discomfort: Partially digested food can ferment in the stomach, causing bloating, gas, and abdominal pain.
• Nutrient deficiencies: If nutrients aren’t absorbed properly due to slow digestion, you might develop deficiencies in essential vitamins and minerals.
• Increased risk of bacterial overgrowth: Stagnant food in the stomach can create a breeding ground for bacteria.

Several factors can contribute to stomach hypo functioning, including:

• Certain medications: Diabetic medications, opioids, and some antidepressants can slow down stomach emptying.
• Medical conditions: Diabetes, hypothyroidism, and scleroderma (an autoimmune disease) can affect nerve or muscle function in the stomach.
• Surgery: Abdominal surgeries can damage nerves or muscles in the stomach, leading to hypomotility.

There can also be a lack of patency, meaning a flimsiness in the lower esophageal sphincter, it’s not strong enough to stay closed and therefore resist the flow of stomach contents coming back up the esophagus.  

H. Pylori

H. Pylori is treatable and is normally diagnosed during an endoscopy.

H. Pylori can burrow itself into the gastric lining causing irritation and inflammation of the gastric lining itself.  This can result in heartburn, reflux, and ulcers.

H. Pylori is a very smart and adaptive microbe and has mechanisms within the bacteria to shut down stomach acid production so that it can increase its survival.  This can result in Hypochlorhydria (a deficiency of stomach acid), manifesting all the symptoms downstream from that – inability to digest protein, absorb minerals, release pancreatic enzymes, bile from the gallbladder and affecting the gut microbiome and more likelihood to develop SIBO because you don’t have enough acid to kill off the bacteria. 

Always look at the root cause of the problem. It’s about looking at the bigger picture.

Can you heal Reflux at home?

It is possible to heal your reflux without medical intervention but it is extremely important to establish the CAUSE. This article assumes you are not taking PPIs for any serious condition or following treatment for cancer. In all cases, you must seek advice from your doctor or other medical professional to establish whether or not there is an underlying cause of your reflux.

Healing Reflux

Problems with Proton Pump Inhibitor Medications

There is an epidemic proportion of people in the Western world, who are either taking Proton Pump Inhibitors (PPIs) or other over-the-counter ant acid medications. The principal method of PPIs is to shut down the mechanism that produces stomach acid.

However, stomach acid is essential for not only breaking down food but also killing unwanted bacteria that enter the body through the mouth.

A common problem with taking PPI’s is when you stop. There is often a rebound effect called rebound acid hypersecretion (RAHS). This results in the reflux symptoms returning or being worse for several weeks after taking a course of PPIs.

In addition, if your problem is related to a physical issue, they do not address the sphincter itself.

To alleviate reflux, we need to apply critical thinking and address the root cause.

Healing Reflux at Home

Resolving acid reflux takes time. It’s never one size fits all. You need to establish the root cause of your reflux and make changes to your diet to improve the overall health of your digestive tract. Here are some tips:-

• Stop drinking caffeine and alcohol 
• Improve your diet
• Sleep studies show that good sleep improves acid reflux
• Reduce stress levels
• Use bitters to fire up your digestion
• Help heal your gastric lining by using natural therapeutics like Bismuth, Aloe, Licorice Root and slippery elm

Once you have made changes then over a period of time you can start to reduce your antacid or PPI inhibitors very gradually, under the supervision of your Doctor ⁽¹⁾.

Ultimately you have to change your diet, and lifestyle

(1) – Note I am not a doctor or any other medically trained person and you should never suddenly stop taking your medication without consulting your doctor. This information is purely for informational purposes based on my own experience with suffering from lifelong problems with GERDS.