Summer is a time for barbecues, picnics, and quick and easy meals. It can also be a time of increased heartburn. The term “heartburn” is a misnomer. The sensation of burning around the diaphragm has nothing to do with the heart. This sensation occurs when stomach acid moves up into the esophagus (it’s supposed to stay in the stomach!) This is a very common complaint in today’s society affecting over 60 million Americans.

For more about the importance of stomach acid and the actual causes of heartburn, see my previous post “Stomach Acid is Good for You!”

Here are a few tips to help you stay heartburn free this summer (or any time of the year.)

• Don’t rush when you eat. By slowing down and eating in a more mindful way you will enhance your body’s digestive abilities and be less likely to overeat. Taking 5 deep breaths before eating can help to put your body in a more relaxed state, ready to digest.
• Avoid trigger foods. If you are prone to heartburn avoid foods that may exacerbate it including fatty foods, coffee, chocolate, mint, sugar, alcohol, citrus fruits, spicy foods, and dairy products.
• Wear loose-fitting clothes. Tight fitting clothes can place added pressure on the stomach and exacerbate heartburn.
• Use digestive bitters. Combinations of bitter herbs have been used to aid digestion for centuries. Digestive bitter formulas can help to stimulate digestion and decrease the occurrence of heartburn when taken before the meal. The best results occur when the bitters are taken in a small amount of room temperature water, 10 to 15 minutes before the meal.  You can buy my favorite digestive bitters through the online dispensary Fullscript by clicking here.
• Elevate your head when you sleep. Elevating the head of your bed by six inches can help gravity keep the acid in its place. Studies have shown that for those suffering from nighttime reflux, this simple solution can be more effective than antacids or acid suppressing medications.
• Chew DGL tablets. If you do experience reflux, try chewing a couple deglycyrrhiziated licorice (DGL) tablets before reaching for the antacid. DGL helps to coat the esophagus and stop the burning sensation without suppressing acid production. For best results, the DGL tablets should be chewed well before swallowing. Chew two DGL tablets either right before or right after your meal.  If you experience nighttime heartburn, you can also chew two tablets before bed.  You can buy my favorite DGL through the online dispensary Fullscript by clicking here.

If after trying these solutions you are still experiencing heartburn, call to schedule an appointment with Dr. Knight to help determine the underlying causes of your heartburn so that you can get lasting relief without long term negative effects.

If you have been watching television in the past decade you have seen the commercials. People suffering from heartburn and indigestion are magically cured by taking a little purple pill that combats the evil effects of stomach acid. No need to change your diet or other habits. Just pop a pill and everything will be ok. Just don’t pay too much attention to the list of possible side effects at the end of the commercial.

Acid blocking medications are the number one selling drugs in the United States accounting for annual sales of more than $13 billion a year. Once only available by prescription they are now available over the counter at your local drug store. With so many people buying drugs to combat stomach acid you would think that it was a horrible thing that we would want to get rid of. Thank goodness we have all of these options, whatever did we do before?

However, there here is another side to this conversation. For the majority of people, the symptoms of heartburn and acid reflux are typically not caused by an over production of stomach acid. In fact, the majority of people suffering from heartburn and reflux actually have low production of stomach acid In addition, suppression of stomach acid can have long[1]term adverse consequences.

How can this be? Stomach acid is produced by cells that line the stomach. The production is increased in response to food and begins the process of breaking down the meal you just ate. The stomach acid is hydrochloric acid; the same hydrochloric acid that you used in high school chemistry class and that can burn a whole in metal. In order to prevent the acid from burning a hole in the lining of the stomach, the cells that line the stomach produce a layer of mucous that protects the lining and allow the acid to do its job.

When you experience heartburn or reflux some of the stomach acid finds it way up into your esophagus. While your stomach has a nice protective coating, your esophagus does not. So, when the acid accidentally comes up into the esophagus you experience a burning sensation.

At the bottom of the esophagus is a gate called the lower esophageal sphincter (LES). The LES is designed to allow food and liquids to enter the stomach from above, but should prevent the contents of the stomach from coming back up into the esophagus. A number of things can decrease the effectiveness of the LES including smoking, obesity, food allergies, and low stomach acid. When the acid production. is decreased it is more likely for acid to find its way back into your esophagus and cause you pain and discomfort.

Taking an antacid such as Tums, a proton pump inhibitor such as Prilosec, or an H2 blocker such as Zantac do work to decrease the symptoms of heartburn. The proton pump inhibitors are able to suppress stomach acid production by greater than 90%. With very little stomach acid in the stomach there is little chance of the acid finding its way up into the esophagus and so you don’t get reflux or heart burn. The drawback is that you are left without stomach acid.

With low levels of stomach acid you are not able to adequately digest the food that you eat and are more likely to have gastrointestinal issues such as heartburn, reflux, irritable bowel syndrome, diarrhea, constipation, gastritis, gall bladder disease and paradoxically heartburn and reflux. Low stomach acid is also associated with an increase in overgrowth of the small intestine with problematic bacteria. In addition to gastrointestinal dysfunctions, low stomach acid production is also associated with increased risk of numerous disease states outside the gastrointestinal tract including asthma, food Allergies, pneumonia, rheumatoid arthritis (and other autoimmune conditions), depression, rosacea, eczema, anemia.

So next time you are experiencing heartburn, instead of cursing stomach acid and reaching for a pill, think about why you might be having heartburn and work on fixing the underlying cause as opposed to using a treatment that may cause more harm than good. For my tips on preventing heartburn, click here.