3 Simple Steps to Eliminate Heartburn and Acid RefluxPosted on August 12th, 2009 |
Categories: Irritable Bowel Syndrome | Heartburn | GERD | Digestive Problems | Acid Reflux
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Are millions of us born with a genetic defect that makes us produce too much stomach acid?
Do we just have a major evolutionary design flaw that requires us to take powerful acid-blocking drugs to prevent heartburn and reflux?
I believe that the answer to all of these questions is a resounding "no."
In this week's blog, I'll explain why, but more importantly, I will outline a simple 3-step approach that will help you prevent acid reflux and heartburn by treating its underlying causes.
The Truth about Acid-Blocking Medications
At least 10 percent of Americans have episodes of heartburn every day, and 44 percent have symptoms at least once a month. Overall, reflux or GERD (gastroesophageal reflux disease, also known as heartburn) affects a whopping 25 to 35 percent of the US population!
As a result, acid-blocking medications are the third top-selling type of drug in America today. Two other drugs to treat reflux, Nexium and Prevacid, are in the top 10 best-selling drugs and account for $5.7 and $4.0 billion in sales annually!
Things have certainly changed since I was in medical school.
In those days, GERD wasn't even considered a serious disease. Instead, people had heartburn or ulcers, but that was pretty much it.
And when acid-blocking drugs first came on the market, even the pharmaceutical representatives warned us how powerful these drugs were. They told us not to prescribe them any longer than 6 weeks and only for patients with documented ulcers.
What a difference a few decades make!
Now, these drugs are given like candy to anyone who ate too many hot dogs at a ball game -- and one drug, Prilosec, is now available without a prescription.
No wonder these drugs are so popular. Their manufacturers have created the illusion that we can eat whatever we want with no consequences, just by popping a pill.
They even have commercials showing a family rushing to stop their father from eating a big sausage with fried onions and peppers -- and he tells them not to worry because he took his acid-blocking pill!
I know someone who used to work for the makers of Pepcid. He told me that when it first became available over the counter, teams of drug company representatives would stand at the gates of county fairs and southern barbeques and hand out free samples.
Talk about sending a bad message!
In reality, acid-blocking drugs are a double-edged sword.
Let's look at some of the recent research on the dangers of these drugs.
Acid blocking drugs obviously block acid that can cause symptoms of heartburn and reflux. But your body actually needs stomach acid to stay healthy.
We know that stomach acid is necessary to digest protein and food, activate digestive enzymes in your small intestine, keep the bacteria from growing in your small intestine, and help you absorb important nutrients like calcium, magnesium, and vitamin B12.
So what happens when you take acid-blocking drugs?
There's evidence that these medications can prevent you from properly digesting food, cause vitamin and mineral deficiencies, and lead to problems like irritable bowel syndrome, depression, hip fractures, and more.
Studies show that people who take acid-blocking medications for the long term can become deficient in vitamin B12, which can lead to depression, anemia, fatigue, nerve damage, and even dementia, especially in the elderly.
The research also tells us that taking these drugs can cause dangerous overgrowth of bacteria in the intestine called Clostridia, leading to life-threatening infections.
For many more people, low-grade overgrowth of bacteria in the small intestine leads to bloating, gas, abdominal pain, and diarrhea (many of the common "side effects" noted in the warnings for these drugs).
This can cause irritable bowel syndrome.
And a recent study in the Journal of the American Medical Association found that chronic use of acid-blocking drugs leads to an increase in the development of osteoporosis and increase in hip fracture because blocking acid prevents the absorption of calcium and other minerals necessary for bone health.
And all this is only part of the problem! There have even been some reports that these drugs may increase the risk of certain cancers.
These are serious problems -- and it's pretty clear that in this case, the "cure" of acid-blocking drugs is worse than the "disease" of GERD. But that's of little comfort when you're suffering from heartburn.
So if drugs are not the answer, what is? We need to find the real causes of reflux and heartburn -- get rid of them! And we need to use the right foods, nutrients, and lifestyle therapies to heal the problem.
What Causes GERD?
Fried food, alcohol, caffeine, and soda can all trigger reflux. Spicy, tomato-based or citrus foods may also cause problems for some people. Smoking also increases the risk of reflux. Being overweight and having your belly fat push up on your stomach can prevent it from emptying, triggering reflux.
Having a hiatal hernia (where your stomach pushes up through your diaphragm) can also cause trouble and can be diagnosed by x-ray. Eating large meals and eating before bed are two other main reasons for reflux.
But there are other causes that are often overlooked. Food is supposed to go down, not up, when you eat.
That's why there are two main valves, or sphincters, that control food going in and out of your stomach -- the one at the top (or the lower esophageal sphincter) and one at the bottom (the pyloric valve).
When you're stressed, the valve on the top relaxes and the valve on the bottom tightens up.
The result? Food goes up, not down. So stress contributes to reflux.
Magnesium deficiency is another cause of reflux because magnesium helps the sphincter at the bottom of the stomach relax, allowing the food to go down.
While controversial, I believe that a common infection can cause not just ulcers but reflux as well. This bug is called H. pylori and can be identified by a simple test. It needs to be treated even if you don't have an ulcer.
Food sensitivities or allergies can also cause reflux. Common culprits include dairy and gluten-containing foods like wheat, barley, rye, and oats. Plus, overgrowth of bacteria in the small bowel or yeast overgrowth in the gut can cause reflux.
These are all treatable conditions that you don't need powerful acid blocking drugs to fix.
To properly diagnose the causes, you may need to do the following.
-
1. Ask your doctor for an H. pylori blood antibody test.
2. Consider a test for IgG food allergies and celiac disease.
3. Get a breath or urine test to check for small bowel bacterial overgrowth.
4. If you don't get better with the suggestions below, consider getting an upper endoscopy or upper GI series x-ray to see if there is anything else wrong.
3 Steps to Permanently Overcoming Heartburn and Acid Reflux
Step 1: Treat the Bugs if You Have Them
-
• If you have H. pylori, treat it with triple antibiotic therapy from your doctor.
• Treat yeast overgrowth with antifungal drugs such as nystatin or Diflucan or herbs such as oregano or caprylic acid.
• Treat bacterial overgrowth in the small bowel with Xifaxin (see my blog on irritable bowel syndrome).
Step 2: Change Your Diet
-
• Try to eliminate dairy and gluten (see www.celiac.com for sources of gluten in the diet).
• Eliminate alcohol, caffeine, citrus, tomato-based, and spicy foods.
• Don't eat within 3 hours before bed.
• Don't eat junk food.
• Avoid processed foods.
• Eat cooked foods, like fish, chicken, cooked veggies, and rice; avoid raw food for now.
• Eat smaller, more frequent meals, at least 4 to 5 times a day.
Step 3: Try Some Natural Remedies to Help Soothe the Gut
-
• Take 2 to 3 capsules of digestive enzymes with each meal.
• Re-inoculate the gut with healthy bacteria by using probiotics.
• Try 75 to 150 mg of zinc carnosine twice a day between meals -- this has been extensively studied and is used frequently in Japan.
• Take 3 to 5 grams of glutamine powder in water twice a day to help heal the gut lining.
• Chew 2 to 3 chewable tablets of DGL (a form of licorice) 15 minutes before meals.
• Try 200 to 400 mg of magnesium citrate or glycinate twice a day.
As you can see, there's no need to suffer from heartburn and reflux -- or to take expensive and dangerous acid-blocking drugs.
I hope the changes I've suggested here will soothe your stomach and have you feeling healthy in no time!
Now I'd like to hear from you...
Do you have heartburn, reflux or GERD? What seems to trigger it?
Have you taken acid-blocking drugs? What was your experience?
What changes have worked for you in preventing and treating these problems?
Please let me know your thoughts by leaving a comment below.
To your good health,
Mark Hyman, M.D.
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enzymes, zinc carnosine
My practitioner advised me to take zinc carnosine twice a day with meals, so I was surprised to read the Dr.'s advice to take it between meals.
I've taken with-meal and between-meal enzymes for >1.5 years, but then quit, as it seemed they might have caused or exacerbated my GERD. I do have more bloating now, even with taking a well known and expensive probiotic twice a day (60 billion).
Omeprazole has really helped me, the concerns about its use notwithstanding. I'd love not to take it, and will taper gently when the time is right.
Was taking glutamine capsules, but felt a bit anxious, which is expected, according to a naturopath I see, as she says glutamine affects dopamine levels. Others may feel differently about this.
One thing that really helps me is to walk for 20 minutes after each meal. This isn't always possible, but really is beneficial when I do it.
I also have battled candidiasis for the last few years (now eradicated, at least according to stool DNA profiling). I also have been tested as having cryptosporidium, though none of my docs (conventional or natural) seems to think this is a big deal, as I don't have the typical sympom of runny stool.
All in all, I continue to be spiritual and work to maintain a positive attitude, but just am not myself anymore. Brain fog, aches and more keep me from being all I can...and used to...be.
IndyVeggie
acid reflux and fish oil capsules
The only time I ever seem to get acid reflux or heartburn is when I take Fish Oil Capsules. I have tried yours and Dr. Sears' as well as a common over the counter brand. I have tried taking it with food and without food and there seems no significant difference.
GERD
Jo Pomeroy
Thank you for this post. After having an endoscopy in 2008 to try to determine once and for all if I am celiac I was told "not celiac, but you have Barrett's Esophagus". Imagine my surprise. I am informed that I have "silent GERD"--I have no symptoms--no heartburn, no reflux. This news followd by a 24 hour PH test and a test to diagnose sphincter action and POW! on to a morning and evening dose of Prevacid. After a more recent 24 hour PH test, my dose has increased to double the amount of Prevacid in the morning and a single dose in the evening.
I do seem to have one "symptom"--the feeling of a small lump in my throat.
So, for a problem that I didn't know I had I am spending a lot of money on medication and the situation appears to be getting worse. But, of course, I am scared to death at the thought of esophageal cancer. Great.
Thank you for the suggestions of supplements to try. I have read some of the literature about continuing acid blockers for long periods of time (eight months now for me) and have not been happy about continuing on this medication. I think that I will have some of the tests that you mentioned and see if I can't get to the bottom of this.
eliminating heartburn and acid reflux
Hi Jopomeroy, I enjoyed your comments on this topic, I, too, am going to have some tests after seeing this, I am an Australian woman looking for buddies in the Ultra Wellness world. Could you be one of my buddies? Lets know, very Sincerely, lily.lake ....ps I also have a blog on Oprah community website
acid reflux
Just wanted to thank Marc for helping me kick the Prilosec habit over 10 years ago - talk about a depressant - and I was not even aware of how depressed I was on that drug.
I recently started the UltraSimple Cleanse to get off the sugar/gluten and feel better than ever.
murphy Via: What
murphy
Via:
What was Mark's advice about how to kick the Prilosec habit? I would like to get of Protonix, an even stronger acid blocker. I've been on it for nearly two years and know it's not a good long term idea.
Prilosec a depressant?
where do you find info on the Prilosec/depressant link? I have to take it for my sinuses.
acid reflux and h. pylori
murphy
Re Dr. Hyman's advice about H. pylori and acid reflux: I have already had three rounds of the triple antibiotic treatment, one every year for three years and have once again, in the fourth year, been diagnosed with H. pylori. I don't want to do any more antibiotics; surely, if they don't work three times in a row, why should they work the fourth time? And I can only imagine the havoc they have caused in my digestive and intestinal system. Is there some other way to approach this problem?
reflux
Liza3
I'm surprised the article doesn't also include the possibility of taking HCL with Pepsin--if one cause of poor digestion is lack of stomach acid, very common due to aging or stress (including physical stress), then supplementing that can be very helpful. I take 1-2 capsules (500 mg) of HCL with every meal with a signficant amounts of protein in it. It's done wonders for me. I think I was born with insufficient stomach acid and made it worse in childhood by taking "Tums" to Reduce acid!
Gerd, acid reflux and heartburn
Once again Dr. Hyman reminds us it is so important to get to the cause of your problems. Covering the symptoms is temporary -- good only until the medication works it's way out of your system. Thank you Dr. Hyman for guilding me as I changed my lifestyle. I'm loving life!!
To Your Optimum Health; http://www.joannefogarty.com
eliminating heartburn and acid reflux
What a timely piece of advice, thank you Doctor Hyman. I have a hiatus hernia, a duodenal ulcer and belly fat. The hernia and ulcer were diagnosed over 20 years ago and for a time I was on zantac. However, I have always been interested in alternative therapies and tried to avoid conventional drug treatments. The ulcer "attacks' have been frequent and regular over the years. I just did not know where to start adressing all my health issues! I felt hopeless and depressed. Since purchasing the UltraMind Solution and the UltraSimple Diet books, and watching the videos, I feel there must be a chance for me to get well.THANK YOU ALL AT THE ULTRAWELLNESS TEAM ESPECIALLY DOCTOR HYMAN
Hiatal Hernia/GERD
I've been diagnosed with hiatal hernia and GERD. I have tried a miriad of natural remedies to no avail. I've tried DGL, glutamine, mastic gum, marshmallow root, slippery elm, digestive enzymes, probiotics, etc. I eat a bland diet consisting of mainly rice and vegetables. The only thing that stops the nausea, stomach pain, reflux and trouble breathing has been PPI's. My GI doctor says the hernia is too small to cause these problems and is too small to repair. Has anyone else had these problems and found a nautural rememdy or rememdies that work for them?
Frank
Hiatus hernia and gerd relief-- go with functional medicine
Hi there fedavis-frank. I have heard that sleeping with your legs very slightly elevated ie have the bottom end of the mattress slightly elevated can help hernia. I read this actually in a very small book called Heal Your Hiatus Hernia. It was a British book, I can not remember the authors name except I recall it was a woman. She also said to eat very small meals frequently, ie not allowing the stomach to empty. I recall Dr Hyman or Dr Oz saying that an empty stomach causes short term starvation stress. I am putting my faith in the UltraWellness functional medicine approach. I am at the start of my journey towards wellness using the functional medicine approach, love and peace, hope this has been useful, lily.lake ps you can be on my buddy list if you want
Liza3 see my comment on
Liza3
see my comment on indigestion and low HCL, below
Reflux is getting worse
I have had reflux for about 5 years now. I am not overweight, eat a healthy diet and exercise 4 to 5 times a week, but my reflux has gotten progressively worse over time. I started taking pepcid at the beginning then moved to prilosec and now am on protonix which does not control it completely either. I have been on protonix for 2 years now and this last year I started getting IBS symptoms as well as already having fatigue and brain fog. I've also noticed that I am getting muscle type twitches/spasms in my abdomen and chest area regularly at night. Not sure what it is but it has been happening for a while now.
I recently had an endoscopy and it came out normal except for there being inflammation in my stomach. I tested negative for Pylori and Celiacs too. After telling me this the GI doctor said to stay on the protonix and to come back if things get worse. So it doesn't feel good to be told they will not do anything further until I get worse. I feel like my health is declining and doctors want it to decline further before doing anything. That is crazy.
After reading this article I have decided to take my health into my own hands and ween myself off of the protonix. I bought Dr Hyman's book and going to do the 6 week eating plan as well as buying some of the recommended natural remedies. I just want to be healthy and feel normal again. I will keep you posted on my progress. :-)
acid reflux
I developed acid reflux after removal of gall bladder. This has also happened to a few friends. It became very intense during a period of high stress - a couple of years worth! I took the prescription meds, it got worse, had horrible stomach cramps. With a blood panel found out my liver was messed up from the meds. Now I use soda and water for the heartburn, have reduced much of the stress and may have occasional bouts but nothing like it was. I do use the prescription if it gets bad or hurts but only for a week at the most. I wish it would all just go away but have not found a healthy way to get it done!
indigestion and HCL
Liza3
I'm surprised the article doesn't also include the possibility of taking HCL with Pepsin--if one cause of poor digestion is lack of stomach acid, very common due to aging or stress (including physical stress), then supplementing that can be very helpful. I take 1-2 capsules (500 mg) of HCL with every meal with a signficant amounts of protein in it. It's done wonders for me. I think I was born with insufficient stomach acid and made it worse in childhood by taking "Tums" to Reduce acid!
Hiatial Hernia & Bloated Stomach-Still no relief
I have suffered from GI problems for about six or seven years now and I am still trying to find a viable solution. In '03 I had an upper endoscopy and discovered that I have a hiatial hernia. I have been to many internists, specialists, naturopaths, etc. since then. My main symptoms are a bloated stomach (this has become a constant.) indigestion, some gas and occasional acid reflux (from the hernia.) I have tried many different remedies and diets and still have yet to find something that I can stick to permanently. The two times that I felt best were:
when I was seeing a doctor in Santa Fe, NM who put me on a diet similar to your ultra mind. No alcohol, wheat, sugar, caffeine or dairy. In addition, I was taking a colon cleanse daily and digestive enzymes with every meal.
The second time I felt relief was when I saw a GI doctor in Los Angeles who put me on Xifaxian. For the first time in years, my stomach was not bloated! Unfortunately, as soon as the course of antibiotics ended, my symptoms returned.
I recently ended up in the hospital with severe chest pains and after many tests, the doctor surmised that it must have been a result of my hiatial hernia (an extreme case of acid reflux.) I have been on Prilosec ever since but have not felt much relief.
I am under a severe amount of stress at the moment, which I am sure has triggered an outburst. I have been good about eliminating caffeiene and spicy foods from my diet as well as limiting my alcohol consumption. I did your Ultra Mind diet and did not find much of a difference with my GI troubles.
I was excited to find your email addressing acid reflux and heartburn and appreciate your sharing your wisdom. I will follow up with my doctor and try the tests that you mentioned. Beyone that, can you offer any other advice to me considering my symptoms?
Thanks again for all of the wonderful information!
Heather
natural remedies for acid reflux
Dr Hyman,
I have gastritis and also I just had h.pylori infection but is gone now. I bought probiotics which I already started taking, I also have dgl tabs and digestive enzymes but I don't know if I should be taking all of these since I stopped taking the antacids that were prescribed for me. I would like to fix my digestive problems naturally so I would like to ask Dr Hyman if I should be taking all of these since he said to take 2-3 caps of digestive enzymes with each meal, 2-3 dgl tabs 15 mins B/4 meals and then too I have the probiotics. I don't have zinc, magnesium except in my multi-vits w/c is only a portion of what he recommends.
Thanks and wait for response
Sinus Relief with Prilosec
My ENT prescribes Prilosec for my sinuses and it works! While I don't have any severe symptoms of heartburn, I do wake up in the morning with a stuffy nose without the Prilosec. And if I don't use Prilosec every evening before bed, inevitably I have chronis sinusitis. My ENT says I have mild acid reflux which causes my sinus problems. My ENT says I will probably need to be on Prilosec for the rest of my life. I have tried not using it but I'm miserable with sinus infection without the evening dose of Prilosec.
Reflux from the UltraSimple shakes
I wish someone could give some insight. I occassionally suffer from reflux/esophageal spasms when eating certain foods (that I typically try to avoid now). So I started the UltraSimple diet and after drinking the flax/rice protein shake I get the absolute most HORRIBLE case of reflux you could possibly imagine! I even limited the amount of flax and rice protein I use to 1/4 of the suggested amount. Minutes after drinking the shake I get debilitating chest pain, throat spasms causing me to burb up slimy clear frothy stuff (acid?), and coughing. The shake stays down and eventually digest but I can't imagine why such a 'healthy food' would cause such a terrible reaction in me! Any thoughts on this? Thanks ~
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