Do you or someone you know have an annoying chronic cough? Is your voice hoarse on a regular basis? Do you have difficulty swallowing and constantly regurgitate food and or sour liquid? Do you experience a burning sensation in your chest after eating and especially at night when you lie down? Have you lived with this for more years than you can count?
You may be among the many who suffer from a chronic condition known as GERD (Gastroesophageal Reflux Disease). This occurs when stomach acid or bile flows up from the stomach into the esophagus, creating a burning feeling in the chest and throat. Chronically, this condition can lead to other problems including a constant sore throat, the symptoms listed above and Barrett’s esophagus and cancer. Barrett’s esophagus is a condition where the cells lining the esophagus change to resemble those of the intestines and may eventually develop into cancerous cells. It is estimated this cancer affects approximately 10-15% of people who have GERD. (1)
So what is the cause of GERD?
The LES (Lower Esophageal Sphincter) is located at the bottom of your esophagus at the junction of the stomach. When closed this trap door like sphincter functions to keep stomach acid down in the stomach. Unfortunately, many with GERD have low trap door integrity and their sphincter opens when it should not, allowing stomach acids to flow up into the esophagus.
Some may have a hiatal hernia, where part of the stomach has bulged past the diaphragm muscles restricting the sphincter from closing. Hiatal hernias typically are a functional problem and must be corrected with surgery or pushing the stomach back down through the diaphragm. However, when a hiatal hernia is ruled out, doctors often diagnose GERD due to the following causes:
- Abdominal obesity causes increased upward pressure on the stomach pushing stomach acids up against the LES.
- Smoking which exposes the LES to toxins that damage the muscles of the LES causing them to be relaxed and allow acid to flow up into the esophagus.
- Alcohol which decreases the ability of the LES to close tightly.
- Medications
- Foods containing high fat, spicy, caffeine, citrus, and chocolate which often cause increased GERD symptoms.
The Real Problem: Low Stomach Acid
When you see a doctor for GERD symptoms, the first thing they will often do is diagnose high stomach acid and prescribe an acid blocker. These well known prescription and over the counter medications like Prilosec, Nexium and Prevacid decrease the production of stomach acid by up to 70%. They are meant to be short term medications to relieve symptoms, yet patients often take these medications for 20+ years. There are a few problems with this scenario:
- Patients remain on acid blockers for years and often increase their dose due to continued and worsening symptoms.
- If the original problem was actually high stomach acid the acid blockers should work to decrease symptoms.
- Lowering stomach acid decreases the ability to digest food which causes food to sit longer in the stomach and putrefy.
- Low stomach acid opens the LES allowing any acid in the stomach to leak into the esophagus.
- Low stomach acid allows partially digested food to sit in the small intestines and cause havoc leading to dysbiosis.
How can I get rid of GERD?
Lowering stomach acid actually aggravates the problem and leads to worsening symptoms of acid reflux. It also decreases digestion and thus the absorption of food leading to low nutrient absorption and other factors associated with the integrity of the small intestines and the immune system.
In fact, although there are some who have true high stomach acid, all the factors listed above that cause GERD can be explained by low stomach acid. Low stomach acid is a result of stress. Obesity, smoking, and alcohol use all create physical stressors on the body. Environmental stressors like your job, relationships, and toxins can all cause a decreased release of stomach acid. Medications like acid blockers induce even lower stomach acid and foods that seem to cause GERD symptoms are most likely not digested well due to low stomach acid.
The solution, therefore, is to actually increase your stomach acid and decrease stress. This will allow the LES to function properly, allow your stomach to digest food, and do away with your chronic cough, sore throat, hoarse voice, and other GERD symptoms!
I have seen lots of success with oral hydrochloric acid and bitters to stimulate your own stomach acid. These along with stress management techniques can make a significant difference in your health by increasing your stomach acid. However, for those who have dealt with GERD symptoms for years, it will not be an overnight fix for your sphincter. The sphincter muscles have been weak for a long time and it will take time to stimulate them to work well and become strong.
How can I test for low stomach acid?
Although there are expensive lab tests you can take to determine your level of stomach acid, a simple and easy way to test is the Baking Soda Test. This is not terribly scientific but gives a fairly accurate picture of your stomach acid. For this reason I recommend taking this test 4 days in a row and looking at your average outcome. This test should be taken first thing in the morning after you wake up, before you eat or drink anything.
- Take 1/4 tsp of baking soda and dissolve well in 1/2 cup of lukewarm water.
- Drink without gulping.
- Set an alarm for 5 minutes.
- Record when you burp.
- No burps indicate low stomach acid.
- Immediate and repeated burps may indicate adequate or high stomach acid
- Late burps after 3 minutes may indicate lower stomach acid.
- Testing ends after 5 minutes.
If you experience GERD symptoms and would like more help in discovering the root causes of your symptoms and how you can treat them, feel free to schedule a Free Discovery Call with me by clicking on this link: https://my.practicebetter.io/#/5e5c47d32a9c240a005a9380/bookings
References:
1. https://www.niddk.nih.gov/health-information/digestive-diseases/barretts-esophagus/symptoms-causes
