Acid reflux, also referred to as heart burn, indigestion, or gastroesophageal reflux disease (GERD), occurs when contents of the stomach flow backwards into the esophagus and create a burning sensation in the lower chest area. Many people assume this is caused by too much stomach acid and are quick to take an over-the-counter medication to treat it. You may be surprised to learn that one of the underlying causes of acid reflux isn’t too much stomach acid, but it’s actually too little stomach acid! Don’t worry–I’ll explain!
First, let’s start out with some basic information on the beginning of the digestive process. Did you know, digestion actually begins in the brain? When you smell, see, or think about the food you will eat your entire digestive system is primed. It stimulates the salivation process, digestive enzyme production, and stomach acid production–all of which help you break down food. The actual break down of food begins in the mouth by the way of chewing and digestive enzymes (released through saliva). The chewed food then flows through the esophagus into the stomach where break down continues. After food enters the stomach, the lower esophageal sphincter should close and remain closed. (The esophageal sphincter is what separates your esophagus from your stomach.)
A healthy stomach has a thick mucosal lining and is extremely acidic–it generally measures between 1 and 3 on the pH scale. Stomach acid, also known as hydrochloric acid (HCl), is very important for multiple reasons: 1. It is your first line of defense against bacteria and pathogens found in food. 2. It supports the chemical breakdown of food. 3. It releases nutrients like zinc, B vitamins, calcium, iron, and more so they can be absorbed into circulation. Essentially, your stomach “churns and burns” food by physically breaking it down while mixing it with gastric secretions (end result is called chyme) and sends it on its way to the small intestine.
This is the point of the digestive process where some people can run into problems and experience acid reflux. Per the paragraph above, stomach acid play very key roles in the removal of harmful pathogens and proper break down of our food. If we do not have proper stomach acid to complete these processes, we can experience negative consequences like “bad bugs” or undigested food lingering around too long. Both of these things “muck up” the digestive flow and prevent food from flowing as it should through to the small intestine. Instead, it puts pressure back on the lower esophageal sphincter and allows the contents of your stomach to creep back into your esophagus. Because the esophagus is not nearly as acidic as the stomach, any amount of gastric fluid that touches the esophageal lining with cause a burning sensation regardless of whether it contains “a lot” or “a little” of HCl. We tend to link any burning sensation with having too much stomach acid, but as you know now, it can be caused by too little stomach acid.
Low stomach acid isn’t the only cause of acid reflux–hiatal hernias, pregnancy, obesity, over-sized meals, alcohol, spicy foods, or underdeveloped digestive systems (generally in the case of babies) are also causes. In our society, it is all too common to “band-aid” a problem with medication instead of working to understand the “root cause” of the problem. If you experience acid reflux, it is important to figure out why you are experiencing it. If you can pinpoint the root cause, you will be able to take steps to naturally fix it, rather than covering up symptoms with a medication. If you can’t blame your acid reflux on any of the other reasons listed above, it may be worthwhile to try naturally supporting stomach acid production to see if that helps.
Natural ways to support stomach acid production:
- Enter into “rest and digest” mode prior to eating. We are generally running around in a constant state of stress and are living in “fight or flight” mode. When we are in this “fight or flight” mode during mealtime, our body is unable to focus on digestion as the main priority. To set your digestive system up to function optimally, it is important to relax before a meal, sit down while you eat, and be mindful of the food you are enjoying. This increases salivary function, stomach acid production, digestive enzyme secretion, and proper release of digestive hormones.
- Chew your food 20 times per bite. Gahhh-what?!?! I know, this is so hard to do–try it! Proper chewing allows for the physical breakdown of food, increased salivary function, and continues to prime downstream digestive processes, like the production of stomach acid.
- Drink water in-between meals, not during. Drinking large amounts of water with a meal can dilute stomach acid.
- Drink lemon juice or apple cider vinegar 15 minutes before a meal. Try about 1 tablespoon in 1 oz. of water. This should help improve stomach acid production.
- Try digestive bitters. These are herbs that support digestive function by stimulating bitter receptors on the tongue, stomach, gallbladder and pancreas. Their primary effect is to promote digestive juices such as stomach acid, bile and enzymes to breakdown food and assist in the absorption of nutrients. Digestive bitters can be found in tincture form in most health food stores. Dosages vary, so follow instructions on the bottle or talk to your healthcare provider. (This is the same concept as an bitter aperitivo of Campari or Aperol in Italy.)
- Take an HCl supplement under the care of your healthcare provider. These can be found in most health food stores either in the form of betaine HCl or as part of a digestive enzyme supplement. Your healthcare provider should be able to walk you through how to find the appropriate dosage for your needs. Taking an HCl supplement is not recommended if you take any sort of anti-inflammatory medication (aspirin, ibuprofen, corticosteroids, etc.). These medications can cause damage to the lining of the stomach and small intestine–coupling them with HCl can further irritate or damage the GI lining and increase your risk of gastric bleeding or ulcers. Personally, HCl supplements would be a last resort after having tried the other recommendations. Again, please seek guidance from your healthcare provider.
*If you want to experiment with lemon juice, apple cider vinegar, digestive bitters, or HCl, I would recommend doing so only one at a time.
I think it is worth mentioning other tips for supporting your entire digestive system. In this article, we mostly focused on the important role of stomach acid in the digestive process and how to naturally support it, but if you know me at all, you know it’s hard for me not to share more! I am passionate about a healthy digestive system as it is directly linked with overall health and I would feel amiss if I didn’t share these other tips with you.
Tips to support the general digestive process:
- Eat a real, whole foods diet comprised of quality animal protein, vegetables, and healthy fats.
- Avoid foods that are irritating to your digestive system like refined foods, grains, legumes, and highly processed dairy.
- Incorporate probiotic-rich foods like sauerkraut, raw or grass-fed kefir, kombucha, kimchi, and more into your diet to help build a healthy gut flora. These are your “good bugs.”
- Incorporate soluble fiber from squashes, potatoes, and other starchy vegetables into your diet to feed your “good bugs.” These foods are considered “pre-biotics.”
I hope this information was helpful to you and opened your eyes to a surprising, yet seemingly common, cause of acid reflux. This was a topic of conversation in the Balanced Bites Masterclass I recently completed. If this topic interests you, I recommend reading pages 80-81 in Practical Paleo or reviewing online articles by Dr. Axe.
