In a world where acid reflux affects 20% of the population, it’s more than just a statistic – it’s a shared experience that many navigate silently, relying on over-the-counter medications to ease their discomfort. Yet those very medications often lead to nutrient deficiencies, poor bone health, impaired kidney function and opportunistic infections. These medications are band-aid solutions that don’t address the root cause of the acid reflux – and when the root cause isn’t addressed, the underlying issue will continue to negatively effect your body.
Amidst the prevalence of quick fixes, this article offers an alternative solution – a functional nutrition approach that not only addresses the symptoms but provides a roadmap to lasting relief, transforming your digestive health and improving your quality of life.
What is acid reflux?
Acid reflux is a digestive disorder that affects the muscle between your esophagus and your stomach, called the lower esophageal sphincter. Acid reflux is often described as heartburn, or an unwelcome fiery sensation in the chest, typically caused by the lower esophageal sphincter (LES) relaxing improperly. The LES is the gateway between your stomach and esophagus so if it doesn’t close tightly, stomach contents can splash back into the esophagus, causing uncomfortable upper digestive symptoms. Over time, it can result in esophageal inflammation and lead to complications like a narrowing of the esophagus or the development of precancerous cells.
What’s the difference between GERD, acid reflux, and heartburn?
These terms are often used interchangeably but there are important distinctions.
- GERD – the disease of having reflux symptoms two or more times a week.
- Heartburn – a burning sensation in the chest that is a symptom of GERD.
- Acid reflux – the backward flow of stomach contents into the esophagus that is the reason you have GERD.
Since acid reflux is the root cause of GERD, we’ll spend the rest of this article discussing the functional approach to addressing reflux or GERD.
What causes acid reflux?
The cause of acid reflux can vary from person to person but usually involves inappropriate LES relaxation, allowing the stomach contents to flow back into the esophagus.
Underlying contributors of acid reflux include:
- Dietary triggers are a common culprit since certain foods relax the lower esophageal sphincter. It’s important to know that a well-functioning digestive system should be able to tolerate these dietary triggers, at least in small amounts, but most people are not able to tolerate large amounts without triggering their symptoms. Finding your threshold amount with trigger foods is key. The following foods are common contributors to reflux:
- Spicy foods
- Caffeine – coffee, soda, energy drinks, dark chocolate
- Fatty foods – deep-fried food, marbled meats, sausage, hot dogs
- Highly acidic foods – tomatoes and tomato-based products, citrus
- Onion and garlic
- Meal time habits – Although what we eat can impact reflux, how we eat is equally important. Rushing through meals, eating large portions in a stressed out state, and not chewing enough are common contributors to reflux. Eating late at night or right before bed can also be a trigger.
- Gut microbiome imbalances – An imbalance to the gut microbiome can impact overall digestion and contribute to reflux symptoms. Comprehensive stool testing and/or breath testing can help rule out intestinal bacterial overgrowth, SIBO and/or H. pylori as the underlying cause of reflux.
- Impaired motility – Slowed or disrupted motility in the esophagus or digestive tract is a common root cause of reflux.
- Hypochlorhydria – Low stomach acid (hypochlorhydria) is an often overlooked cause of reflux. We need adequate stomach acid to break food down efficiently and when stomach acid is low, it can leave undigested food particles in the GI tract and lead to gas, indigestion, burping, bloating, and abdominal pain that mimic the signs of reflux. Unfortunately, many Americans are prescribed acid blockers or proton pump inhibitors (PPIs) when they experience these symptoms. Ultimately, these medications further reduce acid production, exacerbating the root cause of their reflux.
- Hormonal imbalance – Dysregulated progesterone and estrogen can lead to or exacerbate acid reflux.
- Chronic stress – High stress levels can trigger or worsen the symptoms of reflux.
- Poor sleep – Not only does poor sleep contribute to reflux, but reflux can disrupt the quality and quantity of your sleep.
- Smoking – Smoking is a well-known factor in acid reflux due to its ability to relax the lower esophageal sphincter.
- Obesity – Being at a healthy weight for your body can reduce the risk of reflux. Excess weight around the abdomen can put upward pressure on the lower esophageal sphincter and push acid up into the esophagus.
- Hiatal hernia – A hiatal hernia occurs when the upper part of the stomach protrudes through the diaphragm into the chest cavity. This can lead to reflux by weakening the lower esophageal sphincter and allowing stomach acid to flow back into the esophagus, contributing to reflux symptoms.
Why treat reflux with functional nutrition vs. pharmaceuticals?
Treating reflux holistically offers a compelling alternative to pharmaceuticals for several reasons. While medications may provide temporary relief, they often address symptoms rather than the root cause. A functional approach focuses on rebalancing the body, considering lifestyle, dietary, and stress factors that contribute to reflux. Natural remedies, such as dietary modifications, supplements, and lifestyle changes, aim to promote long-term healing and prevent recurrence.
What’s more, PPIs or H2 blockers don’t stop the reflux, they just mask the symptoms. But that doesn’t mean the reflux has gone away. PPIs may be necessary (temporarily) if you have a peptic ulcer or Barett’s esophagus, but otherwise, prioritize getting to the root cause of the reflux. Additionally, these medications are often used far longer than intended. Instead of two to three weeks, people stay on these medications for years to avoid the uncomfortable symptoms of reflux. Weaning off these medications can be difficult, but it is possible with a functional approach that works on gradually restoring your digestive function.
Holistic approaches typically have fewer side effects compared to pharmaceuticals, which can sometimes lead to dependency, long term complications and adverse reactions. By addressing the underlying imbalances in the body, we not only alleviate your symptoms but also address the root cause, providing a more sustainable and comprehensive solution to managing your acid reflux. Plus, a functional approach will invariably improve other aspects of your health, too!
A Holistic Approach to Acid Reflux
Leveraging the power of functional nutrition is the best and most effective natural remedy for acid reflux. Small lifestyle adjustments can make significant improvements to your symptoms, while mindful food and movement choices, plus targeted supplements can amplify your progress.
Testing for Acid Reflux
We like to utilize a “test don’t guess” approach at Birchwell to make sure we’re really getting to the root cause of your acid reflux. Then we combine the test results with our comprehensive client assessment to create your individualized and optimized intervention.
Tests we may consider include:
- Stool tests (e.g. GI Map by Genova Diagnostics or GI Effects by Geneva) – to assess digestive enzymes, microbial diversity or overgrowth, pathogens (parasites, candida), H. pylori, or other imbalances rooted in the GI tract.
- Motility test – to assess for slow gastric emptying that can contribute to reflux.
- SIBO breath test – to identify the presence of small intestinal bacterial overgrowth that can be the cause of reflux.
Addressing acid reflux often involves making mindful lifestyle adjustments. Consider adopting the following behaviors.
- Opt for smaller, more frequent meals to ease the digestive burden. Pause halfway through your meals to assess if you’re still hungry and aim to fill your stomach to 80% fullness, rather than 100%. When you leave some room in your stomach, you allow space for the digestive processes to occur without splashing stomach contents back into the esophagus.
- Adopt healthy mealtime practices. Instead of eating in a hurry, while rushing from one thing to the next, sit down, slow down and chew your food. Chewing is a majorly overlooked step in the digestive process and does wonders for your gut health. Chew until the food is an applesauce consistency before you swallow.
- Pace your meals and aim for them to take approximately 15-20 minutes. Try putting your utensils down between bites to help you slow down. Make sure that you are swallowing the food that’s in your mouth before you put the next bite in.
- Take small sips of water during meals, but avoid drinking more than eight ounces of water during meals. Drink most of your water between meals.
- Practice good posture while you’re eating. Sit up straight and avoid hunching over your plate to allow gravity to support your digestion.
- Take three deep belly breaths before meals and try to calm your body and mind. This helps transition your nervous system to the rest and digest state to optimize digestion and improve your eating experience.
- On that note, support your nervous system outside of mealtimes, too. Chronic stress is a big contributor to reflux (among other conditions) and should be taken seriously. Consider what activities help you destress and be intentional about scheduling them into your days. Journaling, gentle movement, taking a warm bath, meditating or connecting with a loved one are some great practices to try.
- Avoid overindulging in spicy or fatty foods and choose water or herbal teas instead of acidic beverages like citrus juices and coffee.
- Eat your last meal at least two to three hours before bedtime to prevent stomach acid from creeping up while you sleep.
- Avoid laying down immediately after meals to allow time for your food to digest. Stay upright for 2-3 hours after eating before lying down (we really can’t emphasize this enough!). Consider propping your head up on extra pillows if you are experiencing reflux. If symptoms are extreme, you can even elevate the head of your bed a few inches.
The right types and amount of exercise can play a crucial role in managing acid reflux. Opt for activities that promote gentle movement and avoid high-impact exercises that may jostle the stomach. Walking, cycling, and swimming are generally well-tolerated and can aid digestion without exacerbating reflux symptoms.
Timing is key – engage in exercise at least a couple of hours after meals to allow for proper digestion. If you’re prone to acid reflux, consider activities that encourage an upright posture, to prevent stomach acid from flowing back into the esophagus. Yoga, specifically poses that promote digestion and avoid putting excess pressure on the abdomen, can be beneficial.
As with any lifestyle change, it’s essential to listen to your body and choose activities that enhance overall well-being while minimizing the risk of triggering acid reflux.
Making strategic dietary adjustments can significantly alleviate acid reflux symptoms. The goal is to remove trigger foods to allow your body time to heal and give us space to correct the root cause. Once you’re symptom-free, we’ll slowly and systematically reintroduce these foods to your body’s tolerance.
Avoid the following foods/beverages until symptoms resolve…
- Lower esophageal sphincter weakeners:
- Fats, fried and greasy foods
- Added sugar
- Esophageal irritants:
- Citrus fruits & juices
- Cooked tomatoes
- Spicy foods
- Carbonated drinks
Prioritize a well-balanced diet that includes an appropriate amount of fiber for your body. Incorporate a variety of vegetables, berries, kiwis, nuts, seeds and whole grains to increase soluble and insoluble fiber to regulate digestion. Add anti-inflammatory foods like olive oil, rosemary, cooked cruciferous vegetables, and salmon to support digestion and overall health. Include high quality proteins like grass fed and finished beef, organic pasture raised chicken and eggs and wild caught fish at every meal to stabilize blood sugar and support gut healing.
Limit alcohol and carbonated beverages since they’re known to contribute to reflux and choose water or herbal teas instead. Drink at least half your body weight in ounces of water a day to remain adequately hydrated.
Other bonus point functional foods to consider are:
- Aloe vera juice (whole leaf, unsweetened) – drink up to 8 ounces a day, divided throughout the day.
- Manuka honey (at least MGO 450) – have 1 tsp, three times a day between meals. It’s best to avoid exposing the honey to heat, so simply enjoy a teaspoon plain.
- Throat Coat Tea (by Traditional Medicinals) contains mucilages that help coat and soothe the GI tract. Aim to drink at least a cup a day.
- Chamomile tea is anti-inflammatory and supports stress relief, both of which can ease symptoms of reflux. Sip a warm cup while you wind down for bed.
There are several supplements that can complement lifestyle and dietary changes in addressing acid reflux.
- Deglycyrrhizinated licorice (DGL) supplements may provide relief by soothing the esophagus and stomach lining. DGL helps create a thicker barrier to protect the throat and esophagus from acid and has anti-inflammatory properties.
- Digestive enzymes containing amylase and lipase can support proper digestion and reduce the likelihood of undigested food causing reflux.
- Probiotics help maintain a healthy balance of gut bacteria, promoting optimal digestion and minimizing the risk of acid reflux.
- Melatonin, a hormone that regulates sleep-wake cycles, has shown promise in reducing acid production and improving symptoms. It helps prevent acid reflux at night by helping the LES maintain pressure.
- Alginate-based supplements can act as natural antacids, providing short-term relief if you’re experiencing a symptom flare.
- If H. pylori is the root cause of your reflux, mastic gum supplements are a good choice.
- Zinc carnosine helps restore the lining of the GI tract and prevent further damage.
- Slippery Elm is a mucilaginous herb meaning it helps soothe and protect irritated tissues in the upper GI tract.
- We like GastroCare chewables and Thorne’s GI Repair because they combine several of these nutrients to ease symptoms associated with reflux.
Supplements can be an important part of a functional protocol for managing reflux, but remember, you can’t supplement your way out of poor dietary and lifestyle choices. Always work with a qualified provider before beginning a new supplement and choose reputable sources to ensure quality and safety. At Birchwell, we only use third party tested supplements so you get the highest quality and safest supplements on the market.
Can I get rid of reflux entirely or just manage it?
Most clients who come to us with acid reflux are able to become 100% symptom free and maintain their progress. That’s because we use a root cause, whole body approach.
Our goal is to identify and address the root cause(s) of your acid reflux to give you long term relief, rather than merely managing your symptoms. We’ll investigate your health from every angle and address the underlying issues with targeted interventions and in doing so, we’ll manage your current symptoms, heal the underlying cause, and prevent future recurrence.
Potential long-term impacts of acid reflux?
Persistent acid reflux, if left untreated can lead to more serious health issues like esophagitis, ulcers, chronic dental cavities, and scarring. Over time, this can contribute to a condition known as Barrett’s esophagus, where the normal esophageal lining is replaced by tissue similar to the lining of the intestine. Barrett’s esophagus increases the risk of developing esophageal adenocarcinoma, a type of cancer. Additionally, ongoing reflux can impact respiratory health, leading to conditions such as asthma or chronic cough. Therefore, it’s crucial to address acid reflux promptly to prevent potential long-term complications and improve your current sense of wellbeing.
Acid reflux is a common digestive disorder that affects a large portion of the population and has lasting effects if left unaddressed. The conventional approach to treating acid reflux is limited to symptom management and comes with long term consequences of its own.
Fortunately, an alternative exists. Proper lab testing, alongside dietary, lifestyle, and supplemental interventions can address the root cause of reflux. Unlike pharmaceuticals that only temporarily alleviate symptoms, a functional approach helps you find lasting relief and promotes long-term healing so you can calm your acid reflux for good.