Understanding Acid Reflux, Heartburn, and GERD
Acid reflux, heartburn, and gastroesophageal reflux disease (GERD) are common conditions affecting many individuals. While often attributed to excess stomach acid, the underlying causes can be more complex and varied than commonly believed.
What most people don't know! The Paradox of Low Stomach Acid:
- Contrary to popular belief, low stomach acid is often the culprit behind acid reflux and heartburn.
- Natural aging process reduces stomach acid production:
* Teenagers have ample stomach acid
* By age 40, stomach acid levels decrease to about half
* By age 70, levels drop to approximately a quarter of teenage levels
Let's review Common Causes of Acid Reflux:
a) Low Stomach Acid:
- Symptoms include:
* Quick satiety when eating
* Excessive belching
* Bad morning breath
* Gas, bloating, or constipation
* Feeling of food being "stuck" in the stomach
- Low acid keeps the lower esophageal sphincter open, allowing reflux
b) H. pylori Infection:
- Can initially increase stomach acid
- Long-term infection typically reduces stomach acid production
c) Food Sensitivities:
- Common culprits include gluten and dairy
- Proper testing is crucial for identification
Symptoms and Manifestations:
- Classic symptoms: Heartburn, acid reflux
- Less obvious symptoms:
* Silent reflux
* Chronic cough
* Hoarse voice
* Feeling of a "frog in the throat"
Symptom Patterns:
- May worsen throughout the day
- Often most severe after dinner or larger meals
- Can be linked to specific food groups
Trigger Foods:
- Common irritants:
* Spicy foods
* Tomato-based products
* Alcohol
* Coffee and caffeine
* Citrus fruits
Clinical Approach:
- No definitive functional medicine testing exists for low stomach acid, therefore...
- Symptom evaluation is key
- In addition, Stool tests can reveal:
* H. pylori infection
* Pancreatic enzyme levels (affected by low stomach acid)
* Microbiome imbalances, all conditions that contribute to Low Stomach Acid.
Dr. Paul's Approach:
- Identify and address root causes
- Potential strategies:
* Addressing H. pylori if present
* Identifying and eliminating food sensitivities
* Stress management
* Addressing nutritional deficiencies
* Using soothing herbs for gastritis
Potential Dangers of Heartburn:
- Long-term risks include Barrett's esophagus
- Changes in esophageal cell structure possible
Conclusion:
Understanding the complex nature of acid reflux, heartburn, and GERD is crucial for an effective approach. While symptoms may be similar, underlying causes can vary. A comprehensive approach involving proper testing, dietary modifications, and addressing root causes is key to managing these conditions effectively.