Ease Heartburn Naturally
By Linda Knittel, Senior Editor
Ask anyone who has felt the searing chest pain of heartburn or the singed throat of acid reflux and they will say stomach acid is the culprit—and they’d be right. But don’t let that burning sensation fool you. It’s not too much acid that causes heartburn and gastroesophageal reflux disease (GERD); it’s too little.
Ignore the antacid commercials, dive into the science, and it all makes sense. Studies show the incidence of heartburn and GERD increases with age, while stomach acid levels generally decline with age. And according to Jonathan Wright, MD, author of Why Stomach Acid Is Good for You, when stomach acid is measured in people with heartburn or GERD, it’s almost always low.
The Bane of Bloat
The real culprit behind heartburn symptoms may be an increase in intra-abdominal pressure (IAP), which pushes the stomach contents through the valve that separates the stomach from the esophagus. Factors such as overeating, obesity and consuming spicy or fatty foods can contribute to stomach pressure; but emerging evidence is suggesting that a primary cause of IAP may be a vicious cycle involving bacterial overgrowth and improper digestion of protein and carbohydrates caused by too little stomach acid.
“The pH of the stomach has to be at a certain level for proteins to be broken down properly,” says Chris Kresser, LAc, a licensed acupuncturist and practitioner of integrative medicine in Berkeley, California. Low stomach acid prevents proper pH, leaving proteins to putrefy and generate gas. It also creates a perfect environment for bacteria to thrive. “Bacteria overgrowth then feeds on carbohydrates, fermenting them and creating more gas and pressure in the gut,” Kresser explains.
To treat his heartburn and GERD patients, Kresser has them decrease carbohydrate intake and increase their stomach acid by taking between 200 and 600 mg of betaine HCl (with pepsin) at each meal to start. They then increase the dose by one pill (up to a max of five) until they notice a bit of burning or GI discomfort. When this happens, they know their ideal betaine HCl dosage is one pill less than the amount they just took. “I have found this method to be safe for everyone except those with ulcers or people who frequently use NSAIDs,” says Kresser.
For those who cannot tolerate betaine, Kresser suggests that bitters or a bit of apple cider vinegar in water before meals can help get the digestive juices flowing. Stress management is an important part of the protocol too. Considering 400 times more serotonin and 500 times more melatonin are made in the gut than the brain, lowering stress is crucial to healthy digestive function. “I recommend a restorative yoga practice, as well as mindfulness-based stress reduction and lots of pranayama,” says Kresser.