Heartburn, Acid Reflux, GERD
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Heartburn and Acid Reflux Disease
What is Heartburn?
"Heartburn" (i.e. acid reflux or GERD) is actually some particles of partially digested food covered in stomach acid being regurgitated from the stomach up into the lower esophagus (throat). The most common of all heartburn symptoms is a burning sensation (called pyrosis) in the esophagus (sometimes spelled as "oesophagus").
Heartburn is commonly called by some other sames such as "sour stomach", "indigestion" or "acid indigestion". The correct term for the action of stomach acid entering the esophagus would be "acid reflux", and the medically correct term for the burning sensation would be "pyrosis". The chronic condition (i.e. acid reflux re-occurring over a long period of time) would be called "acid reflux disease" or "GERD". Most people experience symptoms of heartburn occasionally, but if it continues for two weeks or occurs more than twice per week you should consult your doctor immediately so he can determine if it is caused by GERD or another condition which may require medical treatment.
The regurgitated acid produces the pain commonly called "heartburn" because it feels like the burning sensation is coming from the area of the heart behind the breastbone, in the middle of the chest and above the bottom of the rib cage. It literally is a "burning" pain because the weak 2 percent hydrochloric acid solution which makes up stomach acid can burn the sensitive mucosa which lines the esophagus.
The bottom of the esophagus (throat) is attached to the top right side of the stomach, which is why escaping acid that causes heartburn is more likely to happen when you lie on your right side and let gravity make the acid flow towards that connection to the esophagus.
NOTE: What is called "heartburn" has nothing to do with the heart, but be aware that some types of heart disease may produce a burning pain in the chest similar to heartburn. Severe heartburn pain in the upper chest that can NOT relieved by antacids might be a sign of a heart attack, so seek emergency treatment immediately, especially if you have a history of heart disease or have been diagnosed with high risk factors for heart disease. Suddenly experiencing heartburn pain when the stomach is empty (about 2 to 3 hours or more after the last time food was consumed) may be a sign of a more serious illness (including a heart attack). If your heartburn is accompanied by symptoms like shortness of breath, sudden weakness, problems with vision, or excessive sweating, it is more likely to indicate a heart attack.
What is GERD?
GERD is an abbreviation for the medical term Gastro-Esophageal Reflux Disease. It means the same as Acid Reflux Disease, and is a result of "reflux" - i.e. stomach acid moving back up into the lower esophagus.
Experiencing frequent heartburn or acid indigestion is the most common symptom of GERD in adults, but not the only one. If you have heartburn symptoms twice a week or more it may indicate that you have GERD. If you have used antacids for two weeks in a row, it is time to call your doctor, who may be able to determine if you have GERD and may prescribe a more effective treatment.
About 25 million adult Americans have acid reflux or heartburn symptoms on a daily basis. More than 60 million Americans suffer from heartburn at least once a month. Too many are attempting self-treatment of the heartburn symptoms with antacid tablets and over-the-counter medications in an attempt to stop the heartburn pain, when they should be consulting their doctor to diagnose and cure the underlying cause of the heartburn. Taking antacids for heartburn will not work as a cure for GERD.
However, some persons, especially children, who have GERD may not have the symptom of heartburn. Instead, they may experience other symptoms of GERD, such a dry cough, asthma symptoms, or trouble swallowing. The acid reflux may not be causing a noticeable burning sensation in the throat, but it may be irritating and inflaming the throat enough to produce these other symptoms.
It is still unknown exactly why some people develop GERD and others do not. Several factors may be involved, and current research is exploring the risk factors for developing GERD, as well as the role of GERD in other conditions such as asthma and laryngitis.
When GERD becomes chronic and is left untreated, it can cause serious complications. Constant use of antacids is not a treatment for GERD. You need to consult your doctor before these complications occur:
Untreated GERD may be leading to the most rapidly increasing incidence of any type of cancer in the USA - a type of esophageal disease called adenocarcinoma.
Treatments for Heartburn and GERD
If you have been taking antacids for two weeks or longer to provide heartburn relief, it is time to consult your doctor and get a professional diagnosis and treatment before you make the situation worse.
The first heartburn treatment prescribed may simply be a change in eating habits, such as avoiding the foods which most likely cause or worsen heartburn because they are acidic, increase stomach acid production, or directly irritate the esophagus. Yet the most effective treatment for heartburn may be to AVOID the foods which cause the lower esophageal sphincter (LES) muscle to malfunction and allow acid to escape from the stomach.
If the proper function of the LES can be restored by giving it a break from the things which make it malfunction, there will not be any acid reflux or heartburn symptoms occurring, so acid-reducing or acid-blocking medications may not be needed.
Note that most of the foods which affect the LES muscle are either manufactured or processed foods such as chocolate, coffee, mint oils, and deep-fried foods; or things which contain drugs such as nicotine (cigarettes) and caffeine (caffeinated colas and soft drinks and energy drinks), and alcohol (wine and liquor). None of these are natural whole foods like raw fruits and vegetables.
But some doctors may not be aware of the effect of these foods and drugs which may be at the root of the GERD problem, and may simply prescribe drugs or medications to relieve the symptoms of GERD, such as heartburn.
Unlike naturopathic and homeopathic doctors, the medical doctors (known as allopathic doctors) are not likely to recommend digestive enzyme supplements that contain Betaine, Pepsin, or diluted hydrochloric acid, although it would make more sense because so many people have LOW stomach acid levels and undigested protein leads to acid reflux or heartburn symptoms. Digestive enzymes that contain Papain from the Papaya fruit are also excellent for protein digestion, and you can use 500 mg. of papaya enzymes per meal. Using enzyme supplements is even more important when you eat a lot of processed foods, because the processing destroys the natural digestive enzymes found in raw foods and the processed foods end up being poorly digested.
Prescription Drugs and Over-the-Counter Medications
The following are commonly prescribed drugs and over-the-counter medications used in the treatment of gastro-esophageal acid reflux disease (GERD) or its milder symptoms such as heartburn pain. You should not attempt to self-diagnose and self-treat your heartburn symptoms.
Be sure to take your heartburn medications according to the instructions or your doctor's advice, and not just when you feel the pain of heartburn. More damage to the esophagus will already have been done by the time you feel the burning sensation, and you will not be giving your esophagus a chance to heal.
H2 blockers such as ranitidine (Zantac 75), cimetidine (Tagamet HB), famotidine (Pepcid AC), and nizatidine (Axid AR), are drugs which decrease acid production. They are available in prescription strength and as over-the-counter medications. These drugs only provide short-term relief from heartburn symptoms and are effective only for about half of the individuals who have symptoms of GERD.
Proton pump inhibitors are more effective than H2 blockers and can relieve symptoms and heal the esophageal lining in almost everyone who has GERD. Some common proton pump inhibitor drugs are esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec and Zegerid), pantoprazole (Protonix), rabeprazole (Aciphex), which are available by prescription. Prilosec is also available as an over-the-counter heartburn medication.
Prokinetics help strengthen the lower esophageal sphincter and make the stomach empty faster. One prokinetic drug is bethanechol (Urecholine). Another is metoclopramide (Reglan), which also improves muscle action in the digestive tract. Prokinetics frequently have side effects which limit their usefulness as heartburn medications, such as fatigue, sleepiness, depression, anxiety, and problems with physical movement.
Antacids are usually the first treatment prescribed to provide relief from heartburn and mild symptoms of GERD. These include Alka-Seltzer, Maalox, Mylanta, Rolaids, and Riopan. Many brands of antacids use different combinations of three basic salts (magnesium, calcium, and aluminum) along with hydroxide or bicarbonate ions to neutralize the acid in your stomach. Antacids can have unhealthy side effects. Aluminum is thought to be linked to senility and Alzheimer's Disease. Aluminum salt can cause constipation, and magnesium salt can lead to diarrhea. Aluminum and magnesium salts are often combined in a single product to balance these two side-effects. Calcium carbonate antacids, such as Tums, Titralac, and Alka-2, can cause constipation.
The heartburn and GERD medications mentioned above by name are trademarks of their respective manufacturers. Note that inclusion in the above list of medications is not to be considered an endorsement of its effectiveness, and the ommission of any medication is not meant to imply a lack of ineffectiveness.
While millions of people are spending over a billion dollars per year in the USA alone to buy antacids and acid blockers for heartburn relief, the real cause of their burning pain is not the stomach ACID itself.
The REAL problem is what is ALLOWING the acid-covered food particles to move back up into the esophagus.
Taking antacids may provide temporary relief from heartburn pain, but antacids will never "cure" gastro-esophageal acid reflux disease.
Continually taking antacids for heartburn relief may actually create more serious health problems in the digestive tract, as well as the complications listed above. (Learn more about "What's Wrong With Antacids" below, and learn about some alternative and cheap natural heartburn remedies.)
The information provided in this article about heartburn and acid reflux is "for educational purposes only" and should not be construed as medical advice pertaining to the diagnosis, treatment, or cure of any disease. Consult your medical doctor if you have a medical condition.
The Real Cause of Acid Reflux and Heartburn
While stomach acid keeps getting blamed for the pain and suffering caused by heartburn, the blame really belongs to the real culprit who goes by the name of LES. This LES isn't doing a proper job of keeping the stomach acid from escaping into the esophagus.
Neutralizing all the stomach acid with antacids can stop the burning temporarily, but we really need to stop the acid from getting into the esophagus in the first place!
It's like buying salve for a sunburn, when it would make more sense to protect the skin from getting burned by the sun.
The root of the acid reflux or "heartburn" problem lies in a malfunctioning lower esophageal sphincter at the base of the esophagus - usually referred to by the abbreviation "LES".
This esophageal sphincter is a muscle which acts like a valve, somewhat similar to the anal sphincter at the other end of your digestive tract. This sphincter is designed to keep stomach acid and food from escaping and entering the esophagus.
The LES is a two-way valve which opens to allow food to be swallowed and enter into the stomach, and which also opens to allow the stomach contents to be expelled by vomiting, or to allow excess gas to be released by belching. Under normal conditions the LES should remain tightly closed.
But certain drugs and foods will relax the lower esophageal sphincter muscle, which creates an opening and allows particles of food covered in stomach acid to enter the esophagus and irritate or burn the delicate mucosal lining.
The usual sphincter-relaxing suspects are...
Foods Which Cause Heartburn and Acid Reflux
How many of those foods are you putting into your body? Any one of them could be the cause of your heartburn symptoms and the suffering you endure.
Drinking coffee or colas and smoking or chewing tobacco are the most common causes of a LES malfunction and heartburn for the most people. Coffee is the second most consumed beverage in the world. In the USA, consumption of soft drinks and colas now exceeds the consumption of pure water.
Cola drinks with even greater amounts of added caffeine have become popular in recent years. Combine cola with caffeine and you have a drink with two of the most common causes of LES malfunction and acid reflux. Since caffeine is a highly addictive narcotic drug which in sufficient quantities can stop the heart from beating, we wonder why it is allowed to be added to beverages that are consumed by children. It has no color, odor, or taste, so it appears that it is added only to provide the narcotic effect and perhaps to get the customers addicted to the product.
Eating too many fatty foods and foods fried in fatty oils is another common cause of heartburn for those who don't drink coffee or use tobacco.
Living on fast foods, fatty snack foods, and cola drinks is the slippery slope that leads to heartburn hell for millions of people.
And for those who already have an esophagus irritated or inflamed by acid reflux, eating a pizza made with highly acidic tomato sauce and downing it with a highly acidic cola drink just aggravates the heartburn problem.
Tomato paste is one of the most highly acidic foods, and it's used in most pizza sauces and tomato sauces - not to mention all kinds of processed foods that you would never think contained tomato paste.
Cola drinks have been measured at a very acidic pH 2.5 - on a scale where 7.0 means "neutral" and 0.0 means "strongest acid". A common ingredient in cola drinks is "phosphoric acid". Did you ever try leaving a metal spoon or large nail in a glass of cola for a day to see how the acid eats away the metal?
Foods that will irritate an already irritated esophagus:
To avoid acid reflux and the resulting heartburn pain, it would make sense to avoid the above foods and drinks as much as possible until your GERD has been treated and cured.
Drugs Which Cause Heartburn and Acid Reflux
Certain pharmaceutical drugs can interfere with the normal function of the LES and result in acid reflux and heartburn, such as the following five types...
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly associated with causing peptic ulcers, and may also cause GERD or increase the severity of GERD symptoms in those who already have GERD. In a 3-year study of 25,000 people, NSAID users were twice as likely to have GERD symptoms as nonusers of NSAIDs, but the GERD symptoms did not appear until after about six months of regular use. There are other options for pain relief which do not increase the risk of GERD and heartburn symptoms.
Other Causes of Heartburn and Acid Reflux
Other actions, medical conditions, and drugs that lead to LES malfunction are:
Other Immediate Causes of Heartburn and Acid Reflux
Things that increase the risk of "heartburn" or acid reflux occurring soon afterwards are...
What's Wrong With Antacids?
We know, you just love your favorite foods and don't want to give them up. So you may be willing to suffer a little heartburn before you chew on an antacid tablet to put out the fire.
But have you considered the COST of continually doing this? You are paying a high price in terms of both personal wealth AND personal health.
The sale of antacid products for heartburn relief by the "illness industry" exceeds ONE BILLION DOLLARS annually in the USA alone.
While there may be valid medical reasons to prescribe certain acid-blocking drugs, many millions of dollars are being wasted on over-the-counter antacid tablets and potions that could easily be replaced by this cheap home remedy for heartburn:
Two Cheap Home Remedies for Heartburn
There are two things often found in the home which can bring instant relief from heartburn pain by neutralizing the acid in the esophagus:
Either of these can be taken when immediate relief from the burning pain of acid reflux is needed. You will feel the burning being extinguished as they travel down your throat. You might want to tell your doctor about these heartburn home remedies - or might want to ask why he didn't tell YOU that there was a cheap alternative to antacids.
Celery works as a natural antacid because it is the most alkaline of all the vegetables, and things that are alkaline neutralize things that are acidic. This home remedy for heartburn doesn't put unnatural chemical compounds into your body, such as the aluminum found in many antacid tablets. And celery won't make you fatter, as might the sugars added to antacid products to make them taste sweet.
If you wash and cut a bunch of celery into pieces of the stalk about six to eight inches in length, you can keep them in a glass of water in the refrigerator for up to a week before they lose their freshness. Many restaurants serve a plate of celery and carrots along with chicken wings, or could bring you a piece of celery if you ask for it.
Baking soda is made from sodium carbonate, which is an alkaline compound capable of neutralizing an acid like stomach acid. Stir about a teaspoon into a glass of water and drink enough to stop the heartburn pain. Baking soda can produce some gas in the stomach, which may result in some gas in the intestines and some excess flatulence, so celery is a better choice if you have it available.
Also, be aware that baking soda contains sodium - which may be of concern to persons with heart disease who are on a low sodium diet.
Antacids Are A Symptom Reliever, Not a Solution
But whether you use a cheap home remedy for heartburn such as celery or baking soda, or use expensive antacid pills and potions, all antacids provide only temporary relief from the burning sensation in the esophagus. They help with heartburn pain, but they do not stop heartburn from happening again.
What's worse, antacids also interfere with normal digestion when they neutralize and weaken the hydrochloric acid in the stomach needed to break down the ingested foods.
How will you digest your food?
Antacids Can Create More Problems Than They Solve
What will happen when you keep inhibiting the production of the hydrochloric acid your stomach secretes to break down foods into nutrients you can actually absorb and use for energy and other essential body functions?
The answer is... you won't be getting all the nutrition you should from the food you eat. You will have some deficiencies, and those deficiencies can lead to other troubles.
Have you heard stories about women getting cravings for strange foods while they are pregnant? When their bodies need certain nutrients for the baby inside, they are driven to eat the foods that will provide those nutrients. The same thing happens when your body is deficient in some essential nutrients, such as a certain mineral or vitamin. You will be driven to eat more of the foods that can supply the nutrients - but you will also end up eating more food than you need and may gain weight as a result.
Constant use of antacids won't eliminate the cause of acid reflex disease, and by neutralizing or blocking stomach acid they can do more harm than helping.
LOW levels of stomach acid can be a problem, and reducing stomach acid with antacids and acid blockers may add to the problem.
Recent research indicates that, over a period of time, low stomach acid can lead to a wide range of serious diseases, such as:
Most people already have TOO LITTLE stomach acid to properly digest their food! And this is causing all kinds of problems in the digestive tract, as well as the problems mentioned above.
Do you remember sufferring from heartburn when you were a child or a teenager? Probably not.
Young people produce the MOST stomach acid, and yet rarely suffer from acid reflux. If acid were the problem, why don't those high-acid teenagers have more acid reflux problems and heartburn than anyone else?
Having too little acid in the stomach is a condition known as hypochlorhydria, which refers to low (hypo) levels of hydrochloric acid. It's much more common than most people realize.
Some doctors say that by age 50, fifty percent of people will have this condition of low stomach acid.
Most people with heartburn don't have ENOUGH acid in their stomach.
As we get older we produce less and less stomach acid, and by the time we are in our sixties we may be producing only a third as much as we did as a teenager. And yet we often suffer from more acid reflux problems and other digestive problems as we get older. Does it make sense to take antacids to further reduce what little stomach acid we make?
Some signs of hypochlorhydria (low stomach acid) are:
Are you taking antacids, and also experience those signs of low stomach acid?
Many doctors don't test for hypochlorhydria or know how to treat it, so acid blocking medications are being over-prescribed in the same way antibiotics have been over-used.
Do you really think that taking drugs to REDUCE the amount of stomach acid we secrete is going to make things better?
And do you think it makes any sense to take an antacid to neutralize your stomach acid when it is supposed to be digesting the food you just ate? How will your food get digested?
The stomach will either secrete even MORE acid to finish digesting the food, or some of the food will pass into the small intestine in a partially-digested state.
But it is the stomach acid that gets passed into the small intestine that actually triggers the release of digestive enzymes to aid in the assimilation of the nutrients through the small intestine's epithelial cells and into the bloodstream.
Without enough stomach acid, you won't be assimilating all the nutrients from the foods you eat, and you could suffer from some level of malabsorption and malnutrition.
Even worse, when undigested food travels down to your large intestine (the colon), billions of putrefactive bacteria begin to feed on the undigested meats and fats. About 27 species of bacteria in the gut of meat-eaters produce poisonous toxins. The putrefying meat and decomposing fat produce foul odors which result in very foul-smelling flatus (farts).
Meanwhile, billions of yeast organisms feed on the undigested carbohydrates and sugars and produce lots of gas which can cause bloating and cramps. Poorly digested carbs and sugars become food for yeast like Candida albicans in the small intestine and colon, and these yeast produce carbon dioxide gas and alcohol (which is how beer and wine is made is made by other kinds of beneficial yeast).
An overgrowth of yeast in the gut can produce enough gas to cause bloating and cramps within an hour to two after consuming certain foods like grains, breads, pizza crust, and foods with a high sugar content.
Try leaving a piece of raw animal meat with fat out on your kitchen counter for a week, and see what happens to it! That's pretty much what happens inside your colon when you send undigested meat and fat down there - except there are many more bacteria in your colon than there are floating in the air of your kitchen, so the putrefaction happens much faster. That very bad odor comes from decomposing fat (which is why the revolting smell of a decomposing dead body is so bad it can cause nausea and vomiting in some people).
An intestinal yeast like Candida albicans can also produce allergens, hormones, and toxins which can cause all kinds of health problems - and the more undigested carbohydrates you send down there, the more yeast will be fed, and the more the yeast will multiply until you have a troublesome yeast overgrowth called Candidiasis.
Some of the symptoms of Candidiasis are food allergies, food cravings, other allergies, excess flatulence (farting), abdominal gas and cramps, lower back ache, joint pain, migraines, menstrual problems, infertility, loss of libido, chronic fatigue, insomnia, mood swings, and even depression. Read this page about Yeast Infections to see many more symptoms caused by Candida.
It gets worse. Using antacids to reduce stomach acid and constantly sending undigested food through the colon only encourages the growth of the bad bacteria - so you end up with a bacterial overgrowth that can lead to all kinds of very painful intestinal problems such as Diverticulitis, Colitis and Irritable Bowel Syndrome. If you thought heartburn was bad, talk to someone who has one of these gastrointestinal diseases. Taking antacids won't stop the stabbing pain they feel.
So do you see why constantly popping antacid pills is not ever going to solve the acid reflux problem, and will only create more serious problems later on?
Here's another thing to consider...
Many reports indicate that the highly toxic bacteria Escherichia coli 0157:H7 are acid tolerant. Enough E. Coli bacteria cells are able to survive the low pH of our stomachs to cause an infection.
If we further reduce the strength of our stomach acid with antacids, more E. Coli and other disease-causing bacteria in the foods we eat can survive to make us sick. Some of these pathogenic bacteria can cause serious diseases or even death.
In the space of a pinhead there can be millions of bacterial cells, and it may take only 2 to 2000 surviving E. Coli 0157:H7 cells to cause an infection.
Animals like cats and dogs secrete a much more concentrated and stronger hydrochloric acid into their stomachs (a 5% HCl solution versus only 2% for humans), so they can usually eat raw meat and dirty decaying flesh without harm because their strong stomach acid kills most of the pathogens.
We humans should not be diluting or neutralizing what little stomach acid we normally produce, or we'll increase our risk of food poisoning from bacteria and other pathogens.
Preventing Acid Reflux
It makes much more sense to work on PREVENTING acid reflux than taking antacids to relieve heartburn pain.
Be smart like the forest fire fighters in California. They are pro-active in trying to REMOVE the things that can FEED the fire and help it spread, rather than just spraying water onto brush fires and burning trees before the fire burns down a whole house. They know that preventing fires is easier and more effective than fighting the fires that have already spread.
If you REMOVE the things in your diet that inhibit the normal function of your lower esophageal valve (LES) you can PREVENT the spread of burning stomach acid into your esophagus - rather than just pouring antacids down a burning throat.
Stop trying to put out the fire, and start preventing the fire from happening!
When you do experience the burning sensation of acid reflux, drink a glass of water as your first defense.
Some health practitioners believe that acid reflux is a strong signal that we have become dehydrated - though most people think it's about being hungry for food. Many people are dehydrated at a cellular level even when drinking a lot of water. Most are not even drinking enough water, but are consuming way too much coffee and cola drinks with caffeine, which causes the body to LOSE water!
If the pain persists after drinking pure water (not juice or a cola drink), eat half a stalk of celery to neutralize the acid. It will work as well or better than most antacid tablets, and without the side-effects. If you don't have celery handy, use a little baking soda mixed with water (but note that baking soda contains sodium, which may be of concern to persons with heart problems or hypertension who are restricting their sodium intake).
Dr. Miller's Holy Tea contains two herbs called Malva leaf (Malva verticillata) and Marsh Mallow leaf (Althaea officinalis) which create a slippery substance called mucilage that soothes irritated membranes in the esophagus, stomach, and intestines, and helps protect them from irritants like hot peppers and acidic foods. Try drinking Holy Tea before each meal.
Another ingredient of Holy Tea called Blessed Thistle (Cnicus benedictus) has been shown in recent studies to be useful for indigestion and heartburn.
Many users of Holy Tea have reported that their heartburn diminished or just went away for good after a few weeks of drinking Holy Tea. See some testimonials below.
What Is Heartburn? |
What Is GERD? |
What Causes Heartburn?
What's Wrong With Antacids? | A Cheap Home Remedy for Heartburn
About Holy Tea | Testimonials | Ingredients | Directions | FAQ
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Pain Caused by Irritable Bowel Syndrome May Be Mistaken For Gastro-Esophageal Reflux Disease
Sufferers of irritable bowel syndrome or IBS may report experiencing what they think is "heartburn" or acid reflux when it may actually be pain from irritation or inflammation in the transverse colon below the stomach - unless the pain is definitely in the esophagus above the stomach, higher up near the heart.
The colon (i.e. the large intestine or large bowel) runs up one side of the abdomen, across the top (which is the part called the transverse colon), and down the other side of the abdomen. The stomach is actually located just above the transverse colon, next to the liver and just below the lungs and rib cage.
Taking antacids will NOT help relieve pain caused by Irritable Bowel Syndrome, and neutralizing the natural stomach acid will actually interfere with the proper digestion of food, which could make the IBS even worse.
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