Have you ever noticed that after eating certain foods, or after eating too much, you don’t feel quite right? This happens especially on those occasions when we have a large meal before going to bed)? We’re sure you’re familiar with the feeling. After all, the holiday season was just a few weeks ago. That is why it’s time to talk about heartburn.Heartburn is described as the feeling of burning pain in the chest that is felt in the breastbone (aka: sternum) and seems to move up towards your throat. Now you are probably asking, “What causes this burning sensation?” We have the answer. But before we go there, it is important that we recollect what happens when we eat.
After we swallow our food, it travels from our mouth to the stomach. This happens through a specialized tube called the esophagus. At the entrance of the stomach, there is a region called the lower esophageal sphincter (aka: LES) that is closed and only opens to allow the food to enter the stomach. acts as a gate to the stomach. This gate (which is basically made up of muscle) also prevents what is inside the stomach from returning to the esophagus. Though, sometimes this gate loses its strength, and the stomach acid travels upwards reaching the esophagus. his is called acid reflux. And is what causes heartburn.
But why does it feel like burning?
The common belief is that this acid reflux causes a lesion in the esophagus. This occurs because the regular pH range in the stomach is between 1-3 (aka: acidic); while in the esophagus it is around 7 (aka: neutral). Now you can see: the acid is what is causing the burning. In medical terms, this condition is called gastroesophageal reflux disease (aka: GERD). And it is characterized by pH values less than 4 in the esophagus, two or more times a week; instead of a normal pH of 7.,
Knowing this, you might assume that having too much acid in the stomach is a bad thing. Logically it makes sense, right? You are not alone. This is the common belief shared by many health professionals. Yet, this idea could not be further from the truth. We need plenty of acid in our stomachs for two main reasons. The first reason is that this acidic pH helps our stomach perform its function; which is to digest food so we can absorb its nutrients. The second reason is that the acidic environment of the stomach helps with the elimination of parasites and harmful bacteria.
Not to mention that the stomach was designed to support this highly acidic environment.4
Do you remember about the gate of the stomach? There is another one called the pyloric sphincter, which separates the stomach from the small intestine. And its ability to work depends on the acidity of the stomach. Therefore, what we eat has an impact on the ability for these gates to keep the acid where it belongs—in the stomach.
For example, eating fatty foods can lead to an increased time of digestion. This happens because the second gate will be delayed in its opening; and thus force the food to sit in the stomach for much longer. This can also lead to the first gate (LES) opening while all the food and acid are still in the stomach; which in turn can trigger acid reflux.
In the same way we are talking about fatty foods, we can mention foods you are sensitive to. Food sensitivity can cause a compromise on the gates’ (sphincters’) mechanics and trigger the same acid reflux response.
In other words, it’s not about too much acid. It’s about the foods we eat that may be compromising the proper function of our sphincters.
What Can We Do About This?
Sadly, the traditional approach to acid reflux or GERD is to take acid blockers. These are molecules that neutralize the acid. They counterbalance the acid in the stomach. So it becomes closer to neutral (which minimizes the burning sensation) when acid reflux occurs. You can find them in many forms. Some you can even buy in grocery stores. The two main categories of acid blockers are PPIs (aka: proton pump inhibitors)  and H2 blockers (aka: histamine Type 2 receptor antagonists).
However, by taking these pills, you are only masking the heartburn symptoms and allowing the issue to get worse. Additionally, you are creating more severe health issues beyond just acid reflux and GERD. Remember, ideally, the pH of the stomach should not be above 3; so it can properly digest your food. Although when we take acid blockers, we raise the pH of the stomach and severely compromise our digestive ability.
Now, imagine what can happen if you are not digesting your food properly. For starters, the food will sit in the stomach for longer periods of time; which will cause the LES to open prematurely. This then leads to an exacerbation of acid reflux. We might not feel the burn because of the blockers. But the stomach content is traveling upward and making this issue worse each time.
As a consequence, we will simply not be able to break down complex proteins. At least, not as efficiently as before. This then causes big proteins to start circulating in the intestines and potentially translocate through the walls of the gut. As you already know from our previous articles, this can lead to Leaky Gut and Autoimmunity.
We also have to consider our gut flora. All of our beneficial “bugs” should live in our large intestines. And they are usually kept there because the small intestine is still too acidic (due to the “leftovers” of the stomach acid). Nonetheless, if this acid is not neutralized by the blockers, you will not create this natural bug deterrent. This can then lead to small intestinal bacterial overgrowth (aka: SIBO). Beyond SIBO, acid blockers can also have a deleterious effect on your entire microbiome. And as we already discussed in previous lectures, a disrupted microbiome can lead to many problems, such as inflammation, autoimmunity, anxiety, and even depression.
Finally, we should not forget that acid in the stomach is also crucial to keep parasites and harmful bacteria deterred. We definitely do not want harmful bacteria and parasites wreaking havoc inside us.
Let’s make one thing clear. There are medical conditions where using acid blockers is not only beneficial but necessary. For example, if you have an ulcer (which is a lesion in the stomach), you will need to take this medication to protect it from acidic aggression, so that the lesion can heal. (not a good idea to give detailed medical advice like this). There are also people who have a condition called Zollinger-Ellison syndrome, who may need to take acid blockers for a longer duration of time (since their stomach produces too much acid).
A Wiser Approach
Mostpeople do not need acid blockers. As a matter of fact, they should stay away from them so they don’t exacerbate these issues. Instead, what we all should do is look at our diets and assess which foods are triggering our GERD. Many of these foods will be those you are currently sensitive to. These are foods that can trigger inflammation. For example, in a study with patients who have inflammatory bowel disease, the pH of their stomach was higher—meaning less acidic (ranging from 1.55-4.40) than in healthy individuals (ranging from 0.95-2.60).
Some easy short-term heartburn hacks you can use is to eat acidic foods, such as lemons or apple cider vinegar before your meals to promote the right acidic environment in your stomach. Or, you can also take a betaine HCL supplement. Then again, these should be used short term. The focus should always be to address the cause, not the symptoms.
If you are experiencing heartburn, it’s time to take action; assess your food sensitivities; and get a complete diet revision. Begin a new plan to help you deal with heartburn, and live a better life.
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Marcos de Andrade MD, MBA
Chief Executive Officer