What to do About Heartburn (Reflux)

You relax on your sofa after dinner and watch a movie.  Then you start tasting acid in your throat and you feel like your food is coming back up on you.  This is often referred to as Heartburn and it is often diagnosed as Gastroesophageal Reflux Disease (GERD).  More than 50 million Americans experience  this condition frequently.  But why does it happen?Conventional medicine thinks that the problem is caused by too much hydrochloric acid secretion and it is typically treated with drugs that block stomach acid.  Is this correct and what are the effects of these drugs?

The fact is that esophageal reflux is likely caused by too little rather than too much stomach acid, which then results in insufficiently digested food being pushed back up through the esophageal sphinctor towards the throat.  This bolus of undigested food carries the limited amount of acid from the stomach back up into the esophagus, thus irritating the lining of the throat.  We know that it takes a tremendous amount of the body’s energy to produce hydrochloric acid and that is why many of us are producing too little hydrochloric acid.  This is especially the case as we get older.  See the following graph from the book, Why Stomach Acid is Good For You, by Jonathan Wright:


Reflux (GERD) is typically treated with drugs that block acid production, including proton pump inhibitors like omeprazole (Prilosec), lansoprazole (Prevacid), esomeprazole (Nexium), and pantoprazole (Protonix).  In fact, such proton pump inhibitor drugs are among the most prescribed drugs and last year over 147 million prescriptions were filled for such drugs.  But these drugs have lots of side effects and they don’t get to the cause of the problem.

One reason these proton pump inhibitor drugs have such serious long term negative effects is that they block your ability to properly break down and digest your food.  This prevents you from absorbing many of the nutrients in the food.  Along with pancreatic enzymes, hydrochloric acid secreted in the stomach is part of the chemical process in our digestive tract that breaks down our food.  This can lead to deficiency of calcium, magnesium, zinc, iron, sodium, beta-carotene, folic acid, vitamin B1, and vitamin B12.  This, in turn, can lead to increased risk of osteoporosis, hip fracture, and anemia.

Another reason for problems with PPIs is that stomach acid helps control the growth of certain kinds of bacteria.  Therefore taking these drugs can result in bacterial overgrowth of the stomach and small intestine, increased risk of Costridium difficile infections, and of bacterial infections such as pneumonia, Cympylobacter, and Salmonella.

In addition, PPIs increase the risk of kidney and heart problems.  And while it is known that GERD increases the risk of Barrett’s esophagus and of esophageal cancer, despite widespread usage of PPIs in the United States, there has been an increase of these conditions.  Therefore these acid blocking drugs are not reducing the incidence of esophageal cancer.

 So if these acid blocking drugs are not the answer, what should we do?  For many of us the answer may be to take supplements of betaine hydrochloric acid to enhance the digestion and breakdown of our food.  Digestive enzymes may be needed as well. This strategy should be coupled with some dietary changes and nutrients that will help to rebuild the damaged lining of the digestive tract.  But don’t just stop taking your acid blocking medication without speaking to your doctor and slowly reducing the dosage and weaning yourself off.  Schedule a nutrition consultation and Dr. Weitz can guide you through a nutrition program to help your body to heal and overcome this reflux condition.


Part of this blog has been based on a chapter on Over-the-Counter Remedies for Digestive Health: Potion or Poison? by Jerry Hickey and Gerard Mullin in the book Comparative Gastroenterology, edited by Gerard Mullin and published in 2011 by Oxford University Press.

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