Acid Reflux: Causes & Natural Remedies
Tired of unpleasant acid reflux symptoms? Find out what causes heartburn and learn how you can relieve your acid reflux longterm
Are you experiencing an unpleasant burning sensation and abnormal feeling of fullness, or frequent belching after eating?
The struggle is real - acid reflux or “heartburn,” is triggered by stomach acid that’s finding its way back into your esophagus.
According to the American College of Gastroenterology, acid reflux symptoms that occur more than twice per week will classify you for GERD - which stands for “gastroesophageal reflux disease.” And a whopping 20% of Americans are thought to have GERD today. (1)
GERD has many faces and can come as:
A burning sensation in your throat, stomach, or chest
A sour or bitter taste in your mouth
Regurgitation or vomiting
Increased feeling of fullness after meals
Belching
Bad breath
Chronic sore throat
Dysphagia (difficulty swallowing)
Hoarse voice
Feeling a lump in the throat
Undigested food in the stool
Inflamed gums and other dental problems
While you’re definitely not alone in your struggles, let’s find out why you’re experiencing acid reflux symptoms in the first place.
Why Am I Getting Acid Reflux?
Your esophagus, the connection between your mouth and your stomach, has a valve that’s known as the lower esophageal sphincter (LES). Sometimes this valve doesn’t function properly, opens too often, or does not close well. (2)
The LES is pH sensitive and closes when sufficient stomach acid is present. In other words, you need robust stomach acid for the LES to function properly and why the commonly prescribed acid-lowering treatments only excacerbate the problem.
If your LES doesn’t close as soon as food has passed through it, you’ll feel an unpleasant pain sensation in your esophagus. The pain is indicative of damage caused by stomach acid to your esophagus, given stomach acid is known to be highly acidic. (3)
Over longer periods of time, this low pH of stomach acid (pH 1.5-3), which your stomach is equipped to handle, can alter the cells in your esophagus (pH 7).
Your esophagus does not have the same cells and is not lined with the same kind of protective mucosal barrier as your stomach.
In effect, the tissue of the lower esophagus starts to change to cells that are normally only present in the small and large intestine. Over time, these cells can even develop into a form of cancer called esophageal adenocarcinoma. (3)
But besides causing uncomfortable symptoms, untreated acid reflux can further lead to a variety of secondary problems. Therefore, seeking treatment is important.
Acid Reflux Causes: Genetics or Lifestyle?
A variety of factors can cause acid reflux. Some causes constitute body changes that trigger acid reflux. Others are tied to diet, lifestyle, and personal choices.
Let’s dive in, shall we?
Hiatal Hernia
One of the most common causes of acid reflux is a hiatal hernia. This hernia most frequently occurs in people over age 50 and is prevalent in tobacco users and overweight people. (4)
What exactly does a hiatal hernia look like though?
Picture your diaphragm, which has an opening for your esophagus, also known as “hiatus.” Now sometimes, part of the stomach pushes through the small opening into your chest. This is called a hiatal hernia. (4,6,7)
While a small hiatal hernia generally wouldn’t cause any issues, larger ones can cause significant acid reflux and lead to regurgitation of foods, and Barrett’s esophagus. (5-7)
Helicobacter pylori
H. pylori is a bacteria in your stomach that disrupts the stomach homeostasis inducing inflammation using proinflammatory cytokines and altering the activity of a variety of stomach cells.
The cells that produce stomach acid (aka hydrochloric acid) are damaged, less acid is produced, and proteins cannot be digested fully. These start to ferment, creating more gas and a feeling of fullness.
This builds up more pressure in the stomach and starts to push the bolus upward through the LES into your esophagus. As a result, downstream gastrointestinal problems, such as small intestinal overgrowth (SIBO), leaky gut, and food sensitivities can develop.
Obesity
Obesity triggers a long list of health risks and symptoms. One of these symptoms includes acid reflux.
Research points at obesity as either a cause of acid reflux or a factor capable of worsening this condition - if you already have acid reflux. Excess belly fat appears to exert additional pressure on your stomach, pushing stomach acid back up into your esophagus. (8)
Studies also show that vice versa, you can, in fact, reverse symptoms of acid reflux by losing weight. However, the amount of relief from acid reflux is strongly connected to the amount of weight lost. (8)
Pregnancy
While most women attribute pregnancy-related heartburn to a rapidly growing fetus, that is only part of the story.
Hormones, particularly progesterone, cause relaxation of the LES and make acid reflux much more likely to occur.
Tobacco Use
Smoking is directly tied to higher rates of heartburn, but why is that?
Turns out smoking lowers the pressure on the lower esophageal sphincter (LES). Remember the LES? It’s the valve connecting your stomach and esophagus. (9)
Lower pressure on the LES could mean that stomach acid can flow back into your esophagus more easily and thus cause acid reflux. (9)
Medications
If you are suffering from acid reflux, it may be time to take a closer look at your medications. The following classes of medications have been shown to cause acid reflux via different mechanisms:
Blood pressure medications — Calcium channel blockers, such as Diltiazem (Cardizem, Dilacor), Nifedipine (Adalat, Procardia), Amlodipine (Norvasc), and alpha-adrenergic agonists, such as Clonidine (Catapres) and Guanfacine (Tenex) (13)
NSAIDS — Including Asprin, Ibuprofen, Naproxen, and Diclofenac
Asthma medications — Diazepam (Valium), Alprazolam (Xanax), and Oxybutynin (Ditropan)
Anticholinergics — ipratropium (Atrovent), Tiotropium (Spiriva), Benztropine (Cogentin), Dextromethorphan (Robitussin DM), Diphenhydramine (Benadryl), Dimenhydrinate (Dramamine), and Chlorpheniramine (Chlor-Trimeton) (14)
Antidepressants / Antianxiolytics — Bupropion (Wellbutrin, Zyban), Levodopa (Sinemet, Larodopa), Diazepam (Valium), Alprazolam (Xanax), and Oxybutynin (Ditropan)
Hormones — Hormonal birth control and hormone replacement therapy that include progesterone
Foods
Foods are on top of the list of potential acid reflux triggers and an easy factor to avoid. Greasy foods, such as fried foods and pizza, as well as most restaurant foods in general, are using low-quality, pro-inflammatory oils for preparation which can contribute to heartburn. (10,11)
Here’s a rundown of foods that can commonly exacerbate your heartburn: (10,11)
Fried / greasy foods
Red meat
Chocolate
Black tea
Coffee
Alcohol
Tomato sauce
Carbonated drinks
Lemons and oranges
Spicy foods
Peppermint
Sugar
Consider eliminating the foods that are triggers for your acid reflux.
Hypochlorhydria
It may come as a surprise, but GERD is associated with hypochlorhydria (low stomach acid), not hyperchlorhydria (high levels of stomach acid). Pharmaceutical treatment focuses on reducing stomach acid, thus only further exacerbating the problem.
When stomach acid is too low, proteins sit in your stomach and ferment, producing more gas and pressure which then pushes the bolus (food plus digestive secretions) upward. The bolus then goes through the LES into your esophagus, and voila, here are your symptoms of fullness and acid reflux.
Other digestive issues follow such as dysbiosis, opportunistic infections (e.g. C. difficile, parasites), leaky gut, food sensitivities, and micronutrient deficiencies. These can then lead to more serious health problems down the line.
How to Relieve Acid Reflux
Conventional allopathic medical treatment commonly prescribe acid-reducing medications for GERD, including:
H2 Receptor Blockers: such as Famotidine (Pepcid)
Proton Pump Inhibitors (PPIs): such as Esomeprazole (Nexium) and Omeprazole (Prilosec)
Although these medications may help to relieve symptoms initially, they reduce stomach acid leading to worsening hypochlorhydria. As we have learned it’s not excess stomach acid, that is the problem in acid reflux, but issues with stomach acid traveling upward through the LES.
As a matter of fact, hypochlorhydria will only make your symptoms worse in the long run, and add a list of secondary issues.
Stomach acid is important for:
Protein digestion
Killing harmful bacteria that enter our digestive tract
Absorption of various minerals (e.g. iron, calcium, magnesium, zinc)
Activating the absorption of vitamin B12
Stimulating the production of other digestive enzymes
New evidence, particularly with extended use of PPIs and H2 receptor blockers, has revealed: (15-20)
A decreased absorption of various vitamins and minerals
(e.g. vitamin B12, vitamin C, calcium, iron, and magnesium)
Increased risk of fractures in postmenopausal women
Increased risk of heart attack
Gut dysbiosis or SIBO
Increased risk of acquired enteric infections such as C. difficile
Rebound stomach acid hypersecretion
Increased reflux-like symptoms
Hypergastrinemia
Stomach cancer
Allergies
Asthma
Depression
Anxiety
Autoimmune diseases (e.g. RA and Graves disease), irritable bowel syndrome (IBS), Crohn’s disease, ulcerative colitis, and many more
Hypergastrinemia may be associated with an increased risk of stomach cancer. (21)
Other serious consequences include chronic kidney disease and an increased risk of dementia. (22-24)
Natural Approaches to Treating Acid Reflux
But there are other safe and effective methods you can use to help counteract and resolve your heartburn. These include:
Acupuncture
Traditional Chinese Medicine (TCM) principles specify that acid reflux is often due to dysfunction of the stomach, liver, and spleen.
TCM principles also notate that emotional swings or dietary irregularities weaken the liver’s ability to govern the free coursing of qi, impairs the spleen’s ability to transport and transform water and grain, and damage the stomach’s ability to maintain the balance of upward and downward bearing qi.
Water and grain (i.e. food) in the stomach fail to be transformed into the essence and instead turn into toxic masses. If the downward flow of qi in the stomach is disturbed, it pathologically ascends. As a result, the stomach contents backflow into the esophagus.
Reflux in TCM focuses on transforming turbidity, harmonizing the stomach, and restoring the downward bearing of stomach qi to prevent counterflow. This focus restores the normal functioning of the lower esophageal sphincter (LES), enhances gastric motility, and improves gastric emptying.
Acupuncture plus herbal medicine outperforms Omeprazole (Prilosec, Zegerid) for the treatment of acid reflux. (25)
Acupuncture treatment for heartburn is a safe and effective acid reflux remedy. (26-28)
TCM Herbs
In TCM, gastrointestinal disorders are complex patterns of imbalance characterized by both excess and deficiency: excess refers to the stomach heat (inflammation and rising of stomach acid), and yin deficiency refers to the damaged mucosa of the digestive tract.
This condition may be caused by external factors such as infection, alcohol, smoking, drugs, or internal conditions, e.g. stress.
Therefore, herbs are used in this formula to clear heat, regulate liver qi, strengthen the stomach to restore its descending function, and restore normal digestive functions.
TCM herbs have shown therapeutic effects similar to omeprazole in relieving GERD. (29)
Herbs/Supplements
A healthy gastric mucosal lining protects the GI tract from the damaging effects of stress, bacteria, and other irritating physical and chemical substances. Various herbs and supplements can support the integrity of the mucosal lining, such as:
Zinc Carnosine — A unique compound that appears to enhance mucosal integrity in the stomach. (30,31)
Slippery Elm — It’s reported to cause stimulation of nerve endings along the GI tract, leading to beneficial mucus secretions. (32, 33)
Marshmallow — A high-mucilage-containing ingredient that forms a demulcent gel when consumed orally, marshmallow has been used traditionally in many cultures for various maladies, including the support of intestinal mucosal membranes. (34)
Aloe Vera — The polysaccharide content of aloe gel is thought to be responsible for supporting a healthy inflammatory response in the GI tract. (35)
Deglycerized Licorice — The roots and rhizomes of licorice are used for a wide range of therapeutic applications, including the reported use of enhancing gastric mucus secretions to support GI health. (36)
In vitro research suggests that licorice flavonoids have a beneficial impact on Helicobacter pylori (H. pylori) activity in the GI tract, and animal studies show that deglycyrrhizinated licorice (DGL) is effective in the alleviation of ulcerated gastric mucosal damage. (37)
L-glutamine — A free-form amino acid, L-glutamine supports gastrointestinal health through its vital role in maintaining mucosal integrity.
L-glutamine is also involved in the production of secretory immunoglobulin A in the intestines, contributing to the immune barrier function of the intestinal mucosa. (38)
Okra — The pod contains a soft tissue that exudes a mucilaginous (long-chain polysaccharide) juice when cooked, linking okra’s effectiveness as a demulcent agent to its formation of a soothing film over inflamed mucous membranes. (39)
Lifestyle Changes that Alleviate Acid Reflux
Believe it or not but lifestyle plays a key role when it comes to acid reflux - as it does with many other health issues.
The upside of simple lifestyle changes is that it’s an all-natural approach that more and more people prefer over taking medications. So, what can you do to help relieve your acid reflux?
Weight Loss - As mentioned previously, obesity can lead to significant acid reflux symptoms while weight loss can reduce said symptoms. Also avoid tight clothing, especially such that constricts the belly area and adds pressure on your stomach.
Reduce Stress - Stress is a frequently underestimated contributor to many medical problems, but stress can, in fact, lead to a surge in stomach acid production, which, in turn, can worsen your heartburn. (12)
Do Not Smoke - Tobacco poses many health risks and can lower the pressure on your LES. Do yourself and your health a favor and quit the cigarettes. Need help with that? Consider acupuncture as an aid to stopping smoking.
Elevate Your Head While Sleeping - Sleeping in the right position can reduce the frequency of your heartburn. Try to prop your head up with an extra pillow or even better, use a wedge to avoid stomach acid flowing back into your esophagus.
Dietary Changes
The foods we eat, including our dietary habits, are big contributors to your acid reflux symptoms. Besides avoiding certain foods as mentioned previously, here’s what else you should consider:
Eat smaller meals.
Chew your food thoroughly.
Eat in a relaxed state.
Stop snacking between meals (constant snacking and grazing reduces gastric and intestinal motility).
Don’t eat right before you go to bed. Your last meal of the day should be about 2-3 hours prior to going to bed.
Incorporate some of these foods into your daily routine:
Foods rich in fibers, such as whole grains and green vegetables. (11)
Coconut water, contains helpful electrolytes that promote pH balance and help control acid reflux.
Plant-based milk, full-fat cow’s milk can worsen acid reflux and may be difficult for you to digest.
Bone broth, can reduce inflammation and heal the gut lining.
Lean meats, such as chicken, turkey, and certain types of fish are lower in fat than other meats, which helps reduce your symptoms.
Oatmeal, helps absorb stomach acids.
Kale, the minerals in this leafy green can reduce stomach acid.
Ginger, an anti-inflammatory herb, that’s often used as a treatment for stomach conditions.
Purple cabbage, helps regulate the body’s pH levels and reduce digestive issues.
Parsley, a medicinal herb used to settle the stomach and aid digestion.
Couscous and brown rice, provide complex carbohydrates and add fiber to your diet.
Fennel, helps improve stomach function.
Bananas, help neutralize stomach acids.
Melons, are low in acid and contain magnesium, which is also found in many reflux medications.
Apple cider vinegar and lemon juice, drink warm water with apple cider vinegar or lemon juice (if tolerated) in the morning before breakfast. They can also be used with meals to increase stomach acid for protein digestion.
Celery juice, drink between meals as it’s rich in minerals and mineral salts and helps to restore your stomach’s HCl.
What Can HelpYou Relieve Your Acid Reflux
Acid reflux causes a variety of unpleasant symptoms. For many people, acid reflux is a chronic problem that leads to regular discomfort and can ultimately lead to more serious issues. We're sure you’ve tried your fair share of meds, but have you ever tried a holistic approach?
Uncovering the root cause of your acid reflux, as well as your body’s interactions as a whole, can help unveil what’s really going on. Most importantly, it can help you find a way to treat your symptoms and provide you with the long-term relief you seek.
Want to learn more about what a holistic health professional can do for you? Schedule a completely free consultation and let us be your guide on your journey to better health!
Resources:
Moreau, Lindsay. “Getting Help with GERD, Learn how integrative intervention may support longer-term relief from GERD, heartburn, and acid reflux symptoms.” vol. 2, no. 4, pp. 32-37. Wholescripts. Accessed June 2022