Understanding and Treating Acid Reflux – GERD

Acid reflux, also known as gastroesophageal reflux disease (GERD), is a common condition where stomach acid flows back up into the esophagus. This can lead to irritation, inflammation, and damage to the lining of the esophagus over time. In this comprehensive guide, we will explore the causes of acid reflux, natural remedies and lifestyle changes to treat it, and the connection between stress and gut health.

What is Acid Reflux?

Acid reflux occurs when the lower esophageal sphincter (LES) malfunctions. The LES is a ring of muscle located between the esophagus and the stomach. Its job is to relax to allow food into the stomach when you swallow, and then quickly tighten back up to prevent stomach acid and contents from flowing back into the esophagus.

With acid reflux, the LES remains too relaxed or weakens over time, allowing stomach acid to reflux back up into the esophagus. This exposes the lining of the esophagus to corrosive acid, leading to symptoms like:

• Heartburn
• Regurgitation of food or sour liquid
• Sensation of a lump in the throat
• Trouble swallowing
• Chest pain

If left untreated, the constant acid irritation can cause permanent damage to the esophagus over time, including scarring, narrowing, ulcers, and even precancerous changes like Barrett’s esophagus.

The Importance of Stomach Acid

Contrary to popular belief, acid reflux is usually not caused by too much stomach acid. In fact, it’s often due to not having enough acid in the stomach.

The stomach needs to be highly acidic, with a pH between 1-3, in order to:

• Stimulate the release of pepsin, the enzyme that breaks down protein
• Trigger the production of protective mucus to line the stomach
• Maintain the tone of the LES to prevent reflux

When stomach acid is too low, food sits in the stomach undigested for longer. This allows more time for acid reflux to occur when the LES relaxes. Low stomach acid is associated with many common symptoms and conditions, including:

• Bloating, belching, gas, constipation
• Poor appetite, nutritional deficiencies
• Weak immune function
• Chronic infections like SIBO or Candida
• Iron and vitamin B12 deficiency

10 Natural Remedies for Acid Reflux

There are many natural ways to improve low stomach acid and treat acid reflux without resorting to acid blocking drugs, which can interfere with digestion over time. Here are 10 simple remedies to try:

1. Apple Cider Vinegar

Apple cider vinegar contains acetic acid, which can help bring down stomach pH while stimulating digestion. Try diluting 1-2 tbsp in water and drinking before meals. Look for raw, unfiltered vinegars with the “mother” for maximum benefit.

2. Betaine HCL Supplements

Betaine HCL capsules contain hydrochloric acid, which brings pH levels down in the stomach. They come in various strengths, so work with a practitioner to find the right dose for your needs.

3. Pink Himalayan or Sea Salt

Natural salts like Himalayan and sea salt provide chloride, one of the key components the stomach needs to produce its own hydrochloric acid.

4. Digestive Enzyme Supplements

Digestive enzymes like bromelain, papain, amylase, lipase, and proteases can improve digestion and prevent undigested food from sitting in the stomach.

5. Probiotics

Probiotics support gut health and influence digestion through the gut-brain connection. Strains like Lactobacillus and Bifidobacterium can be particularly helpful.

6. Zinc Carnosine

Zinc carnosine coats and protects the stomach lining, helps reduce inflammation, and improves wound healing.

7. DGL Licorice

DGL (deglycyrrhizinated licorice) has soothing properties that coat and heal the esophagus and stomach lining. It increases mucus secretion and blood flow.

8. Slippery Elm

The mucilage in slippery elm helps protect against stomach acid and enhances the protective mucosal barrier. Demulcent herbs like marshmallow root have similar effects.

9. Mastic Gum

Mastic gum is a natural resin that may increase LES pressure and block acid production in the stomach.

10. Melatonin

Melatonin helps promote gastric motility. Slowed emptying of the stomach makes reflux more likely. Start with 3mg before bedtime.

The Gut-Brain Connection

The state of your gut health and digestion is closely tied to your brain function and mental health. This is known as the gut-brain axis. When gut health is compromised, it can impair mood, focus, willpower, stress resilience, and sleep quality.

Conversely, chronic stress and anxiety negatively impact gut function and acid secretion in several ways:

• Alters gut microbiome balance
• Decreases blood flow and mucus secretions
• Slows digestion and stomach emptying
• Weakens the lower esophageal sphincter

Finding ways to manage your stress levels and engage your body’s relaxation response is key for addressing acid reflux at its root cause.

Stress, Sympathetic Tone, and Acid Reflux

The autonomic nervous system is made up of the sympathetic (“fight or flight”) and parasympathetic (“rest and digest”) nervous systems. These two branches have opposing effects on digestion.

When you’re under stress, your sympathetic nervous system kicks in, directing blood flow and resources away from the gut and toward the big muscles to aid your “fight or flight” response.

At the same time, it decreases activity in the parasympathetic branch, slowing or halting digestion. This directly impacts the function of the lower esophageal sphincter. The increased sympathetic tone causes the LES to relax more often, making acid reflux more likely.

Chronic stress keeps your body in a constant low-level fight or flight mode, which impairs LES function and leaves you prone to reflux symptoms. Learning stress management techniques to engage the parasympathetic system can help restore normal LES tone and stomach acid secretion.

Lifestyle Tips for Reducing Acid Reflux

Make the following lifestyle changes to take pressure off your LES and improve gut function:

• Eat smaller, slower, earlier dinners – Large meals late at night require lots of work from your LES and stomach. Give your body at least 3 hours to digest before laying down.
• Wear loose clothing – Tight clothes add pressure on your stomach and LES.
• Maintain a healthy weight – Excess abdominal fat puts pressure on the LES and stomach.
• Quit smoking – Smoking weakens the LES, decreases saliva (which is protective), and may provoke coughing.
• Limit problem foods – Common reflux triggers include citrus, tomato, alcohol, chocolate, mint, coffee, and fatty foods.
• Elevate your head – Sleep with your head and shoulders propped up on 6-8 inch blocks to use gravity to keep acid down while sleeping.

Relaxation Techniques to Reduce Stress

Here are some simple ways to engage the parasympathetic nervous system to counterbalance chronic stress:

• Diaphragmatic breathing – Deep belly breathing massages the vagus nerve, triggering relaxation.
• Guided imagery – Visualization and guided meditations work quickly to induce the relaxation response.
• Progressive muscle relaxation – Alternate tensing and releasing muscle groups to relieve tension.
• Yoga, tai chi, qigong – These gentle arts focus on breathing, mindfulness, and movement.
• Regular exercise – Aerobic exercise fights stress hormones and promotes circulation.
• Spending time in nature – Forest bathing, earthing, and time outdoors calms the mind.

Supporting Brain Health

The prefrontal cortex region of the brain acts as the control center for tuning up the parasympathetic system and downregulating stress responses. Supporting brain health with key nutrients and supplements can help restore balance.

Key supplements for brain support include:

• Omega-3s (high EPA/DHA ratio)
• B vitamins
• Magnesium
• Polyphenols like curcumin, resveratrol, and cocoa flavanols

Summary: Improving Low Acid Levels Through Diet

In most cases, acid reflux results from having too little stomach acid, not too much. Improving low acid levels through diet, hydrochloric acid supplements, stress reduction, and other natural means can treat reflux at its root cause.

Reducing meal size, not eating late, managing stress, and engaging the parasympathetic nervous system are pivotal lifestyle factors for treating acid reflux long-term. Supporting digestion through all stages, as well as optimizing brain health, can help strengthen the lower esophageal sphincter and control symptoms.