Food goes down the esophagus, through the lower esophageal sphincter (LES), and into the stomach. The LES is a valve that normally stays closed after food has passed through. However, there are certain situations where it will open and allow contents of the stomach to come back up into the esophagus, causing burning from exposure of the esophageal tissue to hydrochloric acid (HCl). The esophagus is not lined with mucous the way the stomach is to protect it from HCl exposure as the body does not expect food to come back up the esophagus. All situations where food and HCl come back up into the esophagus thus cause discomfort.
It is commonly believed (and promoted by the medical and pharmaceutical professions as well as the media) that heartburn should be relieved by taking products, which either neutralize stomach acid (HCl) or prevent the body from producing it. Although these strategies may provide temporary relief from discomfort, they are counterproductive to proper digestion and healthy nutrition in the long run, which requires regular and copious production of HCl. Therefore, the emphasis with heartburn should be on first healing irritated esophageal, LES, and stomach tissue with supplements (talk to your holistic health practitioner about how to do this) and employing the strategies outlined below.
What Causes Food to Come Back Up the Esophagus
Consumption of alcohol and/or caffeine can overly relax the LES muscle – causing the muscle to fail to close properly, allowing contents to come up and burn the esophagus.
- Solution: Avoid alcohol and caffeine.
An overly full stomach can put pressure on the LES to open – this leads to stomach contents coming up and burning the esophagus.
- Solution: Eat small meals – stop eating before you feel full.
Food staying in the stomach too long due to insufficient hydrochloric acid production. Natural occasional spasms of the LES open it up very briefly, but long enough for food and HCl to come up into the esophagus when food is in there for too long.
- Solution:Follow strategies for optimal HCl production and concentration: eat in a relaxed state; avoid stress in general and/or learn to manage it; make sure you are well hydrated all the time; avoid drinking more than 6 ounces of liquid during meals; avoid alcohol, sugar and caffeine; and avoid any foods you know you are sensitive to.
Population of the LES by “bad” bacteria from insufficient HCl production– this allows “bad” populations to root and weaken the LES muscle. The LES then fails to close properly, again allowing contents of the stomach to come up into the esophagus.
- Solution:Follow strategies for optimal HCl production and concentration, and consume probiotic foods and beverages daily such as yogurt, kefir (if you tolerate dairy), cultured vegetables, and kombucha.
Excess gas in the stomach created by “bad” bacteria will also put pressure on the LES to open and allow food and HCl to come up into the esophagus. The bacteria feeds on foods putrefying in the stomach when HCl production is insufficient to kill them.
- Solution: Follow strategies for optimal HCl production and concentration, and consume probiotic foods and beverages daily.
Consumption of foods that weaken the LES – fats, chocolate, coffee, mints (especially peppermint and spearmint), sugar, alchohol, onions, and any food you are sensitive to will weaken the LES, allowing contents to come up into the esophagus.
- Solution: Avoid foods you are sensitive to as well as fats, chocolate, coffee, mints (especially peppermint and spearmint), sugar, alchohol, and onions. (Note: Certain prescription medications can also weaken the LES: bronchodilators, NSAIDs, calcium channel blockers, Beta-blockers, Diazepam, Nitrates, and Demerol.)
Consumption of foods that irritate the esophagus, including foods you are sensitive to – this will make heartburn doubly uncomfortable. Common esophageal irritants include: citrus fruits and juices, tomato-based foods, spicy foods, coffee, and carbonated drinks. Common foods that people are sensitive to include: gluten in wheat and other grains and casein in dairy products.
- Solution: Avoid citrus fruits and juices, tomato-based foods, spicy foods, coffee, and carbonated drinks. Also avoid foods that you have noticed you are sensitive to in any way. Do a two-week challenge and cut out the major allergens like gluten and casein, then add them back in and see what changes you notice. Do this with other suspected foods as well and remove them permanently if they are causing problems. (Note: Certain over the counter medications can also irritate the esophagus: aspirin, NSAIDs, Tetracycline, Quinidine, Potassium chloride tablets, and iron salts.)
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