Acid reflux also known as GERD (Gastroesophageal Reflux Disease) affects millions of people on a daily basis. As a result, acid blocking medications like Pepsid, Prilosec, and Nexium are some of the world’s best selling drugs with annual sales in the billions. These powerful pharmaceutical drugs were originally developed and marketed as a short-term solution for severe cases of peptic ulcers with a suggested use of no longer than six weeks. Despite that clear recommendation from the manufacturer and the FDA, the majority of patients I see who have reported reflux symptoms to their doctor have been placed on one of these medications as a long term solution and have stayed on the medication for years. Prilosec is even available over the counter now without a prescription.
The danger of taking acid reducing medications daily for a long period of time is that you need stomach acid to digest food and absorb nutrients properly. Long term use of acid blocking medication has been shown to lead to a myriad of vitamin and mineral deficiencies like magnesium, calcium, and B12 and increased risk of osteoporosis, insomnia, depression, anemia, fatigue, nerve damage, and dementia. Long term use of acid blockers can also lead to overgrowth of bacteria in the stomach and small intestine leading to peptic ulcer disease and irritable bowel syndrome.
The Underlying Cause
Believe it or not, acid reflux is not typically caused by too much stomach acid but by too little. Confused? Hang in there and stay with me.
Your esophagus is separated from your stomach by a ring of muscles called the Lower Esophageal Sphincter (LES). This sphincter is responsible for keeping the contents of the stomach including food and stomach acid from entering back up into the esophagus. The single most important determinant of the LES staying closed and preventing acid reflux into the esophagus is adequate levels of stomach acid. When there is sufficient acid production in the stomach there is direct feedback to the LES which causes increased tone and prevents the stomach contents from rising back into the esophagus. If stomach acid is low when food enters the stomach, the tone of the LES is compromised and is not able to keep the stomach contents, including acid, in the stomach thereby leading to acid reflux.
So what causes low stomach acid production? On-the-go, high stress lifestyles fool our body into responding as if we are being chased by a tiger instead of peacefully eating dinner. This stressed state leads to a decreased ability to properly digest our food. Your nervous system has two main states you are constantly oscillating between. A sympathetic nervous state is when you are being chased by the tiger and need to move quickly and make fast decisions, a.k.a. “fight-or-flight.” A parasympathetic nervous state is the “rest-and-digest” state. One of the main underlying causes for acid reflux is people are eating when they are in a sympathetic dominant state. This causes insufficient stomach acid production leading to laxity in the LES and regurgitation of the stomach contents into the esophagus. Bingo.
So why are acid blocking medications dispensed like candy for acid reflux? The answer is in order to experience relief it is much simpler and quicker to just eliminate the acid altogether than to try and change someone’s lifestyle and dietary habits. When you take an acid blocker the tone of the LES plummets, but there is no acid left to rise up into the esophagus. Once again, suppressing the symptom but not treating the cause.
The Real Solution
The following are some simple steps you can take to address the underlying cause of acid reflux and get off your acid blocker for good.
Practice good food hygiene. Take a few deep breaths before meals to relax, smell your food, chew your food thoroughly. These simple steps will signal to your stomach and pancreas that food is coming and dramatically reduce incidence of acid reflux and increase absorption of vital nutrients.
Eat smaller meals slowly and more frequently. Overeating causes distention of the stomach and decreases LES tone.
Get analyzed for a condition called hiatal hernia syndrome (not to be confused with an actual hiatal hernia).
Avoid foods and substances which tend to decrease tone of the LES. Citrus fruits, tomatoes, chocolate, mint, spicy foods, alcohol, caffeine, refined carbohydrates and cigarettes have all been correlated with decreased LES tone.
Find a doctor who will work with you to improve acid production in your stomach. For more severe cases it is sometimes necessary to use a tapered dose of hydrochloric acid with digestive enzymes until the stomach can produce enough acid independently again.
Conclusions
Acid blocking drugs are effective at temporarily relieving heartburn but when taken long term can lead to serious health consequences. The real underlying issue with acid reflux is insufficient tone in the lower esophageal sphincter which is caused by stress, improper mealtime habits, and a poor diet leading to decreased stomach acid levels. Addressing the underlying cause of this issue is very important for long term health and wellness.
