Natural Remedies for Heartburn and GERD

Welcome to The Perfect Stool: Understanding and Healing the Gut Microbiome. This is your host, Lindsey Parsons. Today I'm going to be discussing heartburn, which is a symptom of acid reflux, more formally known as GERD or gastroesophageal reflux disease, but can have other causes as well. I'll break down the underlying causes of heartburn as well as explain why heartburn and GERD may present themselves in unsuspecting populations such as children and healthy adults or adolescents. I will also explain healthy alternatives to PPIs, or proton pump inhibitors, and antacids, which are the conventional treatments for heartburn but can have dangerous side effects. But before our conversation, if you haven't yet followed or subscribed to the show, be sure to do so. If you want to get transcripts of the podcast, pop over to my website, HighDesertHealthCoaching.com, and sign up for my newsletter. You'll also get my free ebooklet, Finding Your Root Cause Through Stool and Organic Acids Testing, when you sign up. And if you haven't yet done my quiz on which if a little test would help you get to your root cause, you can find a link in the show notes and take that. Now on to the show. Heartburn is one symptom of acid reflux, which is where the stomach acid travels back up your esophagus. The term heartburn can be deceptive as it implies that the heart is involved in the discomfort, but in fact, heartburn actually occurs within the digestive system, specifically in the esophagus. GERD is a chronic and more severe form of acid reflux. GERD is the typical culprit in people who frequently suffer from heartburn. According to the National Institutes of Health, more than 60 million Americans experience heartburn at least once a month, and that number is continuing to rise. However, many people who have GERD do not experience that burning sensation, but rather have what's called silent reflux or LPR, laryngopharyngeal reflux. People with LPR may have symptoms that they might confuse for a variety of other conditions, such as a sore throat, hoarseness, a chronic cough, a bitter taste in the mouth, phlegm or a lump in the throat, and a need to clear the throat and/or post-nasal drip. I had a chronic cough for years and post-nasal drip and was put on asthma inhalers, which didn't help that much at all, until finally a doctor realized I had reflux. For me, giving up dairy was a big part of decreasing those symptoms, although when my SIBO flares, I do sometimes experience the cough still, especially when I cheat and eat dairy. GERD, no matter how it manifests, involves the regurgitation of food and stomach acid into the esophagus. Leading to the sensation of a burning-type discomfort in the chest, neck, or throat, which people refer to as heartburn, or the symptoms of LPR mentioned above. Although GERD is more prevalent in adults, children or adolescents, and even infants can suffer from gastroesophageal reflux disease. Children who have risk factors, particularly a hiatal hernia, asthma, or a strong family history of GERD, may experience recurring and long-lasting GERD later in life. So identifying and treating GERD early in those at-risk children can result in fewer complications and potentially preventing the development of GERD in adulthood. Untreated GERD can pose a significant concern as the continuous reflux of stomach acid can result in harm to the esophageal lining, leading to inflammation and discomfort. In adults, if prolonged and unmanaged, it may result in Barrett's esophagus, a reddening and thickening of the wall of the esophagus, which is a precursor to esophageal cancer. In order to prevent this, gastroenterologists will often prescribe long-term use of PPIs or a surgical intervention called fundoplication. This surgery entails wrapping the upper part of the stomach around the esophageal sphincter muscle in order to strengthen the sphincter and prevent reflux. Obviously, these options are best avoided if possible. Additional symptoms of GERD, aside from the burning discomfort of heartburn or symptoms mentioned with LPR, may include a frequent sour taste of acid, especially when lying down, in your throat, a sensation of burping acid into the mouth, difficulty swallowing, a feeling of food being stuck in the throat, a choking sensation that may disrupt sleep, the wearing away of teeth, and halitosis, aka bad breath. So why might otherwise healthy young people get heartburn? Research has indicated that the prolonged presence of GERD or its onset during early stages of life are contributing factors to the development of Barrett's esophagus and esophageal cancer. In fact, 1 out of every 4 adolescents suffer from GERD, according to the National Institute of Diabetes and digestive and kidney diseases. So why are more and more children and teens suffering from a disease that usually targets older, more unhealthy populations? Some research points to the fact that more and more teenagers are overweight, a product of a society with too little exercise, too much time indoors, and the constant eating of ultra-processed foods. Teenagers have a fondness for, and are mostly offered at school and at events, junk food like french fries, pizza, and burgers. These high-fat, deep-fried foods are exactly the type of foods to trigger GERD. But changing habits is often difficult for children and teens, and food restrictions can distance them socially from their friends when they need to avoid things like pizza, fries, or tacos, and that's all teens are eating. Further, teenagers are known to frequently snack during the later hours of the day and also stay up late, and this type of late-night snacking mixed with lying down is another trigger for GERD. Even lack of sleep can impact GERD symptoms, as sleep is so critical for overall health. Treating GERD means the managing of a new lifestyle. And this is often too difficult for adolescents to face, potentially explaining the increasing numbers of young people with GERD. So what causes these symptoms? The esophagus functions by carrying food from the mouth to the stomach and is only separated by a small muscle known as the lower esophageal sphincter. This muscle will open to allow food and liquid to enter the stomach and then is supposed to close to prevent any contents from leaking back up into the esophagus. Typically, GERD is caused by the sphincter muscle improperly closing or relaxing when it's not supposed to. The mechanism of this muscle dysfunction varies from person to person. For some people, the muscle simply does not tighten correctly. For others, the muscle doesn't close quickly enough after eating, allowing stomach contents to move up the esophagus. The treatment for GERD depends on the severity of symptoms, but for most people, simple lifestyle changes can make a huge difference, such as changing your diet. There are many foods purported to make GERD symptoms worse. The common culprits cited are citrus fruits, Chocolate, caffeinated drinks or foods, carbonated beverages, fatty or fried foods, garlic and onions, peppermint, spicy foods, and tomato-based foods. Those are the typical foods you'll be recommended to avoid as you try and figure out the root cause of your symptoms. In my experience, however, it's often an underlying case of dysbiosis, either small intestinal bacterial overgrowth or SIBO, or the bacteria H. pylori, or other issues that lies at the root of the problem. And in the case of SIBO, a diet high in fermentable carbohydrates along with excess bacteria in the small intestine may actually be causing the issue, because those are the most fermentable foods. If a low FODMAP diet, which stands for fermentable oligo, di, monosaccharides, and polyols, eases your symptoms, you may want to seek out a gastroenterologist knowledgeable about SIBO and try to get a SIBO breath test. Or you could order a FoodMarble device and test yourself, and you can email me to get a medical device with the testing medium at a discount. I've also seen a recent study that showed that just eliminating gluten and dairy, because wheat and lactose are two of the biggest components of a typical diet that are high in FODMAPs, is almost as successful as a full-blown low-FODMAP diet, and it's much easier to implement. So if eliminating those two— plus I'd add also eliminating added sugar— brings you a lot of relief and you're having bloating after eating, I'd pursue SIBO testing. Aside from diet changes, there are many other lifestyle changes that can be implemented to provide GERD relief. Some of these changes include quitting smoking, avoiding alcohol, and losing weight. Other more serious reasons for GERD or heartburn could be pregnancy, scleroderma, an autoimmune disease, or a hiatal hernia. So these should also be considered when you have symptoms. A hiatal hernia is when part of the stomach slips up through the lower esophageal sphincter into the esophagus. It may be possible to feel this as a bulge under your left breastbone. Hernias are actually incredibly common, with an estimated 60% of adults having one, although they're often asymptomatic. Hernias can be caused by obesity, pregnancy, heavy lifting, excessive coughing, or even straining on the toilet when constipated, as well as things that weaken the diaphragm, which normally prevents the movement of the stomach into the esophagus, like smoking, poor diet, lack of exercise, alcoholism, and chronic stress. Some hiatal hernias can result in gastrointestinal bleeding, which would show up as vomiting or bloody stools and can lead to iron deficiency anemia. So if you can't seem to get your iron levels to normal and have heartburn or GERD symptoms, you should be examined by a doctor for hernia. There are ways to naturally pull a hernia down, and I'll put a link in the show notes with a page explaining how. Other symptoms of scleroderma, another possible cause of GERD, are hard thickening or tight skin, hair loss, inability to sweat through your skin, dry skin, itching, sores, changes to skin color, salt and pepper looking skin, stiff joints, muscle shortening and weakness, sores and pitted scars in the fingers, visible blood vessels showing up as tiny red spots, usually on the hands and face, calcium deposits beneath the skin, and extreme sensitivity to cold or stress. So if you have heartburn or GERD symptoms plus any of those symptoms, you may want to see a rheumatologist to get a diagnosis. And if you do, don't neglect dealing with your gut health. A hyperpermeable or leaky gut is a precursor to all autoimmune disease. Finally, GERD is a side effect of many prescription drugs, so if you started a new prescription recently, do check the insert and make sure that your new drug isn't your root cause. Do you have unspecified gut health issues and haven't gotten tested yet, or diagnosed SIBO, IBS, IBD, or Candida? My newest supplement, Serum Bovine Immunoglobulin, or SBI Powder, may be the perfect thing to try. In a randomized, double-blind, placebo-controlled study of adults with IBS-D, GI symptoms including loose stools, hard stools, flatulence, and incomplete evacuation were significantly improved with a 5-gram-a-day dose of SPIs after 6 weeks, and abdominal pain, bloating, and urgency were also significantly decreased after 6 weeks of use at a dose of 10 grams a day of SPI powder. It's basically the immune system of a cow derived from plasma and made into a powder so it binds and neutralizes a wide array of pathogenic bacteria and fungi and carries them out with your stool without hurting your beneficial microbes like antibiotics or even strong antimicrobial herbs will. It's also been shown to decrease intestinal permeability, decrease fat in the stool, increase the absorption and utilization of nutrients, and increase lean body mass. So give it a try today at perfectstool.com, where you can also find my supplement Tributrin Max, which helps solidify stool and slow down motility for people with diarrhea or loose stool. Now back to the show. Beyond what you eat How you eat and proper meal hygiene may be at the root of heartburn or GERD symptoms. My son, for example, has complained of years of stomach pain and heartburn-type issues. However, his diet consisting almost entirely of gluten and dairy, along with the fact that he inhales his food within less than 5 minutes of sitting down, no doubt has a huge impact on his symptoms. Don't be asking yourself how I could have a son with such terrible eating habits. Anyone with kids knows they are very hard to control. So starting with the obvious, eating slowly and calmly, taking small bites and chewing your food adequately, which for some people is supposedly 25 chews per bite. I can never quite get there, but that will depend on how large the bite is and how hard to chew the food is. But basically until the food is mush. Taking time between bites by putting down your fork and not working or multitasking while you eat are also good meal hygiene practices. And of course you wanna be in a parasympathetic state before you even start eating. Your parasympathetic nervous system is responsible for stimulation of rest and digest activities that occur when the body's at rest. These activities include digestion, bowel movements, urination, and salivation. The other part of the autonomic nervous system is the sympathetic nervous system, which is responsible for fight or flight reactions. The body can only be in one or the other state at a time. So to properly digest food, the body needs to ensure optimal blood flow to the digestive organs in order to absorb nutrients efficiently. This process is hindered when the body is in motion, stressed, or physically agitated, as the sympathetic nervous system redirects blood flow to the extremities rather than the digestive system. This is why eating while working, walking, or when under stress can lead to indigestion. In a relaxed, parasympathetic state, the mere thought of food can trigger the initial stages of digestion. In this state, cranial nerves stimulate the salivary glands to release enzymes in your saliva which aid in breaking down food, while also prompting the stomach to release gastric juices, hydrochloric acid, and additional enzymes crucial for proper digestion and nutrient absorption. It's important to consider your mental and emotional state before a meal, as it significantly impacts food choices, eating habits, and portion sizes. Eating while stressed restricts blood flow to the stomach, resulting in poor digestion. When digestion is compromised, symptoms like heartburn, bloating, gas, constipation, low energy, and weight gain may occur. To make sure your parasympathetic nervous system is activated prior to eating, you can try sitting in silence for 1 minute before you eat, taking deep breaths from your diaphragm. And then it's important to eat without distractions like television, your phone, a computer, or a book. Just focusing on eating alone can aid in digestion. As I said earlier, even the simple act of consciously eating slowly can help the body enter its parasympathetic state, which is crucial for proper digestion. Other things that may influence heartburn or GERD symptoms include your clothes, your body position after eating, and your meal size and timing. Tight-fitting clothes tend to push your stomach upwards, even slightly, which can cause your stomach to push itself and/or its contents towards the esophagus, either causing heartburn or exacerbating it. You should also avoid lying down or sleeping after a meal for at least 2 to 3 hours. While it won't address the root cause of your issue, one way to get gravity on your side is to raise the head of your bed 6 to 8 inches by putting blocks or books under the legs of the bed so that the body is less horizontal during sleep. The human metabolism is more active earlier in the day, so establishing a daily cutoff time in the evening for eating, maybe 7 PM, is a good idea to allow your stomach to empty before you sleep sleep, as well as being much better for blood sugar regulation. These simple bedtime tweaks may help alleviate your symptoms. Reducing your meal size can also be very impactful in reducing heartburn. Large meals expand the stomach, which can prevent the sphincter muscle from completely closing, resulting in acid reflux. Usually, people are advised to eat only until they are 75% full, which will allow the stomach to empty more quickly and reduce the risk of heartburn. Using smaller plates and bowls can make you feel more satisfied, despite the smaller portion you're consuming. I also have made a habit of keeping the food in the kitchen during meals, filling up the plates with reasonable portion sizes, and then requiring people to get up to get seconds rather than putting the food on the table. It usually takes about 20 minutes for your body to perceive fullness, so I also recommend waiting until 20 minutes are up before getting seconds, as what you perceive as hunger will pass if you just give it a few more minutes. Also, eating smaller meals every 3 to 4 hours throughout the day rather than a few large meals may alleviate heartburn and help you to avoid overeating. In addition, eating high-fiber foods that make you feel full lowers your risk of overeating. This includes whole grains like oatmeal, brown rice, and quinoa, as well as beans, lentils, root vegetables, and winter squashes. Vegetables like peas, carrots, asparagus, broccoli, Brussels sprouts, and green beans are also a great source of fiber, as well as most fruits. People suffering from heartburn often look for quick relief, typically reaching for antacids and over-the-counter medications like Alka-Seltzer, Maalox, Tums, or Rolaids to neutralize stomach acid. But there are natural home remedies that can offer the same relief without the risk of medications that may be taxing on the body. Drinking a glass of water can be a quick fix, as it will quickly dilute stomach acid. Milk is known to coat the stomach lining and protect it from acidic stomach contents. And a half teaspoon of baking soda in 4 ounces of warm water can also have a quick alkalizing effect. Try those home remedies next time you have heartburn instead of reaching for an antacid or potentially damaging over-the-counter medication. Most conventional doctors will recommend antacids for heartburn, over-the-counter medications that mix aluminum, magnesium, or calcium with hydroxide or bicarbonate ions to neutralize the acid in the stomach. Next-level treatments include histamine 2 blockers, which target histamine, a component of stomach acid, lowering stomach acid and cutting down on heartburn. Common H2 blockers are famotidine, which is Pepcid and Pepcid or Pepcid AC, cimetidine, which is Entagamet or Tagamet HB, and nizatidine. If those are unsuccessful, proton pump inhibitors are often prescribed to block the pumping of hydrogen ions into the stomach from the intestinal lining. Common PPIs are dexlansoprazole or Dexilant, lansoprazole or Prevacid, and omeprazole or Prilosec. Unfortunately, treating GERD with antacids, H2 blockers, and PPIs has been linked to adverse events like pneumonia, SIBO, or gastroenteritis. Short-term side effects of PPI include constipation, diarrhea, dizziness, dry mouth, headaches, fever, gas, abdominal pain, lightheadedness, itching, and rashes. However, long-term, they can lead to protein maldigestion as they inhibit stomach acid production from something like 65% to as much as 99%. As stomach acid is essential for breaking proteins into amino acids, this can lead to osteoporosis-related fractures, thrombocytopenia, which is low platelet count, iron deficiency, B12 deficiency, reduced absorption of other vitamins and minerals, rhabdomyolysis, or muscle breakdown and death, kidney damage, and dementia. The typical recommended course of PPIs is 2 weeks. I wouldn't worry too much about short-term PPI use, but some people do end up with gastroenteritis and even SIBO post-PPI use, so I'd recommend the probiotic L. reuteri DSM-17938 at the same time which is in Biogaia Protectus and Biogaia Gastris, the latter being a probiotic I often recommend for constipation as well. In a study of 128 children with GERD on PPIs, after 12 weeks of treatment, 56.2% of the children from the placebo group had SIBO versus only 6.2% of the children on the probiotics. If you can't find relief without PPIs and end up taking them longer term, I'd also recommend taking free-form amino acids like Designs for Health's Amino Acid Supreme or Pure Encapsulations Amino Replete each day to make sure you're getting enough of the building blocks of proteins, and periodically test your amino acid levels using a test like the Metabolomics+ or a simpler amino acid test. Helicobacter pylori, or H. pylori, an otherwise commensal bacteria present in the stomach, can become overgrown, especially following periods of chronic stress when gut immune defenses are down. When it overgrows, it can cause either high or low stomach acid depending on its location. It is often the root cause of GERD and heartburn. Whenever grown, it can also develop virulence factors that put you at an additional risk of stomach cancer or ulcers. But I found in testing clients that these virulence factors are relatively rare. There are tests done by gastroenterologists like urea breath tests for H. pylori, H. pylori stool antigen tests, and upper endoscopy exams, which usually include biopsies for H. pylori to diagnose it and esophageal pH tests, although the latter is harder to come by, to check if you have low or high stomach acid. I use stool tests including the GI-MAP and the US Biotech GI Advanced Profile to see if there is H. pylori, which I'm particularly suspicious of if there's stomach pain, often on an empty stomach, and constipation. Both tests include the virulence factors for H. pylori. So what's counterintuitive is that low stomach acid can manifest similar symptoms to excessive stomach acid. When the pH in the stomach gets too high or alkaline, this can trigger the opening of the lower esophageal sphincter. Often taking supplemental stomach acid in the form of betaine HCl or apple cider vinegar and water before meals helps resolve the issue. I've had a number of clients who had heartburn that was relieved when we addressed their low stomach acid this way. However, this is contraindicated if you have extreme burning or pain in your stomach or blood in your stool, which may be indicative of an ulcer. A good place to start is trying the betaine HCl challenge to test your stomach acid. To begin, take 1 capsule per meal alongside animal protein, usually sold in the 500 to 750 mg range. Gradually increase your dosage by 1 capsule per meal every 2 days until you experience heartburn or warm sensation in your stomach, up to a maximum of 5 capsules. Once you reach this point, reduce your dosage back to the previous amount. If you experience immediate burning, it could indicate an excess of stomach acid or a potential hiatal hernia or other problem. In such cases, you can alleviate the discomfort by taking an antacid or consuming baking soda and water to neutralize the acid. Another alternative to taking betaine HCl is 1 to 2 tablespoons of apple cider vinegar or lemon juice mixed in water prior to meals. If you've been diagnosed with Barrett's esophagus, esophageal strictures, or reflux esophagitis, it's not recommended to use these products. In such cases, it's advisable to opt for digestive enzymes that do not contain betaine HCl. However, if you still wish to try the betaine HCl approach, it's best to find a product that includes pepsin, an enzyme naturally produced by the cells in your stomach. I also like one that includes gentian bitters, which also helps promote bioflow. I'll provide links to reliable options for both betaine HCl with pepsin and gentian bitters and digestive enzymes in the show notes. However, with conventional medical practitioners, low stomach acid is rarely a consideration, but only high stomach acid, leading to a diagnosis of GERD and the prescription of PPIs, usually. If you have low stomach acid, PPIs or antacids may worsen GERD by hindering the adequate breakdown of foods, particularly protein, which requires HCl for digestion, and straining the enzymatic function of the pancreas and other digestive organs that are stimulated to release enzymes based on stomach acid levels. This could result in calcium, iron, B12, vitamin A deficiencies, resulting in heightened inflammation and intestinal harm, and protein deficiency, all of which contribute to additional health complications. Some people do in fact though have excess stomach acid and not low stomach acid. So if taking apple cider vinegar or betaine HCl creates immediate heartburn, then you may need a temporary course of antacids, H2 blockers, or PPIs while trying to get at the root cause of your problem. Ideally, PPIs should only be used as a treatment for a 14-day period, as prolonged use can lead to other problems, as I already mentioned. Ah, so that was a lot to absorb, so I'm going to stop there. If you have follow-up questions, a great place to ask them is in my Facebook group called Gut Healing. And if you're struggling with these issues or other health issues and need some help, that's what I do for my clients. I offer free 30-minute breakthrough sessions to talk about your issues and to see if gut health coaching might help you resolve them. You can set that up by going to the link in the show notes. If you'd like to support the podcast, you can buy supplements at a discount from my Fullscript dispensary, order tests at a discount from my Rupa Health Lab Store, or use my affiliate links to iHerb, which is available worldwide, Bulk Supplements, or Amazon, or become a regular supporter on Patreon. If you'd like to connect with me online, you can follow my High Desert Health Facebook page, join my Gut Healing Facebook group, or join my newsletter list at highdeserthealthcoaching.com, as well as follow me on Instagram, TikTok, X, or Pinterest. Links for those are in the show notes. Thanks for joining me today, and here's wishing you all the perfect stool.