Posts filed under Digestion

Hidden Causes of Acid Reflux: End it for good (Part 2)

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Last week we discussed how low stomach acid, dehydration and gut overgrowths/carbohydrate malabsorption contribute to acid reflux/GERD symptoms. This week we will continue the conversation and explain ways in which how we eat also contribute to these medical complaints.

  • Stress

Stress reduces gastric acid production and impairs GI motility. Can you recall what your body senses are when you eat during a state of anxiety or stress? Most people report such symptoms of heartburn, cramping, gas, digestive pains, belching, intense hunger and minimal satisfaction from the meal. During stress, the body automatically shifts into the classic fight-or-flight response. Blood flow is rerouted away from the intestines and go to the head for quick thinking and limbs for fast movement and the power to fight. Most importantly, the digestive system shuts down. Biologically, you don't need to waste energy digesting food when you’re fighting for survival. This feature of the central nervous system is a brilliant safety mechanism that supported us during life-threatening events - confronting hostile attackers, experiencing natural disasters and quickly evading or forcibly overcoming anyone or anything. 

However, in our modern-day world characterized by 24/7 stress, lowered gastric acid production can make heartburn a chronic condition. You can even eat the healthiest meal on earth, but if you eat it in an anxious state, your digestion is dramatically diminished. A chronic insufficiency of gastric acid allows a larger quantity of ingested bacteria to pass through the stomach unchallenged and enter the small intestine, where they can proliferate, causing gas and heartburn. Another problem is impaired GI motility allows food to stagnate in the small intestine, where it creates a breeding ground for bacterial overgrowth and again, gas and acid reflux/GERD. Stress is a 2-fold problem!

What We Do: We help clients shift away from the fight-or-flight response (sympathetic nervous system dominance), and activate the parasympathetic nervous system or rest-digest-detox-repair mode. We help them assess where in their life they are experiencing stress and set goals to mitigate it. For example - if stress is work related, can you make time to take a 5 minute walk outside or do 60 seconds of belly breathing (one of the quickest ways to activate relaxation)? If you feel overwhelmed by your to-do list, write out your top 3-5 things you want to accomplish each day. If rush hour makes you mad, is there a scenic back road you can meander through instead of being bumper-to-bumper on the highway? Or maybe you can explore podcasts that make you lose track of time. These are just a few examples on what some of our clients have found work for them. 

However, one of the best places to start is to start relaxing around meal time. Relaxing around the meal is a great way to ensure better digestion. Increase your meal time by 5 minute increments and work your way up to spending 20 minutes with each meal. Instead of eating on the couch watching a suspenseful show or depressing news, move to the dining table with your loved one and catch up. Opt for outside instead of eating at your work desk. Use gentle, fuller breathing as a natural pause during meals. Deep breathe 3 times at each pause.

 

  • Falling Asleep at the Plate/Distracted Eating

When is the last time you ate a meal and don't remember tasting your food? Digestion begins in the mind. Cephalic phase digestive response, “CPDR” (cephalic means “of the head”) describes the pleasures of taste, aroma, satisfaction and visual stimulation of a meal. As much at 30-40% of the total digestive response to any meal is due to cephalic phase digestive response - our full awareness of what we are eating. 
 

Digestion quite literally begins in the head as chemical and mechanical receptors on the tongue and the oral and nasal cavities are stimulated by smelling food, tasting it, chewing it and noticing it. A hearty awareness of our meal initiates the secretion of saliva, gastric acid and enzymes, gut-associated neuropeptides and production of the full range of pancreatic enzymes, including trypsin, chymotrypsin, pancreatic amylase and lipase. It also causes the blood to rush to the digestive organs, the stomach and intestines to rhythmically contract and electrolyte concentrations throughout the digestive tract to shift in preparation for incoming food. If you “fall asleep at the plate” then we are metabolizing the meal at only 60-70% efficiency and we can overeat, contributing to heartburn. 

What We Do: Our clients work on developing a sense of awareness around meals; instead of eating until they are stuffed, we teach them how to eat to the point of energy.  The yogis of ancient India described a special point in any meal whereupon, if you stopped eating at that time, you’d walk away from the table with more prana - more energy or life force- than when you sat down. Finding this “point of energy” takes some experimentation. Ask your gut: “How do I feel? How is my energy level? Do I still feel light? Am I starting to feel heavy?” Estimate the point at which you feel filled with energy yet not filled with food. Your belly will feel light; you’ll feel slightly “up”; you will still be a little hungry yet you’ll translate that hunger and desire for more food into the next thing you do after your meal. Conversely, when you eat even one bite past the point of energy, you’ll start to feel heavier.
 

We can help you with your heartburn or other digestive concerns.

Posted on September 25, 2018 and filed under Digestion.

Hidden Causes of Acid Reflux: End it for good (Part 1)

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In this two part series, I will discuss our holistic approach to addressing the root causes of GERD/acid reflux which are missed by the current medical care model.

Occurrence of GERD/Acid Reflux

2 in 5 Americans experience acid reflux symptoms and the proton pump inhibitor (PPI), Nexium, is the 4th most commonly prescribed acid reflux drug with 15.9 million people taking it. Mind you, this doesn't include those taking over-the-counter antacids on a regular basis which is millions of more people!

Studies suggest that up to 70 percent of PPI use may not be necessary (😳). Further, Nexium should only be given for 4 to 8 weeks only, but most people are on it for months or even years, which can lead to a whole host of other GI related problems and nutrient deficiencies down the road.

Common Causes + Risk Factors of GERD/Acid Reflux

Talk to a medical professional or search the internet and you will find that the common causes are laid out as such:

  • Obesity

  • Bulging of the top of the stomach up into the diaphragm (hiatal hernia)

  • Pregnancy

  • Connective tissue disorders, such as scleroderma

  • Delayed stomach emptying

Factors that can aggravate acid reflux include:

  • Smoking

  • Eating large meals or eating late at night

  • Eating certain foods (triggers) such as fatty or fried foods

  • Drinking certain beverages, such as alcohol or coffee

  • Taking certain medications, such as aspirin


However, at Thrive Nutrition we work with clients who have addressed these causes and still experience GERD/acid reflux. What is conventional treatment missing?


Some Hidden Causes of GERD/Acid Reflux

  • Low Stomach Acid

Yes, you read that right. If you ask the average Joe on the street what causes heartburn, he’ll tell you “too much stomach acid.” That’s what most of the ads seem to suggest too. But there’s a big problem with this theory: the incidence of heartburn and GERD increases with age, while stomach acid levels generally decline with age. Numerous studies have shown this and in one study researchers found that over 30 percent of men and women past the age of 60 suffer from atrophic gastritis, a condition marked by little to no acid secretion. Another study found that 40% of women over the age of 80 produce no stomach acid at all.

Just as studies show acid secretion declines with age, it is also well established in the scientific literature that the risk of GERD increases with age. If heartburn were caused by too much stomach acid, we’d have a bunch of teenagers popping Rolaids instead of elderly folks. But of course that’s the opposite of what we see. In fact, according to Jonathan Wright, MD of the Tahoma Clinic in Washington state, when stomach acid is measured in people suffering from heartburn and GERD it is almost always low, not high.

Antacids and PPIs provide relief because they neutralize your stomach acid. Too often western medicine focuses on suppressing symptoms without paying attention to what is causing the symptom in the first place. The misguidedness of this approach is clearly demonstrated by the use of acid inhibiting drugs to treat heartburn and GERD – problems which are caused by not enough stomach acid!

What We Do: We help clients determine if they have low stomach acid levels with a simple at home baking soda test and follow up dietary and supplemental support as necessary such as betaine HCL, fermented foods, digestive bitters and/or apple cider vinegar.
 

  • Dehydration

Though digestion requires plentiful amounts water, our body needs water for numerous other bodily processes which makes it even more important to stay hydrated. Your body uses water in all its cells and in between cells, it hydrates your nose, throat and lungs, cushions joints, contributes to spinal fluid, is used to help regulate temperature and helps eliminate waste through urination, breathing (exhaling), bulking stool and sweating.

The stomach relies on mucus lining the walls to shield it from the effects of the stomach's hydrochloric acid. A bicarbonate solution is produced from the cells in the lining which neutralizes any acid attempting to break through the mucus. Water is needed to maintain this effective defense system. Too little water, and the mucus barrier is ineffectual, the acid will penetrate and will lead to pain. Ideally, water should be consumed half an hour before a meal, in time to anticipate the production of digestive acid from glands in the stomach wall.

What We Do: We assist clients with setting goals to increase their water intake to half of their body weight in ounces over time. Goals include having clients purchase insulated stainless steel water bottles, drinking 8-16 ounces upon waking by keeping water by the bed, drinking a glass while lunch is being microwaved, etc. A good way to tell if you're well hydrated is that you can eat a meal without an strong urge to drink something. However, it is important to note that our body is extremely adaptable so you may not be thirsty, even if you are dehydrated. Urine color is an objective way to see your hydration status. Very faint yellow or clear is what you're aiming for.
 

  • Carbohydrate Malabsorption/Gut Overgrowths

It is well accepted in the literature that GERD is caused by an increase in intra-abdominal pressure (IAP). Acid reflux occurs when pressure causes gastric distention (stomach bloating) that pushes the stomach contents, including acid, through the LES into the esophagus. According to current thought, factors contributing to this include overeating, obesity, bending over after eating, lying down after eating, and consuming spicy or fatty foods. In his excellent book, Heartburn Cured, microbiologist Dr. Norm Robillard argues that carbohydrate malabsorption leads to bacterial overgrowth, resulting in IAP (gas) which drives reflux. Low stomach acid can contribute to both bacterial overgrowth (independently of carbohydrate intake) and carbohydrate malabsorption. 

At a pH of 3 or less (the normal pH of the stomach), most bacteria can’t survive for more than 15 minutes. But when stomach acid is insufficient and the pH of the stomach rises above 5, bacteria  and other microorganisms begin to thrive. Pathogens in food can easily survive in a stomach treated with PPIs and antacids. At Thrive, at lot of our gut health clients who have been on PPIs tell us IBS symptoms (carbohydrate intolerances, gas, bloating) started after taking them; an indicator of small intestinal bacterial overgrowth.

What We Do: We find bacterial, yeast, parasitic and viral overgrowths with a stool test and we work hard to resolve the overgrowths and restore good gut ecology. We utilize diets like Paleo, low-carb and the Specific Carbohydrate Diet when necessary (2-3 months on average) in addition to herbal antimicrobials and probiotics.

Posted on September 18, 2018 and filed under Digestion.