Heartburn is a common symptom of acid reflux. Many of us have experienced this at some stage in our lives. It is unpleasant and can be best described as that burning sensation we get in our chest after eating. For some of us, it passes. However, for others it lingers and the only thing that seems to relive that unbearable burning sensation is medication such as antacids, H2 blockers and proton pump inhibitors (PPI's). More on this later.
Common causes of heartburn / acid reflux
Gastro-oesophageal Reflux Disease (GORD), a chronic condition causing inflammation and damage to the lining of the oesophagus (diagnosed by your GP)
Oesophageal sphincter issues (poor muscle contraction)
A diet high in ultra processed foods, refined carbohydrates, junk food, etc.
Excessive alcohol consumption
Food sensitivities such as wheat or dairy
Gluten intolerance or sensitivity
Nutrient deficiencies (most commonly zinc and/or magnesium)
Stress
Pregnancy (structural issues – baby pushing up on the diaphragm)
Being overweight or obese (puts pressure on the diaphragm)
Bacterial infections (commonly Helicobacter pylori infection)
Hypochlorhydria (low stomach acid)
Certain medications
Skipping meals and then overeating (a common habit I see in my clients)
That is a somewhat extensive list. So, where do you begin? A good place to start is with dietary and lifestyle changes. However, if symptoms persist (or have for some time), please make an appointment to see your doctor. Untreated acid reflux can cause significant damage to your oesophagus.
Dietary and lifestyle tips to reduce reflux/heartburn include:
Consume less acid forming foods such as caffeine, sugar, refined carbohydrates, chilli, chocolate, red meat
Avoid foods that you know aggravate you (as per above). If you need guidance, I am happy to assist. Click here to book an appointment.
Limit or significantly reduce processed and ultra processed foods
Avoid or minimise consumption of alcohol and carbonated drinks
Eat smaller meals throughout the day
Avoid eating 2-3 hours before bedtime
Avoid smoking (has an impact of the oesophageal sphincter)
Caution with peppermint (relaxes the oesophageal sphincter often worsening symptoms).
Switching to a Mediterranean style diet & lifestyle which focuses on the consumption of vegetables, fruits, wholegrains, legumes, nuts, seeds, healthy fats and quality protein such as fish, eggs, lean meat and regular exercise can work wonders.
So, what’s the issue with some over the counter medications and prescription medications to treat heartburn / acid reflux?
Proton pump inhibitors (PPI’s) are some of the most prescribed medications on the market and are the most effective in reducing gastric acid secretions. The medications commonly used in Australia include omeprazole (Prilosec) and esomeprazole (Nexium).
However, PPI’s work by suppressing the production of hydrochloric acid in the stomach and ideally, should not be taken for long periods of time. Why is this an issue long term? We need adequate amounts of hydrochloric acid not only to facilitate digestion and protect us from harmful bacteria but to also absorb nutrients such as B12. Other nutrients at risk of depletion/malabsorption include calcium, iron, magnesium, & vitamin C. Therefore, long term use and dependence on PPI’s can be quite problematic.
Always speak to you doctor before stopping medication. Some chronic health conditions require long term use of PPI’s. For others, dietary and lifestyle tweaks can make all the difference. Please seek guidance and advice from a health professional.
How can investing in a nutritionist help?
As a clinical nutritionist, I can assist you in identifying and rectifying any dietary and lifestyle triggers, implement strategies to support your digestive health and correct any potential nutritional deficiencies. Click here to book your appointment today.
