How to Resolve Heartburn Issues: A “Root Cause” Approach & Holistic Strategies

Are you constantly battling heartburn or acid reflux type symptoms?

Are you only being given a “bandaid” – an acid reducing medication?

Do you want a root cause approach to reflux symptoms?

Reflux should be taken seriously. Always see a Doctor for medical evaluation and management, and in some cases medication will truly be needed and the best option.

In the same breath, I’ve heard for over a decade that patients leave their 8 minute appointment with an acid reducing medicine based off review of symptoms and often no further testing. Patients get so frustrated by this. People want (and deserve) ANSWERS, not just suppression without exploration.

What are common symptoms of acid reflux or heartburn according to Mayo clinic:

• A burning sensation in your chest (heartburn), usually after eating, which might be worse at night or while lying down
• Backwash (regurgitation) of food or sour liquid
• Upper abdominal or chest pain
• Trouble swallowing (dysphagia)
• Sensation of a lump in your throat

The traditional reponse to a patient reporting they have acid reflux/heartburn symptoms is:

• Antacids (like tums)
• H2 Blockers (medications like pepcid for immediate relief)
• PPIs (medications like omeprazole that work more long term)
• Told to avoid standard “GERD foods” like orange juice, chocolate, coffee, greasy foods, peppermint, tomatoes, and alcohol so the lower esophageal sphincter isn’t as loosened
• Sleep on an incline
• Don’t eat late in the evening
• Maybe just maybe a EGD or other testing is done

Are you chuckling over this standard/cliche approach? Most have heard this before. But it still doesn’t address WHERE and WHY there is reflux. It justs aims to suppress and move on. I agree – patients deserve relief and this list above can give relief but its dumping water on the fire while something is still pouring the gasoline.

So what contributes to acid reflux (the symptom being “heartburn”) in the first place?

Short answer: it’s usually not the body making too much stomach acid but rather acid in the wrong direction (and a few other culprits too)

• Underlying SIBO (small intestinal bacterial overgrowth – causing gas which pushes up opening the lower esophageal sphincter and acid “can come up”)
• Underlying H. pylori overgrowth
• Underlying EoE (eosinophilic esophagitis)
• Hiatal hernia
• Slowed gut motility and/or a weak MMC- migrating motor complex – eating too often and not getting good stomach cleansing waves to “move the food through well”
• Obesity/visceral adiposity pushing up on the lower esphageal sphincter again causing acid to go up
• Low stomach acid (surprising I know – but then food doesn’t get broken down well and can cause excess fermentation causing gas and indigestion pushing upwards)
• Low zinc and/or vitamin b12 – which can lead to low stomach acid
• Smoking
• Living in clinically significant levels of toxic indoor mold

Why not address these root causes instead (when applicable). Do the following if they apply to you:

• Lose weight to reduce pressure on lower esophageal sphincter
• Find H. pylori and eradicate (I order lots of GIMAPs and can help with this)
• Improve gastric emptying/support your body’s migrating motor complex by not grazing all day
  • Sometimes prokinetics are needed – either OTC or prescription
• Find and correct nutrient deficiencies that help make stomach acid like vitamin b12 and zinc
  • You can self order b12 labs and zinc labs here and have drawn at any Quest
• Improve stress management to support healthy stomach acid production and proper digestion
• Find and eradicate SIBO (and the root causes of SIBO)
• Stop smoking
• Explore candidacy of surgical procedures with your Doctor as sometimes structural issues are best dealt with via surgery
• Test your home with an ERMI Kit 1, which is a simple at home dust test. If the score is 5 or higher, they are health hazardous levels of mold in the home that can cause or worsen established health problems

I am very “test, don’t guess” focused when it comes to my approach with patients and my nutritional evaluation. I do what I can to help guide the patient in their efforts to have a “smooth assembly line” when it comes to the function of their GI tract. This ultimately helps with reducing acid reflux/heartburn, and in turn there is better quality of life and reduces risk of damage to esophagus in the long run. Typically a person doesn’t need medication in my experience but to find and deal with the root issue that is driving the symptom. I still recommend medical evaluation but if you aren’t getting answers within the conventional healthcare system, consider looking at your body via the lens of functional health.

It is possible to not only suppress reflux but to aim to resolve it (when feasible).

Self schedule a consult package today for one on one help.

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