Heartburn is a common symptom that is often caused by gastroesophageal reflux disease (GERD). GERD is essentially the medical term for “stomach acid improperly rising into the esophagus”, which ultimately causes a burning sensation. This uncomfortable feeling of heartburn is one of the most common reasons for a visit to the doctor. In fact, approximately 30% of those in the United States reported experiencing heartburn on either a weekly or monthly basis and this number increases to over 50% in pregnancy.
There are many reasons to account for heartburn being so commonplace in North America, almost all of which are diet and lifestyle related. Major risk factors for GERD include: obesity, smoking, high intake of fatty foods, low intake of fruits and vegetables, lack of exercise and chronic stress. In other words, the same things that make you sick, tired, overweight and at higher risk for disease also give you heartburn!
With this in mind, it should come as no surprise that diet and lifestyle modifications are often the most important treatment considerations for heartburn. Try these suggestions:
- Eat small frequent meals instead of few large meals
- Do not lie down after eating for at least 3 hours
- Fully chew your food before swallowing (minimum 20-30 chews per bite)
- Avoid known food sensitivities or consider a trial of reduced/eliminated wheat and dairy
- Avoid known food triggers, with the most common being: coffee, alcohol, chocolate, tomatoes, mint, onions, spicy foods and citrus foods
- Sleep on your left side to prevent positioning the stomach into an acid-reflux promoting position
- Avoid straining on the toilet or lifting heavy items as these can cause or aggravate hiatal hernias (which leads to heartburn)
Most of these aforementioned suggestions help to maintain proper esophageal sphincter function. This is important because the esophageal sphincter is responsible for closing the connection between stomach and esophagus, thereby preventing reflux of stomach contents upward! Despite popular belief, heartburn is not exclusively caused by excess stomach acid. You may have too much or too little acid, but in each case, it is finding its way into your esophagus where it shouldn’t be. You need to heal the stomach, the esophagus and the sphincter.
It is also worth mentioning that certain drugs can irritate the esophagus and/or weaken your esophageal sphincter. Among these include blood pressure medications (beta-blockers and calcium channel blockers), pain medications (aspirin and tylenol) and asthma medications (bronchodilators). While these medications may be necessary for your optimal health, aggravation of heartburn might be a reason to speak with doctor about potential alternatives.
What about natural health ingredients? There are multiple natural health ingredients that can promote the healing of the stomach and esophagus (see Dr Hrkals latest article: Natural Ways to Heal your Digestive Tract). Many people have heard of Deglycyrrhizinated Licorice (DGL) or similar herbs to aid with heartburn, but less are familiar with the healing action of melatonin.
Although many think of melatonin as a sleep aid, it is also found in high amounts in the digestive tract and it is quite useful in healing damaged gastrointestional tissue. Melatonin has been shown to stimulate gastrin secretion, which is important for signaling the esophageal sphincter to close. One study compared 3mg of melatonin, omeprazole (a proton pump inhibitor drug used to treat GERD) and placebo. While omeprazole was most effective at reducing symptoms, melatonin was still more effective vs. placebo. Moreover, the melatonin group had improvements in esophageal sphincter function while the omeprazole did not! This is important because it implies that the root cause of heartburn is being addressed via melatonin.
Speak with your Integrative Healthcare Practitioner if you are interested in using melatonin for any reason to ensure its safe and effective use.
Let me know which suggestions have worked or do not work for you, ask a question or leave a comment below!
Yarnell, Eric. Natural Approaches to Gastroenterology. Second ed. East Wenatchee, WA: Healing Mountain Publishing, 2011.
Kandil TS, Mousa AA, El-Gendy AA, Abbas AM. The potential therapeutic effect of melatonin in Gastro-Esophageal Reflux Disease. BMC Gastroenterol. 2010;10:7.
Patrick L. Gastroesophageal reflux disease (GERD): a review of conventional and alternative treatments. Altern Med Rev. 2011;16(2):116-33. Review.