Feel the Burn?

By Parul Kharod

Stomach Acid

To understand acidity, let's understand what this acid is and why we have it. Our stomach makes hydrochloric acid (HCl) and other enzymes that are important for digestion. Approximately two liters of HCl is produced daily. Hydrochloric acid helps your body to break down, digest, and absorb nutrients. It also eliminates bacteria and viruses in the stomach, protecting your body from infection. The most important thing to understand is that we need that stomach acid!

GERD/Acid Reflux/Heartburn

GERD stands for Gastroesophageal Reflux Disease, and it affects approximately 20 percent of the population. GERD, acid reflux and heartburn are terms used interchangeably but they have slightly different meanings.

Acid reflux is the backward flow of acid from the stomach back into the esophagus and throat.

• Heartburn is a symptom of acid reflux. During an episode of acid reflux, you might feel a burning sensation in your chest.
• GERD is the chronic, more severe form of acid reflux, which may cause frequent heartburn —two or more times a week. You may not always experience heartburn when you have GERD.

Common GERD symptoms:

Heartburn
Difficulty swallowing
Excessive salivation
Regurgitation
Gas and bloating
Pain or discomfort in the chest
Intolerance of certain foods and liquids
Bad breath or a sour taste in the mouth

Atypical or other less common GERD symptoms:

Hoarseness or laryngitis
Frequent swallowing
Asthma or asthma-like symptoms
Excessive clearing of the throat
Chronic dry, irritated, or sore throat
Persistent cough
Burning in the mouth or throat (acid taste in the mouth)
Teeth and gum disease or inflammation
Discomfort in the ears and nose
Trouble sleeping

Causes

There is no known single cause of GERD. Reflux can be caused by poor clearance of food or acid from the esophagus, too much acid in the stomach, or delayed stomach emptying.

Acid Blocking Medications

Many chronic heartburn sufferers turn to antacids or other medications for relief. Some medications, known as Proton Pump Inhibitors (PPIs), work to reduce the amount of acid in the stomach. These medications treat the symptoms of GERD but not the disease.

PPIs are overprescribed and although long-term use of PPIs daily may reduce or eliminate symptoms, they do not stop the flow of stomach contents into the esophagus. Consequently, GERD can progress and potentially lead to complications such as Barrett's esophagus or esophageal cancer.

PPIs also seriously impact the composition of intestinal bacteria. When the quantity of beneficial bacteria is reduced in the gut, there is an opportunity for pathogenic bacteria to grow. Numerous research studies have shown that chronic PPI users had less gut bacterial diversity, making them more prone to intestinal infections.

Chronic use of acid blockers can cause Achlorhydria (no acid) or Hypochlorhydria (low acid). These conditions can cause damage to the gastrointestinal (GI) system, increased infections, and a number of chronic health issues such as Thyroid disorders and anemia.

Ayurvedic Principles of Digestion

According to Ayurveda, the root of all diseases lies within the digestive tract. The strength and weaknesses of digestion are dependent upon the power of Agni (fire). Agni is present within saliva, stomach acids, bile, and enzymes of the pancreatic and small intestine. When there is Sama Agni, everything is in balance. The digestive fire is strong, and supports a healthy appetite, optimal digestion, energy, satiety, and overall health.

When Agni is slow (Manda Agni), there are symptoms such as low appetite, slow digestion, heaviness in the stomach, acid reflux, and irregular bowel movements. When there is Tikshna Agni, there are symptoms such as large appetite, low blood sugar, hyperacidity, gastric or bile reflux and inflammatory digestive disorders. Vishama Agni is when things are haphazard. Sometimes there may be good digestion and sometimes there may be symptoms such as gas, bloating, abdominal discomfort, constipation and lower bowel disorders. Another traditional classification of indigestion is known as Ajirna where the normal state of Agni is disturbed, and can lead to a negative effect on physical and emotional health.

Digestive Imbalance may be caused by:

Eating or drinking too much, too little or the wrong types of foods for our constitutional needs
Eating on the go
Erratic meal times
Not chewing food well
Eating too late at night or too close to bedtime
Drinking too much liquid at or close to mealtimes

Steps for optimal digestion

• Eat small and balanced meals at regular intervals
• Do not skip meals or have long gaps between meals
• Have a routine for eating and sleeping
• Do not eat too late at night – eat dinner before 8 pm
• Make a habit of drinking water regularly throughout the day. Take small sips and do not gulp
• Do not lie down after eating
• Avoid vigorous exercise soon after eating
• Eat a wide variety of plant foods to get enough fiber – whole grains, pulses/legumes, nuts, seeds, fruits, and plenty of vegetables
• Avoid smoking and alcohol
• Avoid overuse of medications

Foods to Limit/Avoid:

• High-fat foods (fast food, fried foods, processed meats, cream, cheese, whole milk, heavy desserts)
• Concentrated tomato products (pasta sauce, tomato paste, tomato juice)
• Coffee and tea (in excess amounts and/or on an empty stomach)
• Orange juice
• Carbonated beverages
• Excess animal proteins
• Simple starches and sugars

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Parul Kharod, MS, RD, LDN is a registered dietitian and licensed nutritionist and works as a Clinical Dietitian with Outpatient Nutrition Services at WakeMed Hospital in Cary and Raleigh. She can be reached at parulkharod@gmail.com