Sunday, January 9, 2011

Heartburn Explained

Heartburn is an interesting issue in natural medicine. 45 million prescriptions for Prilosec (omeprazole) were written last year, making the “Purple Pill” the 11th most popular prescription drug in the United States. My thousands of hours in human physiology, pathology, and nutrition give me a unique perspective from that of western medicine when it comes to heartburn or GERD. Please let me explain.

Your body’s digestive symptom is a complex machine. Similar to the engine in your car, each of the parts of your digestive system has a specific function and a dysfunction in one part can effect other related areas. The process of digestion begins in your mouth with chewing and salivary enzymes. The next part of digestion is gastric digestion in the stomach. The stomach slowly churns your food and mixes the food with stomach acid. The pH (acid level) of the stomach normally is 1.5 to 3.5 (VERY acidic). It is this strong acid that allows the food to be broken down. When your food leaves the stomach it is “squirted” into the small intestine as chyme, a substance resembling a milkshake.

A complex system that should not be short-circuited.
Take a moment to think how much you chew your food. For most people it’s not much. So the large chunks of meat, veggies, bread, etc rely on the stomach’s gentle massage and strong acid to turn your pieces of food into a milkshake. (Note: your stomach doesn’t have any teeth for further breaking up food, so make sure to chew your food thoroughly.)

Let’s contrast someone who has a proper, very acidic stomach to someone who is on antacids. The very acid stomach digests the food from the mouth properly and releases a milkshake consistency of chyme into the small intestine for proper digestion. The 20-25 feet of small and large intestine can them digest the food they ate properly. Proper digestion means you get the nutrients from your food (more about this later), don’t have gas and bloating, no burping, and your bowel movements are regular and of good consistency.

Contrast that to the person on antacid medication who purposefully decreases the pH of their stomach contents with each meal. The food is not properly digested in the stomach, due to lack of stomach acid, and therefore the chyme includes chunks of meat and other food products. These chunks cannot be properly digested in the small and large intestines and therefore they putrefy, giving off gas and being used by “harmful” bacteria as fuel. Additionally, some of the nutrients from that food is “bound up” and unavailable to be assimilated into the blood.

In summary, if you don’t have an acidic stomach you cannot digest your food properly. And each step of digestion after the stomach is short circuited. This includes the normal digestion that should occur in the duodenum, jejunum, ileum, and all four parts of your large intestine (colon). So why would western medicine prescribe heartburn medication to 1 out of every 5 patients? Because the patients are complaining of heartburn. Right? Yes.

But what is the cause of the sensation of heartburn? There can be a few very common causes that are rapidly and easily solved by natural medicine. Many times a patient complaining of heartburn AFTER meals has TOO LITTLE stomach acid and the sphincter at the top of the stomach (which is triggered by an acidic pH) that is supposed to close when the stomach is digesting the meal doesn’t close fully. Therefore, when the stomach starts churning some of the stomach contents can go up into the esophagus and cause discomfort. We find that if we give these patients a supplement containing HCl, naturally derived stomach acid, their heartburn symptoms go away immediately. And as a side effect they note that their overall digestion improves. A patient with heartburn symptoms BETWEEN meals or at night when sleeping is a different problem, and this is treated using natural supplements to help heal the stomach lining and remove harmful bacteria. Other causes of heartburn AFTER meals can include too large of meals, drinking too much liquids with meals, hiatal hernia (which can many times be corrected with a simple chiropractic adjustment in our office), and occasionally food sensitivities/allergies.

I hope that you will conclude from the above discussion that digestion is a complex issue, but that covering up the symptom of heartburn with a medication is short sighted and leads to needless complications. Recently two major studies have linked antacid usage with an increased risk of osteoporosis and deadly gastrointestinal infections. While western medicine might have been surprised by these findings we have been telling our patients of these side effects for years. Here’s why: Calcium can only be absorbed in an acid intestinal environment (along with many other minerals) and thus the increase of osteoporosis in patients on antacids. And your stomach acts as a important disinfecting area for food you put into your body. The strong acid of the stomach helps to kill bacteria, parasites, and viruses that we all unknowingly ingest. Without the protective barrier of an acid stomach you have significantly weakened your immune system.

If you are having heartburn, or other digestive issue, we would love the opportunity to diagnose the cause of your symptoms and help you find a sensible natural solution. At Positive Motion in Los Gatos, Dr. Brant Pedersen (DC), routinely works with patients suffering from heartburn to help them get healthy and feel better. Good digestion is fundamental to great health and we can help you improve yours.

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