The What and Why of Heartburn
Heartache makes for good poetry, heartburn not so much. – Sean Anthony Tarr
According to the American College of Gastroenterology, “More than 60 million Americans experience heartburn at least once a month and some studies have suggested that more than 15 million Americans experience heartburn symptoms each day.”1 That means almost 1 in 5 Americans suffer from heartburn on a monthly basis! Knowing what heartburn is and its causes can be your first step toward relief.
What IS Heartburn?
Heartburn may feel like a burning heart, but in reality the burning sensation is neither in the heart, nor even in the stomach. The searing pain comes from the esophagus. It is the structure and function (or malfunction) of the gastrointestinal tract that makes heartburn possible.
Once food enters the stomach from the esophagus, the food gets churned and broken down into tiny particles before moving on to the small intestine for absorption. Part of the digestive process in the stomach is producing gastric acid to breakdown proteins. Because the stomach secretes this very acidic gastric juice, it also produces a very thick mucus lining to protect itself. The esophagus, however, does not have a protective mucus lining. The esophagus is meant to only transport food stuff from the mouth to the stomach. So when acidic gastric juices make their way up into the esophagus, the delicate lining becomes burned by the acidity and heartburn ensues.
What CAUSES Heartburn?
Despite popular belief, heartburn from too much stomach acid, a condition called Zollinger-Ellison Syndrome, is one of the least common causes of heartburn. The most common causes of heartburn include:
Low stomach acid causing a weakened lower esophageal sphincter
Insufficient digestive enzymes
Bacterial infection, such as H. pylori
Candida yeast overgrowth
Food sensitivities
Hiatus hernia
Poor food choices such as highly processed foods and excessive sugars and refined carbohydrates
Bad habits such as eating too quickly, consuming large meals, having dinner too close to bedtime, eating under stress and smoking.2
Let’s discuss the first two common causes.
Weakened Connection Between the Esophagus and Stomach
Studies indicate that in a majority of cases heartburn is not caused by excessive stomach acid, but rather from a weakened lower esophageal sphincter (LES).3 The LES is the entryway from the esophagus into the stomach. When it is strong, it opens long enough to move food from the esophagus to the stomach, then closes to prevent regurgitation. But, when the LES is weak, contents of the stomach, including gastric acid, can easily enter the esophagus causing heartburn.
How does this sphincter become weak? From too low stomach acid levels! Adequate stomach acid levels trigger the LES to remain closed until food needs to move from the esophagus into the stomach. If stomach acid is low, the LES remains relaxed in between meals allowing for heartburn symptoms.
You may have low stomach acid, called hypochlorhydria, if you have any of the following symptoms: anemia, asthma, autoimmune disease, belching, gas and bloating, Candida overgrowth, Celiac disease, constipation, diarrhea, fatigue, food sensitivities, gallbladder disease, heartburn after meals, feeling of food sitting in stomach, inability to eat large meals, weak or brittle nails, macular degeneration, nausea after taking supplements, osteoporosis, skin conditions like acne or eczema, dry skin, ulcerative colitis, and more.
Inadequate Digestive Enzymes
Enzymes are needed for every function in the body, including digesting, absorbing and utilizing the foods you consume. If you do not have adequate enzymes to digest your food, meals sit in your stomach for much longer than necessary. This not only creates digestive symptoms such as gas, bloating and constipation, it also creates upward pressure on the LES. This can force it to open, allowing stomach acid to bubble up into the esophagus, causing heartburn.
You may have insufficient digestive enzymes if you have any of the following symptoms: food sensitivities, dry skin, rash, floating stools, undigested food in stool, gas and bloating, irritable bowels, heartburn, malabsorption of nutrients, depression, hormonal swings and muscle weakness.
Check with Your Doctor to Rule out Other Potential Causes
You should always speak with your doctor first to rule out potential H. pylori infection, Candida overgrowth, hiatus hernia, Zollinger-Ellison syndrome, ulcer, gallbladder disease, gastritis, pancreatitis, food allergies, leaky gut and stomach cancer before self-treating for heartburn. Over-the-counter acid blockers can mask symptoms of a more serious condition.
Next up, we’ll discuss the importance of stomach acid in the proper functioning of body and mind!
RESOURCES:
1 http://patients.gi.org/topics/acid-reflux/
2 Natural Alternatives to Nexium, Maalox, Tagamet, Prilosec & Other Acid Blockers, Martie Whittekin, CCN
3 Scand J Gastroenterol Suppl 206: 14–19, 1994
Photo courtesy of: https://www.youtube.com/watch?v=AB5t3dc8AG0