Saturday, January 19, 2013

Heartburn Heartache

By Dr. Iva Lloyd, BScH, BCPP, ND

Heartburn, or gastroesophageal reflux disease, is common after the holidays.  The most common symptom of heartburn is burning pain in the upper abdomen or chest that is worse with bending or stooping, lying down or eating. It can also manifest as gas and bloating, belching, nausea or vomiting, bitter taste in the mouth, coughing, difficulty swallowing, hiccups, hoarseness or sore throat.

For some the symptoms of heartburn mimic the symptoms of a heart attack, if you are unsure at all, seek medical care.

There are many factors that contribute to heartburn including:

  • certain foods lower esophageal sphincter tone and can irritate the esophagus including: alcohol, spicy and fatty foods, chocolate, citrus foods and juices, coffee and carbonated drinks.
  • food allergies and food sensitivities can trigger or aggravate the symptoms.
  • eating large meals or eating too close to going to bed increases the chance of heartburn.
  • dehydration and heartburn tend to go hand-in-hand.
  • improper breathing and chest breathing is associated with an increased risk of GERD.
  • for many people heartburn is triggered due to increased levels of stress or specific types of stress.
  • H. pylori infection can cause heartburn.
  • smoking cigarettes reduces lower esophageal sphincter tone, prolongs acid clearance and has been related to increased numbers of reflux events.
  • medications can initiate or exacerbate GERD symptoms: Anticholinergics, Beta-blockers, Bronchodilators, Calcium channel blockers, Dopamine-active drugs, Progestin, Sedatives, Tricyclic antidepressants.
  • Obesity, pregnancy, asthma, ulcers and other conditions are associated with heartburn.

If you suffer from heartburn it is important to first identify the factor(s) that are contributing. If your heartburn is severe or chronic it is important to work with a naturopathic doctor to determine the best therapeutic approach.

General guidelines for acute heartburn include:

  1. Address the dietary factors that are triggering or aggravating the symptoms.
  2. Relax while consuming food: always sit down, eat meals slowly and deliberately, avoid doing other activities simultaneously.
  3. Eat smaller, more frequent meals with low fat content.
  4. Increase dietary fiber intake.
  5. Ensure you drink adequate water, but not while eating.
  6. Engage in regular exercise or movement
  7. Address any postural issues. Standing and sitting up straight provides from more room in the abdomen.
  8. Learn how to breath into the abdomen and back versus into the chest.

Naturopathic medicines are effective in the management and treatment of heartburn. 

  • Liquid calcium magnesium can be used in place of antacids. It coats the esophagus which decreases the acute symptoms of heartburn.
  • Some supplements work by neutralizing the stomach acid with a base such as sodium bicarbonate, others, such as glutamine, work by soothing the mucous membranes and healing the damage caused by the stomach acid.
  • Herbs are effective in healing the lining of the esophagus, addressing inflammation and treating conditions such as h. pylori. Common herbs used in the treatment of heartburn include: Marshmallow root (''Althea officinalis''), Slippery Elm (''Ulmus rubra''), Chamomile (''Matricaria recutita''), Ginger (''Zingiber officinale'')
  • Herbs are also used to manage stress and to decrease the occurrence of heartburn due to stress.
  • Homeopathics can be helpful in the treatment of both acute and chronic heartburn.
  • From a Chinese perspective heartburn is due to stagnation in the body. Acupuncture is effective in clearing stagnation.
For most people heartburn can effectively be treated by addressing the causal factors and using natural therapies. Prescription medication for heartburn may be needed in severe cases, but  one concern of most prescription medications for heartburn is that they often result in a condition referred to as hypochlorhydria (Low Stomach Acid).  Many people associate heartburn with high stomach acid, yet it is commonly caused by low stomach acid, especially as people getting older. Low stomach acid impairs digestion and is associated with a range of other health concerns.

For more information on heartburn and other common conditions check out To learn more about how naturopathic medicine can assist you talk to one of our naturopathic doctors or contact us to book an appointment.