What Heartburn Reveals About Your Health, Part 1: Is Heartburn Caused by Unhealthy Bacteria?
By Nicole Crane, BS, NTP
You’ve probably heard the saying, “The eyes are the window into the soul.” Along those same lines, the GI tract is the window into the rest of the body. If the GI tract is healthy, the rest of the body is likely to be healthy, too. The proper functioning of the digestive tract has a profound impact on how we absorb nutrients, get rid of waste, levels of inflammation, and the time and manner of which our immune system responds. Our gut health can affect whether or not we get infections and whether or not we develop allergies, to both foods as well as environmental factors like pollen, dust or fragrances. The health of our gut even has a major impact on our brain function and our mood. The GI tract is tied to the entire body in one way or another, and some of the ways the GI tract can influence your health may come as a surprise.1 Hopefully, understanding how the GI tract impacts your overall health and well-being can also help you understand what exactly is going on inside your body.
The GI, or gastrointestinal, tract includes the mouth, esophagus, stomach, large and small intestines, as well as the pancreas, liver and gall bladder. Digestion is a complicated process, and there are lots of organs, enzymes and other chemical signals that must all be functioning well for the gut and the body as a whole to stay healthy. Think of the parts of the GI tract like a house: the mouth is one wall, the stomach is another wall. The large and small intestines are each another wall. The pancreas is the floor, the liver is the roof, etc. When one wall begins to fall down, the others have to work harder to hold the house up. When one wall falls down completely, the floor or roof may cave in. When those walls are the intestines or stomach, and the floor and ceiling are your pancreas and liver, the whole body is likely to suffer the consequences that start with just one wall becoming damaged. When everything in the body is functioning normally, we have no trouble eating, digesting and eliminating. We can have a meal and experience no heartburn, no stomachaches, and little to no burping or passing gas. We can reap the maximum benefits of our food and supplements with no discomfort. Then, about 12-15 hours after that meal, we have an effortless elimination without a problem. With a healthy, well-functioning gut, you don’t think about this process too much. But when the GI tract becomes unhealthy, this process does not occur normally and effortlessly, and it can really affect your quality of life in some significant ways. The body is telling you something is wrong, and if you ignore those signals they will just get louder and more persistent. You probably know at least one person who suffers from heartburn, or terrible gas and bloating, or constipation or diarrhea. You may know someone who has been diagnosed with a digestive disorder like Crohn’s disease, ulcerative colitis, or even a broad diagnosis like irritable bowel syndrome (IBS). Even though these are now very common health problems, there is nothing normal about them. Usually, these disorders have a major impact on all the other parts of the body and overall health2. The GI tract wants to heal itself – given the right nutrition and supplements, digestive function can return to normal with a little patience and work. Know that the body’s default state is one of health, healing and natural repair.
It is important to understand the normal function of the GI tract as well as the consequences of when the gut is not performing in an optimal way. When you eat a meal, let’s say you have organic broccoli, pasture-raised chicken, and an organic sweet potato with a little grass-fed butter. This meal contains protein, fat and carbohydrate from whole sources. The body recognizes it as food, because it is food – no chemicals, no preservatives, nothing man-made. The pancreas releases digestive enzymes to break down the carbs in the mouth and in the stomach. The fats and proteins are digested in the stomach, and further digested in the small intestines. These enzymes trigger the rest of the digestive process, including the release of stomach acid and other digestive juices. The proteins are broken down into individual amino acids, the fat is broken down into individual lipids, and the carbs are broken down into sugar molecules. The stomach churns and works the meal into a liquid substance that passes into the intestines, where bicarbonate is released to neutralize the acidity of the stomach environment.3
The first things we need for healthy digestion is stomach acid, or hydrochloric acid (HCl), and digestive enzymes. Not having enough digestive enzymes or stomach acid can be the first major problem. This may be shocking to many who experience heartburn and have been diagnosed with high stomach acid – however, in these cases, misdiagnosis is common. This is because it is easier for both the doctor and the patient to diagnose high stomach acid rather than to diagnose low stomach acid. But heartburn is almost always caused by low stomach acid – not high stomach acid! We need our stomach acid, as it has several essential functions for good health. When we don't produce enough, it can create a chain of events that affect the entire body. There is a valve between the esophagus and the stomach called the LES, or lower esophageal sphincter. It is a circular muscle that opens when we swallow and should close tightly when there is food in our stomach, so food does not re-enter the esophagus while the stomach is churning. It should be triggered to close by the acidic pH of the stomach after a meal, but the body does not always produce enough digestive juices or the pH may not have a sufficient acidity level. Stomach acid should have a pH of 1. Lemon juice has a pH of around 2, which means that stomach acid is 10 times more acidic than lemon juice. Vinegar has a pH around 3, so stomach acid is 100 times more acidic than vinegar. Many people with heartburn are either not producing enough stomach acid, or the acid produced is not acidic enough. In these cases, the LES muscle does not get triggered to close, and even stomach acid with a pH of 2 or 3 can still burn the unprotected esophagus.4So, what do you do?
Holistically, it is important to find out why you aren’t making enough digestive juices, but this can take months to figure out and correct. Unfortunately, there are millions of Americans who use some form of antacid every day. While this may suppress the symptoms, it does not fix the underlying problem – in fact, it likely makes it worse.5 Suppressing stomach acid can prevent you from experiencing good health and significantly interfere with the body’s normal digestive processes. Having enough stomach acid, or supplementing with HCl and enzymes, benefits the entire body. Without enough stomach acid we do not properly absorb nutrients, especially minerals like Iron, Calcium and Magnesium. Vitamin B12 also requires healthy stomach acid for proper absorption. Stomach acid is also our first line of defense against bad bacteria, so it is crucial for proper protection of the immune system. Stomach acid can kill pathogens and other infectious microbes that enter our body. Furthermore, the digestive action of the stomach initiates a chain of events that trigger the entire process of digestion and nutrient absorption from start to finish.6 There is more evidence that suggests that heartburn and its more severe form, GERD (Gastro Esophageal Reflux Disease), may be caused by an overgrowth of bad bacteria in the small intestine, by a condition called disbiosis, or by SIBO (Small Intestine Bacterial Overgrowth). If you have ever had infections like H. Pylori, C. Difficile, Candida Yeast, E. coli, or Staph, it is possible that you don't have enough stomach acid (or probiotics).7 Bad bacteria are notoriously known for suppressing stomach acid production. SIBO initiates a vicious cycle of the underproduction of stomach acid, leading to greater vulnerability to the invasion of more bad bacteria. When there is a lack of stomach acid, we do not properly digest our food, creating a scenario where the poorly-digested food ferments in the GI tract and feeds even more bad bacteria. When you take an antacid medication, you suppress stomach acid even more. Not only do you open the door wider for bad bacteria, you are not absorbing the nutrients needed to support the optimal – or even normal – functioning of the immune system and digestive tract.8 Heartburn is a miserable feeling, and for most people, doing nothing is not an option. There are natural solutions that can make a world of difference for health and quality of life – you do not have to choose between them.
If you have heartburn, your doctor may give you a long list of foods to avoid, including those that help foster an acidic environment in the stomach like citrus and tomatoes. This is based on the incorrect theory that heartburn is from high stomach acid instead of low stomach acid.9 If you have no discomfort when eating a certain food, there is no reason to stop eating it. You are an individual, and what effects one person may not consequences for you. Personally, I am concerned about foods and lifestyle factors that weaken the LES muscle that is so crucial for proper digestion overall. It is best to avoid peppermint, caffeine (coffee, chocolate), alcohol, nicotine, refined sugar and deep-fried foods.10Short term solutions to improve heartburn include drinking a tablespoon of fresh-squeezed lemon juice or apple cider vinegar at every meal. This introduces acidity into the stomach, but few people are interested in doing this several times every single day. It can also be damaging to the teeth enamel to drink vinegar or lemon juice regularly. For most people, it is very helpful to take a broad-spectrum digestive enzyme supplement with each meal or snack. It is certainly more enjoyable than a shot of vinegar! Digestive enzymes can fill in the gaps of what the body is not producing naturally can be very helpful in curbing indigestion before it even begins. A specific digestive enzyme called Alpha-Galactosidase may be particularly beneficial, as it aids in the digestion of foods like beans and broccoli which commonly cause gas.11 A blend of herbs known as demulcent herbs may be very helpful also. These herbs coat the stomach and esophagus, help heal the esophagus, and reduce inflammation in the throat and stomach. Other natural ingredients such as DGL licorice, slippery elm, marshmallow root, and plantain fruit may provide comfort for heartburn and indigestion while the inflammation is healing as well, due to their protective and shielding abilities for the lining of the stomach and esophagus.
You may be wondering how bad bacteria got into the GI tract in the first place. It might be difficult to pinpoint exactly when or how, but one of the most significant factors is a lack of good bacteria, or probiotics, in the gut. Probiotics are the army of beneficial bacteria that live throughout the GI tract – not just in the intestines, but in the nose, mouth, ears, and every other part of the body that has contact with the outside world as well. Probiotics perform hundreds of functions in the body, many of which transcend beyond the GI tract. Their presence or absence is one of the biggest determining factors on how healthy the tissues of the gut are, and how well the GI tract functions. We need lots of good bacteria (trillions of cells) in our gut for optimal health. There are many common factors that negatively affect good bacteria, thereby allowing a greater chance for bad bacteria to come in and wreak havoc on the body. Taking a probiotic can help address the imbalance of bad bacteria, but this is often just one of the steps required to restore the health of the GI tract.
Stomach health is just one small part of the digestive system. No body part exists in a vacuum, and this is especially true for the different organs and biochemical functions of the GI tract. Stomach problems mean that your body is telling you something is wrong – it is never just one thing that goes wrong. Health problems tend to lead to further health problems, all of them related to the original issue. There is a long list of other health problems – from autoimmune diseases like Rheumatoid arthritis to seasonal allergies – that all stem from poor GI health. Nearly everything that happens in the stomach is related to another part of the GI Tract. It is also absolutely essential to address the possible cause of your heartburn, and it could likely be an overgrowth of bad bacteria in the intestines. There are several things that can help remove existing bad bacteria, and then replace it with the healthy bacteria necessary for overall health. Bad bacteria must be addressed, or it can easily lead to a devastating condition called intestinal hyper-permeability, or Leaky Gut Syndrome. If your body is trying to tell you something is wrong, the time to listen is now. Ignoring your symptoms or masking them with medications does not make them go away. The body cannot be healthy when the GI tract is sick, and it’s never too late to take the steps that restore vitality to the gut. The rest of your body will thank you in ways you never though were connected to digestive wellness!
Stay tuned for Part II, where I will discuss the impact of leaky gut syndrome and its connection to seasonal allergies, food allergies, and much more!
Nicole’s Protocol for Heartburn
- Digestive Enzyme. Take 1-2 capsules with every meal.
DGL Licorice and Herbal Demulcents: Take 1 chewable tablet at the beginning of every meal.
- Probiotics. Week 1: Take 1 capsule every other day at bedtime. Week 2: Take 1 capsule daily at bedtime. Week 3: Take 1 capsule twice per day at breakfast and bedtime. Week 4: Take 1 capsule three times per day. Week 5 and Ongoing: Take 1-2 capsules per day. If diarrhea or other digestive discomfort occurs, reduce dosage by 1 capsule and wait another week. It is important to introduce probiotics slowly, because they kill bad bacteria. If you take too much too fast, there is no problem, but dying and dead bad bacteria release toxins. If they are killed too fast, they can release more toxins than the body can handle, causing discomfort. This is known as the “Die-Off Effect”.
- If discomfort and inflammation persist, consider an herbal inflammation mediator such as Turmeric Extract and Boswellia extracts. Take 1 capsule twice per day to support healing.
1. Lipski, Elizabeth, Digestive Wellness, Keats Publishing, Chicago, IL: 2012 (4th edition)
2. Tortora, Gerald, Derrickson, Brian, Principles of Anatomy and Physiology, John Wiley & Sons Publishing, Hoboken, NJ: 2008 (12th edition)
3. Tortora, Gerald, Derrickson, Brian, Principles of Anatomy and Physiology, John Wiley & Sons Publishing, Hoboken, NJ: 2008 (12th edition)
4. Wright, Jonathon, Lenard, Lane, Why Stomach Acid Is Good for You, Rawman and Littlefield Publishing, Lanham, MD: 2001
5. McColl, Kenneth, Gellen, Derek; “Evidence That Proton-Pump Inhibitor Therapy Induces the Symptoms it Is Used to Treat EDITORIAL” Gastroenterology, published online June 2009 http://www.natap.org/2009/HIV/070409_02.htm
6. Lipski, Elizabeth, Digestive Wellness, Keats Publishing, Chicago, IL: 2012 (4th edition)
7. Robillard, Norm, Heartburn Cured: The Low Carb Miracle, Self-Health Publishing, Thousand Oaks, CA: 2005
8. Robillard, Norm, Heartburn Cured: The Low Carb Miracle, Self-Health Publishing, Thousand Oaks, CA: 2005
9. Wright, Jonathon, Lenard, Lane, Why Stomach Acid Is Good for You, Rawman and Littlefield Publishing, Lanham, MD: 2001
10. Robillard, Norm, Heartburn Cured: The Low Carb Miracle, Self-Health Publishing, Thousand Oaks, CA: 2005
11. Levine B, Weisman S. Enzyme replacement as an effective treatment for the common symptoms of complex carbohydrate intolerance. Nutr Clin Care. 2004; 7:75–81.