Heartburn & GERD
Heartburn is a burning sensation in the chest caused by stomach acid flowing back into the esophagus. Gastroesophageal reflux disease (GERD) is a chronic, more severe form of acid reflux occurring at least twice weekly. GERD affects approximately 20% of Americans and can lead to complications including esophagitis, Barrett's esophagus, and increased esophageal cancer risk if left untreated. While often treated with acid-suppressing medications, addressing root causes provides more sustainable relief.
Symptoms
- •Burning sensation in the chest, especially after eating or when lying down
- •Sour or bitter taste in the mouth from regurgitated stomach acid
- •Difficulty swallowing or feeling of food stuck in the throat
- •Chronic cough, hoarseness, or throat clearing especially in the morning
- •Worsening of asthma symptoms or nighttime breathing problems
- •Chest pain that may mimic heart pain (always rule out cardiac causes)
Causes & Risk Factors
- •Lower esophageal sphincter dysfunction allowing stomach contents to reflux
- •Hiatal hernia where part of the stomach pushes through the diaphragm
- •Increased intra-abdominal pressure from obesity, pregnancy, or tight clothing
- •Low stomach acid paradoxically causing reflux through impaired digestion and sphincter signaling
Naturopathic Approach
Naturopathic treatment for heartburn and GERD focuses on healing esophageal tissue, restoring proper digestive function, and addressing underlying mechanical or physiological dysfunction. Assessment identifies contributing factors including food triggers, stress patterns, eating habits, and potential H. pylori infection or hiatal hernia. Esophageal healing is supported through demulcent herbs including slippery elm, marshmallow root, and deglycyrrhizinated licorice (DGL) which coat and protect irritated tissues. Addressing stomach acid balance is crucial—many GERD patients actually have low stomach acid. Supporting adequate acid production when appropriate through bitter herbs or betaine HCl strengthens the lower esophageal sphincter and improves digestion. Prokinetic botanicals including ginger and artichoke support proper stomach emptying and reduce reflux episodes. Dietary modifications include eating smaller, more frequent meals, avoiding trigger foods, not eating within 3 hours of bedtime, and reducing foods that relax the lower esophageal sphincter such as caffeine, alcohol, chocolate, and mint. Lifestyle interventions include elevating the head of the bed 6-8 inches, weight loss if indicated, stress management, and avoiding tight clothing around the abdomen. Postural exercises and breathing techniques may help address hiatal hernia in some cases. This comprehensive approach aims to heal damaged tissue, restore comfortable digestion, and eliminate the need for long-term acid suppression.
Related Modalities
Frequently Asked Questions
Is long-term use of PPIs (proton pump inhibitors) safe?
Long-term PPI use is associated with increased risks including nutrient deficiencies (B12, magnesium, calcium), increased fracture risk, kidney disease, and altered gut microbiome. While PPIs effectively reduce symptoms, they don't address root causes and may mask underlying issues. Many people can successfully wean off PPIs under professional guidance while implementing naturopathic strategies to address underlying dysfunction.
Can GERD cause symptoms outside the digestive system?
Yes, GERD can cause extra-esophageal symptoms including chronic cough, hoarseness, throat clearing, dental erosion, worsening asthma, and even ear pain. These symptoms occur when refluxed stomach contents reach the throat and airways. Many people with these symptoms don't experience typical heartburn and may not realize reflux is the underlying cause.
What is the connection between stress and GERD?
Stress significantly impacts GERD through multiple mechanisms: it increases stomach acid production, impairs protective mucus secretion, slows gastric emptying, and may reduce lower esophageal sphincter pressure. Stress also increases pain sensitivity and awareness of reflux symptoms. Many patients notice dramatic improvement when incorporating stress management practices alongside other treatments.
How can I tell if my chest pain is GERD or a heart problem?
This distinction requires medical evaluation, as GERD and heart problems can produce similar chest pain. Generally, GERD pain is burning, worsens after eating or lying down, and may be accompanied by sour taste or regurgitation. Heart-related pain often includes pressure, radiates to the arm or jaw, and may occur with exertion or shortness of breath. Any new or severe chest pain requires immediate medical evaluation to rule out cardiac causes.
References
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Dr. Sanika Kshirsagar, ND
Doctorate of Naturopathic Medicine (ND)
Bastyr University, Kenmore, WA
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