From the Desk of Carolyn Dean MD ND
Tis the season for overindulging, and many people throw caution to the wind and become increasingly involved with foods they typically avoid the rest of the year. Before stocking up on antacids, let’s have a look at what’s happening in your gut when you eat something that doesn’t agree with you.
What Dr. Google might say about heartburn:
Acid in the stomach is backing up into the esophagus creating a burning sensation. Over time, this acid can damage the esophagus so it’s important to monitor these symptoms. Medical doctors admit they don’t really know why it happens, but they may throw out the phrase “it’s of ‘unknown etiology’” making it sound like they know something when they really don’t.
Dr. Google might suggest medical testing
- An Xray of the esophagus and stomach taken after you swallow chalky barium can show erosions or ulcers in the esophagus. The radiologist may tilt you at a 45 degree angle to see whether the barium is pushed up to the throat and not down to your stomach.
- An endoscopy will check for physical abnormalities in your esophagus. This is a thin hollow tube with a light and camera at the end that’s inserted into the esophagus so the doctor can view your esophageal tube. A tissue sample of the area may be taken through the endoscope.
- An esophageal pH or acid probe test can monitor stomach acid backing up into the esophagus over 24 to 96 hours. A tube is placed in the esophagus and connected to a monitor which is worn or carried.
- Esophageal manometry or motility testing measures contractions and pressure in the esophagus when swallowing. A tube is placed through the nose into the esophagus and stomach and sensors measure movement.
Dr. Google might suggest these drugs
For the relief of heartburn:
- Antacids work to neutralize stomach acid and can work quickly.
- H-2-receptor antagonists (H2RAs) or H2 blockers (Zantac, Tagamet) can reduce stomach acid and may provide longer relief than antacids.
- Proton pump inhibitors (Prevacid, Nexium) Prilosec can reduce stomach acid.
What I say about heartburn
This condition is called “heartburn” because the area of pain lies close to the heart. People with heartburn can be misdiagnosed with angina (heart pain). Heartburn has many names; it’s also called gastro esophageal reflux disease (GERD), or acid reflux.
First let’s look at the body part involved in heartburn – the esophagus. This moist, pink, muscular tube connects the throat to the stomach. The muscle contracts, pushing food and fluid on a one-way trip to the stomach. The contractions, called peristalsis, move the food and fluid along in waves.
There are two sphincters; the upper and the lower esophageal sphincters that remain closed after eating. The upper sphincter keeps food from going down the wrong way into the lungs. The lower sphincter keeps food and acid in the stomach, preventing it from moving back up the esophagus to the mouth. It’s essential that these protective muscular sphincters are working optimally so that your food can take a one-way route through your body.
When I think about any bodily function, like digestion, that relies on muscles to perform at its best, I immediately consider the magnesium status of a person. When a magnesium deficient muscular sphincter is weakened or goes into spasm, acidic stomach contents can be pushed up into the esophagus, causing burning pain.
Magnesium deficiency can probably cause heartburn all by itself but with an overly full stomach and some associated belching and burping, and weakened sphincter muscles, stomach acid backs up into the esophagus. I’ll say more about associated triggers of heartburn, below.
Esophageal spasms
Allopathic medicine does talk about spasms in the esophagus and the esophageal sphincter, but bizarrely they don’t equate this occurrence with heartburn. They admit that they don’t know what causes these spasms and they certainly don’t say that they could be caused by magnesium deficiency.
Magnesium deficiency and heartburn
Each individual is unique, but the first thing to consider is whether there might be a magnesium deficiency. It’s that simple and equally simple to correct. If the esophageal sphincter is in spasm due to magnesium deficiency, symptoms of heartburn and reflux can appear. Associated symptoms include: leg cramps, insomnia, fatigue, heart palpitations.
Let’s look at some other possible causes of heartburn symptoms:
- A large meal can stretch the esophageal sphincter and allow a reflux of acid, especially if you lie down afterward. The stomach lining is designed to handle very strong digestive acid, but the esophagus is not. Think of holiday dinners that are more like grand feasts and the adults lie down after the meal and the evening is spent in a cacophony of belching and gas release – and heartburn. However, stretching the sphincter with all this gas can trigger a magnesium deficiency spasm, resulting in more discomfort.
- Drinking water – especially ice water – with your meal can dilute gastric juices and hydrochloric acid leading to undigested foods that ferment in the stomach causing stomach bloating and gas that forces through the sphincter, which can also cause magnesium deficiency spasm.
- Eating too fast and not chewing properly can also cause stomach bloating and gas.
- The substances most apt to relax the esophageal sphincter and cause reflux are alcohol, coffee, tomatoes, and tobacco.
- Physical factors such as bending forward while lifting (instead of bending at the knees), overdoing sit-ups or going to bed shortly after eating can also initiate symptoms of reflux.
Food Diary
Track what you eat in a food diary for ten days to see if there are foods you aren’t digesting or actual allergic or sensitive foods. Pay particular attention to any symptoms you may have after each meal (big or small), snack (sweet, salty or fatty). A simple solution is to eliminate the possible culprits.
Deconstructing Drugs
As briefly noted above, the medical treatments for heartburn include: Antacids, H-2-receptor antagonists, and Proton pump inhibitors. Let’s go into the details here, about how they work for you and how they work against you.
Antacids
Antacids coat the esophagus and stomach or neutralize stomach acid. However, they only offer symptomatic relief; they do not get to the root of the problem.
They also greatly interfere with digestion when they take the beneficial acid out of gastric acids. If your food does not digest properly, it cannot be absorbed and your nutritional status suffers. Also, intestinal bacteria and yeast feed off this undigested food causing fermentation, gas, and bloating.
The active ingredients of antacids themselves are suspect and can cause problems. The most common ones are: Calcium carbonate, Magnesium hydroxide, Aluminum hydroxide, and Sodium bicarbonate.
Calcium carbonate neutralizes stomach acidity but it introduces a poorly absorbed calcium into the body, which causes constipation and can precipitate into soft tissues – including the lining of blood vessels. Too much calcium in the blood stream can upset the balance of magnesium and cause magnesium deficiency. Magnesium deficiency symptoms include esophageal spasms and heartburn, the very symptoms antacids are supposed to treat.
Proton Pump Inhibitors
The proton pump inhibitor (PPI) antacids like Nexium, Prevacid and Prilosec stop the production of acid in the stomach. That’s right, they don’t reduce it or modify it, they stop it. And that can’t be good since we need stomach acid to digest our food and to help break down mineral compounds to make them better absorbed.
PPIs have also been found to decrease magnesium in the body to such an extent that the FDA was forced to put a black box warning on these products stating that fact. I don’t know if the FDA has made the connection, but PPIs can increase the risk of hip fracture, which is also associated with magnesium deficiency.
I would say that Prevacid is the major cause of magnesium deficiency in the PPI class because its chemical structure has 3 fluorine atoms. Fluorine loves magnesium and binds to it whenever it can. Intestinal bacteria are very good at breaking down drugs and chemicals that they come in contact with in the intestines. Once released, fluorine binds with magnesium making a brittle compound called sellaite. This compound deposits in tendons and ligaments and other soft tissues and I think is the likely cause of tendon rupture in fluoride drugs like the antibiotic Ciprofloxacin. Did you know that Cipro has an FDA black box warning for tendon rupture?
PPIs can also increase the incidence of pneumonia because a decrease in stomach acid can allow bacterial overgrowth in the stomach and episodes of reflux leading to aspiration in the lungs can cause pneumonia. But you’re not going to find that warning on the box of your PPI.
In 2019, the popular stomach acid blocker, Ranitidine¹ sold under the name Zantac by prescription and over the counter was found to have unacceptable levels of the possible carcinogen, NDMA (N-nitrosodimethylamine) and the product was recalled. Millions of people have used this product since it came out in 1983 and now there are many class action lawsuits against the makers of Zantac².
Sanofi, the company responsible for Zantac has reformulated the product with famotidine as the active ingredient and in 2021 released it under the name Zantac 360. Famotidine is also the active ingredient in Pepcid. I wonder how long it will take for post-marketing surveillance to uncover the side effects of the new Zantac.
Treating Heartburn
Obviously taking magnesium is going to help prevent heartburn – and the picometer-sized, stabilized ion of magnesium is the best one to use but what is “first aid” for heartburn.
First Aid for Mild Hiatus Hernia
Or for a full and bloated stomach.
Gently massage the stomach from the tip of the xiphoid process, which is at the bottom of the sternum (that little space between the ribs where they attach to the sternum or breastbone), down along the right-hand side of the rib cage. Massaging in one downward movement to the right several times will often release the spasm and move the stomach back into place or release the spasm and push food into the small intestine.
Healthy options for heartburn
Diet:
- Eat small meals, chew your food well, and don’t drink with a meal. Small frequent meals move out of the stomach quickly and don’t cause reflux.
- Avoid alcohol, coffee, tomatoes, and tobacco.
- Chewing stimulates enzymes in your saliva that help digest your food, so the more you chew your food, the better digestion you will have.
- When you swallow, the esophageal sphincter releases all the other GI sphincters. So, a big glass of water first thing in the morning encourages sphincters all the way down to the rectal sphincter to help you achieve a morning BM.
- How do you know if your food is undigested? It’s quite easy; you may see bits of greens, corn, beans, or seeds in your stool.
Supplements: Magnesium
As mentioned above, magnesium deficiency can cause muscle spasms and taking magnesium can be very helpful to secure the esophageal sphincter. Magnesium is also a necessary factor in the production of gastric acid. The best form to take is a picometer liquid magnesium.
Herbs:
DGL licorice: DGL can be as effective as powerful prescription medications for heartburn and GERD. Chew one or two wafers twenty minutes before a meal. DGL works by strengthening the stomach mucosal lining and enhancing production of mucin, which protects the stomach against gastric acid. DGL stands for de-glycyrrhizinated licorice. DGL stands for de-glycyrrhizinated licorice, which removes the potential of glycyrrhizin causing high blood pressure.
Apple cider vinegar: Mix 1 tsp in 4 ounces of water and sip throughout a meal to aid digestion.
Ginger, Catnip, Fennel, and Slippery elm bark: Make a tea or take one to two capsules before meals of any of these herbs either alone or in combination. I highly recommend organic herbs because otherwise you have no idea of the source.
NOTE: Mint teas may aggravate heartburn; even though mint can relax cramps and intestinal spasms, it can actually weaken the esophageal sphincter.
Carolyn Dean MD ND
The Doctor of the Future.
²https://www.baumhedlundlaw.com/blog/2021/october/is-zantac-back-on-the-market-/
