Heartburn is one of the most common symptoms faced by Americans today. Indeed, the biggest indicator of that is the sheer quantity of antacids or proton pump inhibitors (PPI) that are sold nowadays so much so that they have been made over the counter instead of requiring a prescription which was the case previously. The number of people taking antacids or PPIs are in the tens of millions. So we definitely need to look at this issue more.

We all occasionally have that feeling of heartburn and discomfort when we eat a large meal or have a dietary indiscretion, however if it is an ongoing issue, it can be a red flag to something deeper going on that needs to be addressed. Constant reflux or the use of tums can suggest a digestive problem that should not be ignored. 

Reflux symptoms are related to an imbalance in hydrochloric acid (HCl) secretion and/or production. HCl is important for the stomach to digest proteins well, absorb nutrients, and provide an inhospitable environment for toxins and microbes so they don’t enter the system. Sometimes paradoxically, HCl levels can be low in individuals leading to reflux symptoms yet they are still given antacids. This is an area conventional medicine largely ignores; the fact that HCl levels being low can be a major issue.

Patient’s with low HCl levels will feel an improvement in their symptoms or digestion if they were to try apple cider vinegar with their meals and this could be an indication that they need to have ongoing supplementation with HCl. Other than antiacids, H. Pylori infections can also reduce stomach acid and need to be investigated as a potential cause. If however, heartburn symptoms are worsened with something like apple cider vinegar, that could be an indication that there is irritation of the gastric lining which will need healing. Those patients should not be supplementing with HCl.

Hiatal hernias are another possible underlying cause of heartburn, which generally get picked up on Endoscopies. These are hernias where part of the stomach rises above the diaphragm wall leading to reflux of acid into the Esophagus. If you have a hiatal hernia confirmed with and Endoscopy, there are certain manual self-manipulation techniques that can be done to reduce that hernia and improve symptoms.

Take home point: Ongoing acid reflux should not be taken lightly and can be a red flag for an imbalance in the digestive system that needs to be addressed.

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