What Causes Acid Reflux and How to Relieve It?

Acid reflux is a condition where gastric acid is regurgitated into the esophagus causing heartburn and other symptoms including indigestion, bloating, and difficulty swallowing. The overall cause of acid reflux or GERD (Gastro-Esophageal Reflux Syndrome) is intra-abdominal pressure (IAP). This pressure is the immediate cause of the constellation of symptoms associated with GERD. This chronic IAP is itself a result of excess carbohydrate which results in a state of pathological bacterial overgrowth in the gut. Bad bacteria thrive on the abundant sugars and starches the human host conveniently provides them with.

The IAP is a function of the presence of large-scale toxins and out-gassing of a bad bug ecology that you have been unwittingly growing for some time. If you want to pursue this further, read “Heartburn Cured” by microbiologist Dr. Norm Robillard. In his book, Dr. Robillard cites from published studies to the effect that “30 g of carbohydrate that escapes absorption in a day could produce more than 10,000 mL (ten liters) of hydrogen gas. That is a huge amount of gas and makes for a lot of pressure.

In turn, this entire carbohydrate-bacteria-IAP engine is driven by hypochlorhydria or low stomach acid. In a healthy individual, food in the stomach is ‘cooked’ in a very highly acidic bath which is routinely produced by the body to properly digest the food before it is passed on down the gut for further processing. One important consequence of the presence of stomach acid is to sterilize the gut against bacteria. When there is not enough stomach acid present, not only does malabsorption of food result but pathogenic bacteria are able to be established. Low stomach acid + lots of carbohydrate = thriving bacteria. This is not supposed to happen and it’s a bad thing. Graphically, it the process looks like this:

This increase in pressure will cause acid reflux. Other contributing factors such as being overweight, lying down after eating a large meal, pregnancy, alcohol use, leaky gut and certain trigger foods can also contribute to acid reflux and heartburn. One of the great medical authorities on this subject is Jonathan Wright, M.D. a veteran gastroenterologist.

In his book “Why Stomach Acid is Good For You” Dr. Wright explains: “When we carefully test people over age forty who’re having heartburn, indigestion and gas, over 90 percent of the time we find inadequate acid production by the stomach”. In Wright’s 25 years of conducting these tests, he found very few people with excess stomach acid.

When stomach acid is sufficient and carbohydrates are consumed in moderation, they are properly broken down into glucose and rapidly absorbed in the small intestine before they can be fermented by microbes. However, if stomach acid is insufficient and/or carbohydrates are consumed in excess, some of the carbs will escape absorption and become available for intestinal microbes to ferment.

The symptoms of heartburn and GERD are caused by stomach acid refluxing into the esophagus. What’s crucial to understand is that any amount of acid in the esophagus is going to cause problems. That’s because its delicate lining isn’t protected against acid like the stomach lining is. You don’t have to have excess acid in your stomach to have heartburn. When the esophagus is exposed to even very weak stomach acid you will experience the classic GERD/acid reflux symptoms.

The reason this happens is that in the absence of sufficient hydrochloric acid, poorly digested food is not passed on out of the stomach. “Reflux” is what results. That’s what the term means. The system is stalled out and backs up. Weak acid washes up into the esophagus and it hurts. When there is enough hydrochloric acid present in the stomach, that signals that the food is sufficiently ‘cooked’ and the contents are moved on in a normal manner. No backwash. No reflux. No GERD.

As a temporary, emergency measure antacids will often relieve the immediate unpleasantness of acid reflux. However, given chronically, antacids will deeply aggravate the condition. You will never be free of this if you just keep taking antacid drugs and it will get worse over time.

If you have an open-minded doctor, or one that is aware of the connection between low stomach acid and GERD, ask for a test of your stomach acid levels. The test is quite simple. A device called a Heidelberg capsule, which consists of a tiny pH sensor and radio transmitter compressed into something resembling a vitamin capsule, is lowered into the stomach. When swallowed, the sensors in the capsule measure the pH of the stomach contents and relay the findings via radio signal to a receiver located outside the body.

As Dr. Wright observes: “In 24 years of nutritionally oriented practice, I’ve worked with thousands of individuals who’ve found the cause of their heartburn and indigestion to be low stomach acidity. In nearly all these folks, symptoms have been relieved and digestion improved when they’ve taken supplemental hydrochloric acid and pepsin capsules”.

To restore stomach acid levels to normal levels, supplement with products (there are many) that contain betaine and/or glutamic acid hydrochloride. Dr. Wright’s protocol of administration is widely followed.

Start with one 650 mg capsule of HCL w/pepsin in the early part of each meal. If there are no problems after two or three days, increase the dose to two capsules at the beginning of meals. Then after another two days increase to three capsules. Increase the dose gradually in this stepwise fashion until you feel a mild burning sensation. At that point, reduce the dosage to the previous number of capsules you were taking before you experienced burning and stay at that dosage. Over time you may find that you can continue to reduce the dosage, or you may also find that you may need to increase the dosage. In Dr. Wright’s clinic, most patients end up at a dose of 5-7 650 mg capsules. The addition of cholagogues (agents which promote bile flow from the gall bladder into the small intestine) and pancreatic enzymes can help tremendously, especially in the initial stages.

Other Measures to Address and Alleviate Gerd/Acid Reflux

Apple cider vinegar, lemon juice, raw (unpasteurized) sauerkraut and pickles are other time-tested, traditional remedies that often relieve the symptoms of heartburn and GERD. However, although these remedies may resolve symptoms, they do not increase nutrient absorption and assimilation to the extent that HCL supplements do. This may be important for those who have been taking acid suppressing drugs for a long period.

Another way to stimulate acid production in the stomach is by taking bitter herbs. “Bitters” have been used in traditional cultures for thousands of years to stimulate and improve digestion. More recently, studies have confirmed the ability of bitters to increase the flow of digestive juices, including HCL, bile, pepsin, gastrin and pancreatic enzymes. There are many bitter herb combination products available. Some of the most common bitters are dandelion, fennel, gentian, ginger, globe artichoke, milk thistle or wormwood. Bitters are normally taken in very small doses – just enough to evoke a strong taste of bitterness. Kerry Bone, a respected Western herbalist, suggests 5 to 10 drops of a 1:5 tincture of the above herbs taken in 20 mL of water.