Welcome to the Gut Honest Truth blog where a Certified Functional Medicine Practitioner gives you digestible information to tackle your chronic health concerns.
That’s me, Katie Morra;
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Living with acid reflux can feel like a constant battle against your own body. From the discomfort of heartburn to the inconvenience of dietary restrictions, it's a condition that often demands ongoing attention and care. However, despite your best intentions, we may suggest that you have been approaching your acid reflux from the wrong directions. Let us explore several areas where we find clients often miss the mark on minimizing or stopping their acid reflux for good.
Diet: Beyond the Low Acid Approach
For years, you've been strictly adhering to a low-acid diet, meticulously avoiding citrus fruits, tomatoes, coffee, chocolate and other acidic foods. While this approach may offer some relief, it's just scratching the surface and truly just aiming to minimize your symptoms versus getting to the root of the issue. It may be time to look beyond simple dietary restrictions and consider lifestyle factors such as the quality of our food, eating habits, and stress management.
Functional medicine takes a comprehensive approach to managing acid reflux, addressing not only symptom reduction but also the underlying imbalances that contribute to gastrointestinal issues. Here's how a functional medicine dietary approach to your acid reflux might look:
1. Identifying Trigger Foods:
Yes, common triggers include spicy foods, acidic foods (such as citrus fruits and tomatoes), caffeine, chocolate, and fatty or fried foods. But more times than not there may be other foods in your regular diet that trigger your acid reflux. In some cases a proper elimination diet may be an effective way to uncover these trigger foods. We know this is no one's favorite suggestion but it is often short lived and gives you way more information on how your body specifically handles certain foods. We highly recommend that you work closely with a nutrition professional to ensure you do this safely and effectively. Honorary mention to high fat and fried foods causing you discomfort and ruling out if your acid reflux is being accompanied by bile reflux (hint: have your gallbladder looked at).
2. Emphasizing Whole Foods:
Simple carbohydrates may exacerbate symptoms by contributing to lower esophageal sphincter (LES) relaxation, and thus an increase in indigestion and heartburn. Focusing on complex carbohydrates, rich in fiber (vegetables, beans, etc), can often help someone reduce flares.
3. Managing Portion Sizes:
Overeating can exacerbate acid reflux symptoms by putting pressure on the stomach and causing stomach acid to move the wrong direction back into the esophagus. Eating smaller, more frequent meals and avoiding large meals, especially before bedtime, may be a therapeutic tool to consider. Bonus tip: go for a 5-10 minute walk after meals to reduce bloating, pressure and reflux symptoms.
4. Reducing Potential Irritants:
In addition to avoiding trigger foods, it's important to minimize other potential irritants that can contribute to acid reflux, such as alcohol, carbonated beverages, gums and artificial sweeteners. These substances can irritate the esophagus and contribute to digestive discomfort. Always check your labels and reduce when possible, especially if you are someone who loves a bubbly drink at meal time- just reducing this part of your fluid intake can make a drastic difference for many.
5. Promoting Gut Health:
Supporting a healthy gut microbiome through dietary and lifestyle interventions can help reduce symptoms of acid reflux. This may include incorporating fermented foods (such as yogurt, kefir, sauerkraut, and kimchi) that provide beneficial probiotics, as well as prebiotic-rich foods (such as onions, garlic, leeks, and asparagus) that nourish the probiotics and good gut bacteria. Tip: Ruling out conditions (and treating them) like Small Intestinal Bacterial Overgrowth (SIBO), Helicobacter pylori (H pylori) and gut dysbiosis (imbalance of good and bad bacteria) with proper testing may prove to be a root-cause approach in alleviating persistent symptoms.
6. Supporting Digestive Function:
Certain dietary supplements and herbs may support digestive function and help alleviate symptoms of acid refluxThese may include digestive enzymes, betaine HCl, deglycyrrhizinated licorice (DGL), slippery elm, marshmallow, mastic gum and aloe vera juice. It is also noting that there are many products out there that can also worsen indigestion as well as considering the timing of taking them. We often find those who take supplements at the end of their meals have an increase in their symptoms as the supplements sit on top of their food and have a harder time being properly broken down with the minimal space. If you are told to take a supplement with a meal, it may suit you best to take it at the start of the meal to avoid a flare.
PPIs: More Than Just a Quick Fix
At one point, you may have turned to proton pump inhibitors (PPIs) as a solution to your acid reflux woes. These medications suppress stomach acid with the intention of temporary relief from symptoms. However, it's essential to realize that PPIs are almost never a good long-term solution—they're merely a band-aid approach.
Prolonged use of PPIs comes with its own set of risks, including nutrient deficiencies, increased susceptibility to infections, and rebound acid reflux when discontinued. Rather than relying solely on medication to manage symptoms, consider addressing the root causes of your acid reflux. Whether it's dietary choices, structural issues, stress management, or underlying gut health issues, functional health encourages us to dig deeper and address the underlying imbalances contributing to our symptoms.
5 warning signs that you’ve been on a PPI too long:
Here are five common warning signs that we see with our clients suggesting that their PPI may have overstayed its welcome:
Gut Dysbiosis and Imbalances:
Prolonged use of PPIs can disrupt the balance of gut bacteria, leading to dysbiosis which is often diagnosed using a comprehensive stool test. Signs of gut dysbiosis include, but are not limited to, bloating, gas, irregular bowel movements, and digestive discomfort. If you're experiencing ongoing digestive issues despite PPI use, it may indicate a need to dive deeper into addressing these possible gut imbalances and overgrowths.
Impaired Nutrient Absorption:
Stomach acid is essential for proper digestion and absorption of nutrients. Prolonged suppression of stomach acid by PPIs may impair the guts ability to properly break down food, release digestive enzymes and bile which over time leads to deficiencies in key vitamins and minerals.
Inflammation and Immune Dysfunction:
Chronic use of PPIs has been associated with increased inflammation and immune dysfunction. Functional medicine views inflammation as a root cause of many chronic diseases and focuses on identifying and addressing underlying factors contributing to inflammation. If you're experiencing symptoms of systemic inflammation such as joint pain, fatigue, or frequent gut or systemic infections, it's important to explore potential contributors, including medication use.
Disrupted Hormonal Balance:
Emerging research suggests that long-term PPI use may disrupt hormonal balance, potentially impacting thyroid function and hormone metabolism. Functional medicine takes a holistic approach to hormone health, considering factors such as stress, diet, and environmental toxins. If you're experiencing symptoms of hormonal imbalance such as fatigue, weight changes, or menstrual irregularities, it's important to evaluate all potential contributors, including medication effects.
Increased Risk of Chronic Conditions:
Long-term use of PPIs has been associated with an increased risk of various chronic conditions, including cardiovascular disease, kidney disease, and osteoporosis. If you have a history of chronic conditions or are concerned about potential risks associated with PPI use, it's essential to work with a healthcare provider who takes a proactive, integrative approach to your health.
Addressing the Issue Sooner Rather Than Later
Perhaps the biggest mistake you've made in managing your acid reflux, like many others, is waiting too long to address the actual problem and relying on medication support to feel better. Ignoring occasional bouts of heartburn or dismissing them as a normal part of life only allows the condition to worsen over time.
By taking a proactive and root cause approach to your health, you can identify and address the imbalances specific to you and your symptoms before they escalate into more serious problems. Whether it's seeking guidance from a functional medicine practitioner, implementing lifestyle changes, or exploring alternative therapies, there are plenty of next steps that can be offered to help you reclaim control of your digestive health and well-being.
Your journey with acid reflux may have been fraught with missteps and missed opportunities for true healing. By adopting a root cause approach to health, you can move beyond the limitations of a low-acid diet, recognize the limitations of PPIs, and address the root causes of your symptoms head-on. It's never too late to course-correct and pave the way for lasting relief and vitality.
How Do I Find a Practitioner Specializing in Acid Reflux and Lab Work?
Our team specializes In gut health and works very closely and frequently with clients with acid reflux, GERD, indigestion and the inability to get off of PPIs on their own. We use an array of testing such as the GI Map, SIBO and H pylori testing to provide us with deeper insights as to what your gut microbiome and nutrition needs more support with.
Ready to get started? Schedule a consultation today with our Institute for Functional Medicine trained and certified health care practitioners.
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