I see many clients with different conditions that are caused by acid and stomach related issues:
Acid Reflux, GORD or GERD (Gastro-Oesophageal Reflux Disease), Gastritis, Acid
Indigestion, Bile Acid Reflux, H Pylori, Silent Reflux.
Acid reflux and GORD
Occurs when stomach acid is regurgitated up into the oesophagus, this can be due to dysfunction of the oesophageal sphincter, or inappropriate relaxation, allowing the contents to rise back up and can cause inflammation and damage to the oesophageal lining.
Symptoms include burping, heartburn & sour taste in the mouth
*Also known as GERD, which is the American spelling (Gastroesophageal Reflux
Disease)
Indigestion
This is typically where acid causes a burning sensation in the stomach lining, this can be due to excess acid or an issue with the mucous lining that protects the stomach. Unlike heart burn, it doesn’t always relate to stomach acid.
Symptoms include feeling full quickly when eating, pain or burning & discomfort in
the abdomen, feeling bloated, burping, gurgling, flatulence, diarrhoea
Gastritis
Gastritis is inflammation of the stomach lining. Often mild, it can resolve without
treatment. However, severe and prolonged gastritis can lead to stomach ulcer.
Silent Reflux
Silent reflux is when small amounts of stomach juice can spill into the oesophagus and further back into the throat. Affecting the throat lining and voice box causing irritation and hoarseness. This is known as laryngo pharyngeal reflux (LPR) or extra oesophageal reflux (EOR). People don’t usually experience the classic symptoms of heartburn or indigestion. It occurs at night. The tissue of the larynx is more sensitive to injury and irritation and can even effect lungs and breathing. It can cause a feeling of a lump in the throat. Stress can make this sensation worse.
A functional medicine approach looks beyond symptoms alone and focuses on
identifying and addressing the root causes driving the dysfunction.
Assessing key triggers
Assesing Key trigger foods such as tomatoes, citrus, chocolate, caffeine, alcohol and smoking. These foods can relax the oesophageal sphincter, allowing the contents of the stomach to regurgitate back up into the oesophagus, causing burning and pain.
Eating in a stress free environment
The body needs to be in a resting state in order to digest properly. There are strategies that you can use for example breathing techniques, avoiding technology during eating, chewing food properly and eating slowly. These simple steps can have an enormous impact on the efficiency of digestion.
Digestive Processes
Digestion begins when we first start to think about the meal we are going to eat, this initiates digestive secretions. Once we have eaten the food it is broken down by acids & enzymes and also the bile salts produced from the gall bladder. All of these phases of digestion can be impacted by stress and other factors. Issues with ‘bile sludge’ are more frequent that we think and it is quite common for bile to come back up to the oesophagus and throat, causing discomfort: reflux and silent reflux – often under-diagnosed. Bitter foods and supplements can be incredibly helpful for issues around bile and reflux.
Gut Motility
The gut has a natural “cleaning wave” that moves food along when your stomach and small intestine are empty. If this movement is too slow, food can stay in the gut too long. This can lead to bacterial overgrowth in the wrong places (called SIBO), which can cause discomfort, burping, hiccups, reflux, indigestion. There are natural solutions to help support this wave for example leaving 5 hours between meals or supplementing with natural MMC stimulants.
Addressing any potential microbiome imbalances
Dysfunctions in acidity or the other digestive processes such as bile production from the gallbladder or enzyme production from the pancreas, can lead to changes in the makeup of the microbiome, further effecting the efficiency of digestion and tendency for fermentation and gas
production.
Healing of the mucosal barrier
Support can be given for the healing of the mucosal lining using diet and also supplements such as aloe vera and slippery elm.
Functional testing
can check for other factors such as H. Pylori* or Small Intestinal Bacterial Overgrowth. You may be able to get H.Pylori tested for via the GP as it is a known cause of gastritis and ulcers.
*H. pylori is a bacteria that colonises the stomach lining and can damage the protective mucus barrier that normally shields the stomach from its own acid. This triggers chronic inflammation (gastritis) and, in some people, leads to the development of gastric or duodenal ulcers. It can be tested for via stool test and an eradication protocol put in place.
Proton Pump Inhibitors (PPIs)
Many people who suffer with heartburn and indigestion are taking prescribed PPIs to keep the symptoms under control. Whilst these medications are great for reducing the symptoms, they are not removing the initial cause and long-term use can lead to nutrient deficiencies (in particular magnesium, calcium and B12). As well as impacting on digestive processes downstream, potentially increasing risk of small intestinal bacteria overgrowth (upper bloating, gas, belching)
There are some patients who no longer need to be on PPIs * but removal of the PPI needs medical support and professional guidance as there will be a ‘rebound’ effect on removal of the PPI. i.e the body will increase its own production of acid to a higher levels for days to weeks after the removal, intensifying acid related symptoms. This process therefore needs to be done gradually and following a specific protocol.
I am trained for removal of the PPI alongside medical care in certain cases where
the PPI is no longer needed.
*If the PPI is being taken to protect the stomach alongside an anti-inflammatory drug
or other medication, or for Barrett’s Oesophagus then PPI removal is not
recommended.