Why Antacids Will Never Cure Your Heartburn
by Vin Miller
Heartburn, also referred to as acid reflux or indigestion, is one of the many common symptoms of compromised health that we’ve come to accept as normal. According to the National Institute of Health, 20% of Americans suffer from heartburn symptoms at least once per week, and nearly half of these people experience symptoms every day.
As with most health problems, conventional medicine treats the heartburn symptoms of acid reflux without making any effort to understand or address it’s cause. Unfortunately, the popular methods of treating heartburn symptoms actually worsen their most common cause and can potentially lead to significant health issues.
The Irony of Conventional Heartburn and Acid Reflux Treatment
The pain associated with heartburn is caused by stomach acid backing up into the esophagus through the valve at the entry point of the stomach. The lining of the esophagus is not able to handle the extreme acidity of stomach acid, and because of this, acid reflux can cause considerable damage and lead to ulceration and even cancer. It’s commonly believed that acid reflux is caused by excess production of stomach acid, but when you take a closer look at how the stomach functions, this doesn’t make any sense at all.
The production of stomach acid naturally declines with age. In fact, we produce about half as much stomach acid by the time we’re in our forties as we did in our teens. Despite this decline, the incidence of acid reflux increases considerably with age. If acid reflux is far more common with older people who are producing less stomach acid, then how could excessive acid production possibly be the cause?
Children and teenagers tend to produce much more stomach acid than adults and have a very low incidence of acid reflux. As such, it’s obvious that the stomach is very capable of containing high levels of acid without any reflux into the esophagus or symptoms of heartburn. A better explanation of acid reflux is based on the function of the lower esophageal sphincter which is the valve that separates the stomach from the esophagus. As long as this valve is functioning properly, it will prevent stomach acid from refluxing into the esophagus. However, if it’s function is impaired, stomach acid can much more easily make it’s way into the esophagus and cause painful damage to it’s lining.
Ironically, impaired function of the lower esophageal sphincter is often associated with low levels of stomach acid which completely contradicts the basis for conventional heartburn and acid reflux treatments. While there are some cases of acid reflux that are caused by excessive amounts of stomach acid, it’s very rare.
Why Stomach Acid is So Important
Stomach acid breaks down the dense food we eat into small molecules that are absorbed by the intestines and distributed throughout the body. This absorption, which is critical to our health, can only occur when an adequate amount of stomach acid is available to create an acidic environment in the small intestine. If stomach acid levels aren’t high enough, food won’t be fully digested and it’s nutrients won’t be absorbed well. Even the absorption of supplements is impaired when stomach acid levels are low.
People who aren’t absorbing much of the nutrients from the food they eat due to low levels of stomach acid are likely to be suffering from malnutrition, even if they’re overweight. This can lead to a wide variety of conditions and diseases including anemia, heart disease, cancer and osteoporosis. It can also inhibit the digestion of dense proteins into amino acids. Because these amino acids are precursors to the neurotransmitters that promote mental stability, an inadequate production of stomach acid can even result in mood disorders.
Stomach acid also protects us from infection. Because of the extremely acidic environment it creates in the stomach, it prevents intestinal bacteria and fungus from migrating into the stomach, and more importantly, kills infectious organisms and prevents them from entering the intestines and the blood stream. Without this protection, infection from such organisms can result in a wide variety of illnesses and even cause death.
Low levels of stomach acid increase susceptibility to infection and allow more undigested protein molecules to enter the intestines. As a result, the intestinal lining becomes susceptible to damage that can lead to hyperpermeability and allow undigested protein molecules to be easily absorbed into the blood stream. This often provokes immune responses throughout the body that lead to food sensitivities and autoimmune diseases.
The Grave Mistake of Conventional Heartburn Treatment
Based on the symptom chasing mentality of conventional medicine and the misconception that heartburn and acid reflux are caused by excessive levels of stomach acid, the most common treatment protocol for these problems is to reduce stomach acid levels with antacids such as Tums, Rolaids or Alka-Seltzer or acid suppressors such as Nexium, Prilosec or Zantac. While antacids work by simply neutralizing existing stomach acid, suppressants are much more invasive because they directly inhibit the stomach’s ability to produce acid.
The fault with most conventional medical treatments is that they’re aimed at relieving symptoms and do nothing to address the problem that’s causing them. Conventional treatments for heartburn and acid reflux are even more flawed because the symptom relief that they provide comes at the cost of more significant problems. They relieve the pain of heartburn by reducing stomach acid levels, and in turn, reducing the chance of it refluxing through the malfunctioning lower esophageal sphincter. In fact, some heartburn treatments nearly reduce acid levels down to nothing. While this may relieve pain, it worsens the digestion and absorption problems associated with low levels of stomach acid and increases susceptibility to serious health issues.
How to Resolve Heartburn and Acid Reflux Naturally
The best way to avoid heartburn and prevent acid reflux is to support proper function of the lower esophageal sphincter. The following are some practical ways to do this.
- Drink more water. Dehydration can lead to acid reflux by causing the lower esophageal sphincter to relax.
- Avoid foods and beverages that can weaken the lower esophageal sphincter. This includes chocolate, coffee, mints, sugar, alcohol and onions.
- With the agreement of your physician, avoid medications that can weaken the lower esophageal sphincter. This includes bronchodilators such as theophylline, albuterol and ephedrine, and NSAIDs such as aspirin, ibuprofen and naproxen. It also includes calcium channel blockers, beta blockers, diazepam, valium, nitrates and demerol. Cigarettes should be avoided as well.
- Don’t overeat. Excessively large meals put pressure on the lower esophageal sphincter and encourage it to open when it shouldn’t.
- For the same reason why you shouldn’t overeat, you should also avoid anything that increases intra-abdominal pressure such as bending, heavy lifting and tight clothing.
- Elevate the head of your bed by 4 to 8 inches. This will keep gravity working in your favor and make it less likely for stomach acid to drain into the esophagus.
- Get tested for food sensitivities and avoid the reactive foods that may be interfering with the function of the lower esophageal sphincter. If it’s not practical for you to get tested, at least consider a trial of eliminating grains and dairy from your diet. These are the two most likely food groups to cause sensitivities.
It’s also helpful to avoid foods and beverages that can irritate the lining of the esophagus. This includes citrus fruits, tomatoes, spicy foods, coffee and carbonated beverages.
Supplementing with Hydrochloric Acid
Hydrochloric acid is naturally produced by the stomach and is the primary constituent of it’s digestive fluid. It’s commonly available in supplement form and is a convenient way to increase low levels of stomach acid. For people who have a chronic insufficiency of stomach acid, hydrochloric acid supplementation can be a very effective way to improve digestion, absorption and many of the health issues that can be caused by malnutrition. People who need hydrochloric acid supplementation tend to also benefit from digestive enzymes, especially pepsin.
Although hydrochloric acid supplementation is generally safe, it does pose some risk. People who have a damaged gastrointestinal lining could potentially worsen the damage by taking hydrochloric acid. As such, it’s recommended that you find a physician who is knowledgeable about acid reflux and it’s frequent association with low stomach acid levels. If possible, seek out a physician who uses the Heidelberg test to assess your current level of stomach acid production. For more information on this test and to find physicians that use it, visit Heidelberg Medical Incorporated.
Additional Information
For more information on heartburn and acid reflux, I highly recommend that you read Why Stomach Acid is Good For You by Jonathan Wright, MD. Dr. Wright is one of the most widely recognized and appreciated supporters of natural medicine and provides a great deal of information in this book. You’ll find more detailed information about the true cause of heartburn and acid reflux, the many problems caused by the digestive issues associated with low levels of stomach acid, the dangers of popular antacids and acid blockers, and a variety of natural supplements that will help relieve heartburn and prevent acid reflux.
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Great article Vin! I wish I had known all this many years ago. I swallowed prilosec and then nexium for years. When I quit taking pills and changed my diet and never had a problem again.
Makes sense! I made the switch from acid suppressants a while ago and instead, changed my diet, changed when I ate, did not eat three hours before going to sleep and inclined my bed using a MediWedge. The MediWedge provided the doctor recommended 4″ of lift, allowed me to sleep on the mattress surface that I purchased for my comfort, allows me to sleep in any position that I like, lets me use the pillows that I love and does not raise the center support of the metal base frame – which voids the warranty of your set of bedding.
I used to have problems swallowing food, but with these changes I enjoy every meal.
People for years have been taught that their heartburn is a result of too much acid. Where did we learn this? TV, magazine ads, and every other media outlet that the big bad drug companies could exploit us with. This book is a must read for anybody with heartburn or any questions about the drug industry.
I think this example is the poster child for how far drug companies will go to make a profit. As your article states, most people have a lack of acid vs. not too much acid. After being bombarded with advertizements, we all are conditioned to think the opposite. Why? How else would the drug companies make their millions. They certainly won’t by telling us that to change our eating habit, giving us some tips on lifestyle modifications, or taking some inexpensive safe supplements.
Here is what really makes me sick. If you don’t have enough acid in your stomach, and you certainly will not have enough after taking their meds, you will not digest your food properly. This will inhibit the proper uptake of nutrients in you small intestines, which could lead to all kind of other conditions as well. Your gut contains between 70-80% of your immune system. You can imagine how harmful any dysfunction here could be.
In summary. The drug companies are pushing meds on us, that not only go against the root cause of the issue but also make us sick with other conditions as well. Yes they sell us meds for those as well.
Proper digesting is a key to a healthy body and mind. It starts with what you put in your mouth. Read this book and educate yourself.
Another great post, Vin. Thanks.
Thanks for the great comments guys!
Stephen – Better late than never!
Ed – It’s great to hear that you resolved your heartburn naturally. Thanks for sharing your experience! The MediWedge looks like a great product.
Don – I was actually going to discuss the influence of the drug industry in my article but I decided not to since it was already long. As Jonathan Wright says in his book, the drug companies are well aware of the fact that heartburn and acid reflux are rarely caused by excessive stomach acid. Unfortunately, many drug company executives care more about their profit than our well being. The misinformation about cholesterol is another glaring example of this.
As you mentioned, the digestive system is at the center of our health. Neutralizing or suppressing stomach acid with antacids or drugs opens the door to a wide range of additional problems.
If I avoid almost all carbs, I just about never get reflux. I’m tempted to just say “never,” but I don’t want to be inaccurate and it’s possible I occasionally get a little bit of heartburn. Still, it’s very, very rare. It’s certainly not the “grease.” If I’m low-carbing I do it high-fat, so by definition I eat grease and oil and fat, and none of it fazes me.
Hi Dana, thanks for sharing your experience! Acid reflux is often linked to diabetes and research has shown that hyperglycemia (high blood sugar) weakens the lower esophageal sphincter in both diabetics and healthy individuals. As such, it makes sense that carbohydrate consumption can provoke acid reflux.
Can you eat low starch fruits and vegetables without incurring symptoms?
Hi Vin,
“This absorption, which is critical to our health, can only occur when an adequate amount of stomach acid is available to create an acidic environment in the small intestine.”
This isn’t how digestion works in the small intestine. A step is missing. As soon as the food broken down by acid in the stomach passes through the pyloric valve into the small intestine, it is met by bile from the bile duct. Bile is extremely basic and neutralizes stomach acid before digestion completes and absorption begins. Acid is bad for the small intestine.
There are some bacteria and parasites that survive well through full strength stomach acid: H. pylori, C. botulinum, tape worms, and round worms to name a few. There are several more.
Eating well before lying down, raising the head of the bed and changing the diet, eliminating foods and drinks that aggravate reflux, staying hydrated and knowing if you have any food sensitivities are all extremely good advice, and most doctors will have you try all those things before putting you on medication for heartburn. Many people won’t follow this advice and just want a quick fix for the problem so they can get back to their unhealthy lifestyles.
However, I must disagree with stopping “bronchodilators such as theophylline, albuterol and ephedrine, and NSAIDs such as aspirin, ibuprofen and naproxen. It also includes calcium channel blockers, beta blockers, diazepam, valium, nitrates and demerol.”
These medicines are needed for serious illnesses that cannot always be controlled by diet and exercise, like hypertension, angina, asthma, blood clots, seizures and painful arthritis. Hypertension, asthma, blood clots, angina and seizures are life-threatening, and relief from acid reflux should not have priority over treating life-threatening conditions.
Anyone on oral demerol has something serious going on that requires significant treatment for pain. There may be other choices for pain relief that could be tried. Demerol is irritating to the stomach and intestines by itself and is usually given with phenergan or visteril to counteract those symptoms.
If someone wants to discontinue these types of medicines, it should be under the direct supervision of a qualified physician with no exceptions.
Acid reflux can be miserable and lead eventually to esophageal cancer, but a stroke, heart attack, seizure or severe asthma attack can kill you fast, in minutes to hours.
I hope you will add a note with the medication bullet point to consult your physician before stopping any of the listed medications. For many people those medicines are a matter of life and death.
Sherri
Sherri.
The recommendation to discontinue all benzos such as diazepam (Valium) Lorezepam (Ativan) Rivotril (Clonazepam) and similar “pams” is because they actually cause reflux by weakening the LES as many things do. In this case stomach acid, too much or too little, has nothing to do with heartburn and reflux symptoms as it is purely a function of the Lower Esophageal Junction receptors being affected by the benzos that act upon the GABA sites (benzodiazepine receptor sites on the post synaptic nerve endings) so if a person is having what they think is an over acid condition and they are taking benzos it is likely from that. Chocolate and caffeine seem to have a similar affect but I don’t know why and sometimes alcohol as well.
However, benzos are not to be prescribed for more than 2 weeks and are a controlled substance in many countries with some of them having been banned over the years.
For those on them for many months and years it is very dangerous to stop them cold turkey. The free Ashton Manual on benzo.org.uk explains how to get off them safely and with lesser withdrawal symptoms. Don’t let a doctor convince you that you need to be on them for life as this is untrue. They just don’t want to deal with the rebound anxiety and withdrawal symptoms their patients exhibit when coming off them.
Hi Randall, thank you for sharing this valuable information!
Hi Sherri, thanks for sharing your thoughts.
Yes, stomach acid is dangerous to the small intestine and needs to be neutralized to prevent damage. This is why dehydration can cause acid reflux. According to Dr. Batmanghelidj, the body would typically not allow a solution of digested food that is too acidic to enter the small intestine anyway.
In his book, Dr. Wright says that adequate stomach acid production is needed for proper nutrient absorption in the intestines. In other words, a specific pH range, which is obviously less acidic than stomach acid itself, needs to be established for proper absorption to occur. Without enough stomach acid in the solution of digested food that enters the small intestine, this range won’t be reached.
The recommendation to avoid those medications is also directly from Dr. Wright’s book. While I am by no means suggesting that people who are currently taking these medications should stop them without talking to their physician, I can see how the wording could be misleading and I changed it. Thank you for your suggestion.
I would like to take this opportunity to clarify that by no means am I attempting to treat or diagnose medical conditions through this website. Rather, my goal is to help educate people so that they are better equipped to make informed decisions.
Just found your website and started exploring. This article caught my eye since I have been dealing with either chronic acid reflux or chronic ulcers for most of my life. Stress makes the problem worse, and I eventually had extreme aching plus severe stabbing pain. My doctor put me on a course of Prilosec, and told me that I could essentially take it long-term if the problem returned. It kept returning, and I ended up taking it for 9 months or so (if I’m remembering correctly), but I became worried about malabsorption and decided to stop. I tried to figure it out on my own. I identified foods that gave me problems (a whole lot), and then realised that inadequate chewing was probably a big factor for me. I tend to chew for a set short time and then swallow whatever is in my mouth, and end up with indigestion and acid backwash (and also sometimes lower GI problems too). Now, I try to chew my food more thoroughly, but it requires constant concentration and I’m not always successful especially when I eat with other people.
Since going off the Prilosec about 2.5 years ago, I’ve managed to not go back on it. I still have acid reflux, and occasionally under stress the pain from (assumed) ulcers returns. But, it’s gotten somewhat better, and I’ve found a secret weapon which I will share with you – perhaps someone else will find it helpful. Sometimes I can’t avoid having a big meal with people and end up overeating/underchewing – the result is an ‘acid’ stomach with some indigestion and reflux. I wait a little while, and then eat a raw egg. (I can now down a plain egg lightly beaten, but started out with the delicious version: free-range farm egg + raw cream + vanilla extract + small amount of natural sweetener.) It immediately cuts the acidity, and relieves the pain!
I couldn’t really find any mention of this anywhere online as a treatment for acid reflux – it seems to be completely unknown. I did find one mention of raw egg being used to treat some stomach problem in an old medical book on Google Books (sorry, don’t remember what it was) that said the protein bound with the acid in the stomach. That makes sense to me – and I use this trick any time I have a problem. It’s a great quick fix, and the rest of the time I try to eat well and chew well to prevent the problem from happening.
Hi Leela, welcome to the site and thanks for sharing your experience!
Congratulations on finding a natural and healthier alternative to your acid reflux! The comfort you gain from eggs is quite interesting. I’ll have to look into that to see if I can figure out why. Chewing thoroughly is a great way to improve your digestion, even for people who don’t suffer from acid reflux.
As long as you’re still experiencing heartburn, you may very well be incurring damage, or at the least, preventing recovery from existing damage. I think it would be a great idea to find a doctor that can administer the Heidelberg test to get a better idea of what’s really going on. You can use the link provided in the article to help you find one.
For a few years, I was having what felt like heartburn. I never had acid coming up my throat, but I’d feel a grabbing pain in the upper stomach when I ate certain foods or after eating.
After 2 endoscopies, they found nothing. One doc said it could be a spasm which I never heard of before. I heard about this product called Heartburn Free (Enzymatic Therapy). It’s basically orange peel extract. There are 10 gelcaps and you take one every other day. I tried it and it seemed to help. I don’t get attacks too much anymore.
Whenever I would eat white meat chicken, salmon that was too dry, pizza and a few other things that I can’t remember..I would feel that gnawing pain. I only eat dark meat poultry now (protein types as I’m told should only eat dark meat).
Before I go to the gym for lifting, I usually only have a liquid meal (smoothie, etc.).
It’s still a mystery as to what I had and why it went away.
Hi Sharona, thanks for sharing your experience!
One of the great things about holistic health is that when you treat your body as a whole and establish a foundation of good habits that promote optimal health, a variety of complaints will often disappear without addressing them directly. Perhaps this was the case for you. It’s always nice to know the exact cause and solution of a problem, but you certainly can’t complain about it being resolved without knowing why.
In regard to protein types, dark meats are recommended because of the purines they contain which slow down oxidation. I’m a protein type too, or a Fast Oxidizer in Metabolic Typing terms. Purines are important for people like us who burn through carbohydrates and light meats too quickly. Salmon is considered to be a high purine food and should be fine for a protein type, but there’s no point in eating it if it causes you discomfort.
I suffered from gerd for years, taking prevacid or ranitidine all the time. I was never told to change my diet, only to avoid spicy foods.
I became a vegetarian, eating mainly whole foods and have been off meds for 2 1/2 yrs. now. I avoid most processed foods, eat lots of spices and even hot peppers sometimes and never have heartburn any more.
Years ago gerd was unheard of, now it seems that everyone has it. What has changed? For one thing the food people eat has changed. It is so highly processed that most of it is nutrient devoid, and it’s full of chemical additives and gmo ingredients. The medical community will not tell you to change your habits, there is too much money to be made on drugs and tests.
I was told I would need to be on acid reflux meds for the rest of my life, and to get an endoscopy every 6 months to 1 year. After changing my diet, none of that is necessary.
I am glad to have found your blog, it is very interesting.
Thanks for sharing your experience, meatlessmama! It’s great to hear that you were able to escape a lifetime of taking medication by switching to a natural diet. Congratulations!
I hear countless instances of people being told they need to take medication for the rest of their life without being given an alternative. It’s such a shame! Although it’s easy to blame the doctors, I think many of them sincerely want to help their patients as best they can. I think the drug industry and the influence it has on what these doctors are taught during medical school is where the problem really starts.
I’m happy to hear you’re enjoying the site!