How to Reduce Acid Reflux

KARA: Welcome to Dishing Up Nutrition. Today's show about acid reflux is brought to you by Nutritional Weight & Wellness. Now, you might not be aware that about 30 percent of people frequently experienced acid reflux, also called GERD, which stands for gastroesophageal reflux disease. It's a very chronic problem. It's a common condition that affects the digestive system of both adults and children. Many people experience a little heartburn or indigestion from time to time, but if it's a weekly occurrence or a regular occurrence, that condition over time can actually lead to something called Barrett's esophagus. That's a disease that can lead to esophageal cancer, so this means that preventing acid reflux is a really important long term health goal. My name is Kara Carper. I'm a licensed nutritionist and I'm super excited to be here today with my co host,Shelby Hummel. She's also a licensed nutritionist. I have a master's degree in holistic health. Shelby has a master's degree in clinical nutrition and over the years we've helped hundreds of people put their acid reflux into remission and we're not talking about for medication but with natural ways, so that's really what our show is going to be about today.

SHELBY: So really what you're saying is when we work with people and when we are able to help them put their acid reflux into remission, really what you're saying is there is hope for people out there who have indigestion here or there. People who maybe have chronic heartburn or people who feel like they're uncomfortable all the time? We have options.

KARA: We have helped all of those different scenarios. You know, whether it's the occasional annoying heartburn or whether it's keeping you up at night and you can't sleep or you're like sleeping in a recliner, we can get to the bottom of it.

SHELBY: And you may be surprised we're not going to be talking about the little purple pill today as the only option. So, Kara, good morning to you. You had mentioned before, one of the reasons why we're so passionate about getting people help is that there are actually some other health conditions, some situations like esophageal cancer that could be the end result of acid reflux or heartburn that is not actually addressed. So I want to bring some research right away this morning. Want to make sure your listeners are awake. We're talking about a study from the Mayo Clinic. They found that five percent of people with acid reflux in the study developed what is known as Barrett's Esophagus, which Kara mentioned is kind of setting the stage four esophageal cancer. It's that precursor. So having recurring acid reflux is much more than just being uncomfortable or having to sleep in a recliner. Recurring acid reflux is actually a dangerous health condition.

KARA: It really is. We just wanted to let listeners know that because I don't think a lot of people have heard of Barrett's esophagus. People have heard of esophageal cancer, but acid reflux is a really common problem. If you're listening, you probably know that it's even common for babies to have acid reflux and we know certainly it's common for teens and adults to have acid reflux as well. It might come as a surprise to you that women seem to be more affected by acid reflux compared to men. So, if you've had it, if you're listening and you've ever had it, even just one bout, and I'll share my one situation later in the show that I had, you know it impacts your quality of life.

SHELBY: Now, Kara, you said that it can be common in babies, teenagers, young adults, older adults, but we have to remember that common does not mean normal. That doesn't mean that that's normal to feel that indigestion, that acid reflux. So if you are showing signs of reflux, that means we want to take a closer look at your nutrition. Now, no surprise as nutritionists, we take a different approach to acid reflux than many other healthcare practitioners. We don't necessarily beat up on conventional medicine, but we just know that in general when you're going to your primary care doctor, they are looking at a quick fix, right? It's more of a bandaid type approach that's treating the symptoms and they may not necessarily have enough time to get into the root cause. So that's where a nutritionist comes in, right? They may be prescribing an acid blocking medication, for example, like an H2 blocker or a proton pump inhibitor. Listeners, you may know those as Omeprazole or prevacid, or some people take over the counter tums, kind of a wide variety of those medications. But as nutritionists, we know that we want to look at the root cause of that acid reflux, which to be honest, more often than not is what people are eating or drinking that's causing irritation in the esophagus, in that upper digestive tract.

KARA: Most people, including a lot of doctors, really believe that acid reflux is the result of too much stomach acid. How often have we heard that? “Oh, I have heartburn. I have too much acid. I better take an acid blocker.” I think this is a really, really big misconception. And we're going to talk more about the research that proves the opposite actually, that we as nutritionists understand that acid reflux most often results from people having not enough acid in their stomach. Now, that's probably a big surprise. Not enough stomach acid. That's correct though. Now, not having enough stomach acid can be caused from a lot of different factors. It can be caused from stress, poor diet, maybe not having enough what we call good bacteria or probiotics in the gut. The good gut bugs. And I think you are going to share some research about not having enough stomach acid and how common it really is.

SHELBY: Well, Kara, it's not just you and I, it's not just the other nutritionists at Nutritional Weight & Wellness that understand that it's not enough acid in the stomach. There's actually other doctors out there. So it's not just our opinion. We're not just going against the Proton pump inhibitors, the acid reducing. I want to bring you some research. Most people assume that heartburn is from too much stomach acid when actually the opposite is true. And so I want to bring you some information from Dr. Jonathan Wright. He is an expert on Gerd at Tahoma Clinic. He actually reported that in his 25 years of conducting tests, he found it very few people with excess stomach acid. So that's Dr. Jonathan Wright at Tahoma Clinic. Very few people with excess stomach acid. And he even goes on to say when we carefully test people over the age of 40 who are having heartburn, over 90 percent of the time, we find low stomach acid production.

KARA: So interesting, 90 percent. So you know, there might be 10 percent or so. It is possible to have too much stomach acid, but we just want to get the point across that it's very unlikely that that would be the issue causing the acid reflux or heartburn.

SHELBY: So Kara, if we say the excess stomach acid is not truly the underlying cause of most heartburn and GERD, then what is it? What are we going to talk about now?

KARA: We're going to talk about that a lot of times it is related to food and beverages, poor gut health. I was going to share, I call it my chili story. So, I have chili in our house on a pretty regular basis and especially in the winter when it's 3 below in Minnesota. And so people kind of associate chili with heartburn, right? The tomatoes, the spicy food. It's the spices and the tomatoes. So I’ve been eating chili for a really long time, never had heartburn. And then one night after having a dinner, I had this worst pain in my chest. I didn't know what it was because I had never experienced this heartburn before. But for those people that struggle with this, I thought, oh my goodness, it feels like you're having a heart attack. It’s really scary this feeling in your chest. And so, my husband said to me, well it was probably the chili, but I said, well, I have chili all the time. But what I at this birthday celebration after the chili, well I had cornbread with it, I also had some cookies and some birthday cake and some wine. OK I'm totally fessing up here. But the corn bread, the cookies, the birthday cake and the wine. Sugar, gluten, that's really what I believe gave me the heartburn,  just an excess of the sugar and the gluten.

SHELBY: Well, and it's interesting because some of the other common culprits that people think of besides tomatoes and spicy food, they often think of things like having chocolate or fried foods and things like that. But we're going to talk more about that notion of food because although it may not be the chili that's the problem, we know that the sugar and the gluten can be.  It may interest you to know that good intestinal health also supports a good immune function. And I know that personally. When we come back from break, Kara will recommend a probiotic or a good gut bacteria that you and your children can take during cold and flu season to keep your immune system strong. We'll be right back.

BREAK

KARA: Welcome back to Dishing Up Nutrition. During cold and flu season, we often think of hand washing, maybe extra vitamin C. Of course both are really good practices. However, your gut or your intestinal tract is actually the cornerstone of your immune system. In fact, 70 to 80 percent of your immune system is located in your intestinal tract, so to support your immune system, we recommend taking two bifido bacteria supplements before each meal. It's really helpful for kids that are going to daycare or going to school. And it's obviously safe for kids. I gave it to my daughter actually when she was an infant and continue to give it to her today and she's seven. So, at Nutritional Weight & Wellness we have bifido bacteria supplements available both in capsules and in powder form.

SHELBY: Good. So when we think about our topic this morning, we're talking about acid reflux and before we went to break, Kara mentioned that a common misconception is that acid reflux is because of having too much stomach acid and we are actually coming out and reminding people that that is not the case for most types, most causes of heartburn or gastroesophageal reflux disease, which we know as GERD, right? Most often people do not have enough stomach acid and that can actually be caused by stress, poor diet, or even a lack of good bacteria. So, Kara was mentioning Bifido bacteria for the immune system, but we would also talk about bifido bacteria to help support good digestion, reducing those symptoms of acid reflux. But I want to talk briefly about the food part. At Nutritional Weight & Wellness, we always say food first. So I want to share a client story. I have a client that I bet many of our listeners can relate to. You may be thinking, oh, she's describing me exactly. I've been working with this client for some time now and when we first started working together, she was experiencing terrible acid reflux during the night, kind of interfering with her sleep. And I kept asking a lot of questions about, well, why is it that you're not getting good sleep? And she would experience reflux at night, sometimes after eating. To be quite honest, she was experiencing acid reflux all the time, so she had been prescribed and was taking a variety of acid reducing medications, which is typically what you're getting from your primary care doctor. But for our listeners, that would include things like Nexium or Prevacid, or even Prilosec, Zantac, or Pepcid. But this particular client wasn't finding that that seemed to help long term. And so she finally decided to give nutrition at try. So we kind of took it one step at a time, changing what she was eating for breakfast, adding in some good supplements with good bacteria. And then of course we had to break that wine habit every night. Right? Drinking more water than wine.

KARA: And that can be a big culprit for people, wine and beer. And Shelby, you told me that her acid reflux symptoms went away and that she even vacationed in Costa Rica without any heartburn. But then you also told me that it returned over this past holiday season. So can you just explain to listeners what happened? Why did it come back after being gone?

SHELBY: Well, and I think what happened, she was really excited that she was able to vacation and have some freedom from that acid reflux. But I think what happened was life, right? Like so many of our clients, they get this glimmer of hope, they see some improvement and then maybe they fall back into their old habits. So for this particular client, first thing that happened was her mother was hospitalized and unfortunately hospital food is just not as good as what we make at home. And so that was really the meal that kind of flared back her acid reflux, eating hospital food. but then I think the nail in the casket here was really a holiday meal. She had a pasta meal and of course there was red wine and those holiday treats and so that really is what set things in motion.

KARA: That makes a lot of sense, so the pasta would likely contain wheat or gluten and for a lot of people that's going to cause inflammation in the intestinal tract and that alone, I think it's that combination again for a lot of people, the gluten grains with sugar, like you had mentioned, wine resulting in food backing up and this acid reflux. Once that inflammation response starts, I mean for some people it can take days, maybe even weeks to really calm that down and get out of symptom mode again.

SHELBY: Exactly, exactly. And this particular client, she was saying that the reflux was really intense and she did actually make an appointment with her doctor who prescribed an acid blocking medication. It helped a little bit with the symptoms, but she knew that she just didn't feel her best on those acid reducing medications. She knew that she tended to have lower moods, low energy, and so she was really committed to that nutritional change. Not only that, she knew that those acid blocking medications can weaken our bones, make it a little bit harder for us to break down our minerals. So, I think after a few little bumps in the road over the holidays, she understands really how sensitive her digestive system is to gluten and wine and sugar in general. And I think honestly, I think she's willing to say no, thank you to the bread, to the pastas, to the cookies and the sweet rolls. Basically any of those processed foods. And I know she has another trip, another adventure coming up. She's actually going to Ireland and I know she'll do just fine. She’s going to be free of that inflammation and that pain. I have not personally been to Ireland, but it's amazing to hear some of my clients with Celiac disease and even gluten sensitivity, they're so excited because they can eat a lot of things in Ireland.

KARA: Well, and you probably assured her because of the research that we were talking about earlier, 50 percent of people in Ireland are thought to be gluten sensitive. I have actually been to Ireland, my grandmother was born there and I have a lot of family there. Restaurants and even pubs are offering a lot of gluten free options. They have gluten free menus, so that's going to be a huge relief for her. So listeners, can you relate to this? Did you also experience maybe worse acid reflux than normal over the holidays? If so, it could have just been kind of a combination of things. Christmas cookies, maybe it was that pancake breakfast that you had, all that stuff just adds up.

SHELBY: Now Kara, I know we're talking specifically about the food piece of this and we will talk a little bit about supplements as we continue with our show. But do you want to take a caller? We've got a call in relation to the probiotics that we were talking about. Good morning, you have a question for us on Dishing Up Nutrition?

CALLER: I do. I will be taking amoxicillin for a week after having dental surgery. And it's the protocol they do so you don't get an infection and I know that, the antibiotics will kill all the good bacteria that I'd been building up. How can I build up the good bacteria as I take the antibiotics at the same time? What kind of protocol do I do?

SHELBY: Oh, Jan, I just want to give you a big, high five. You are thinking ahead and knowing that if you're going to have this sort of exposure to antibiotics, you want to make sure your gut bacteria has some time to recover. So Kudos to you. So Kara, when you think about someone who is going to take antibiotics for a week or 10 days or some short amount of time frame, what sort of things would you recommend for them to make sure that they support the good bacteria and their immune system?

KARA:Yeah. I don't know if Jan, you heard earlier in the show we were talking about the bifido bacteria supplement.

CALLER: Yes. And I take those.

KARA: Wonderful. So I don't know if you're taking ours. A lot of, other places also would have powder or capsules, so those are kind of the two options, and I would just stick with the dose that we had recommended for improving gut health for acid reflux, which is two bifido bacteria capsules before each meal, or you could also do the equivalent, would be about a half teaspoon of the bifido powder before each meal.

SHELBY: And it's important, Jan, because you're taking the antibiotic, you want to make sure to take those good bacteria, the bifido bacteria about two hours away from your antibiotic because we don't want them to be competing. And I would say, maybe a month or six weeks after, make sure that you're getting some good fermented foods, Sauerkraut, Bubbies, pickles, things like that, some of the good bacteria. Thanks for your call this morning!

BREAK

SHELBY: Before we went to break, we were talking about stomach acid and we want to make sure that our listeners really understand when you do not have enough stomach acid, you cannot fully digest the proteins you eat. So think about this. Instead of moving that food from your stomach into your small intestines, you actually have undigested food sitting in your stomach longer than it should be. So you may be uncomfortable after eating, you may be bloated. You may start to feel that acid coming back up into the esophagus.

KARA: So people also get gassy, kind of that bloated, gassy feeling. So when we think about the undigested food, sometimes that backs up into your esophagus, right along with a small amount of stomach acid and the acid burns, and that's the symptom of acid reflux. But here's the thing, if you had sufficient acid in your stomach in the first place, your food would have been broken down and that food would have moved out of the stomach and into the intestinal tract without any incident, and there would be no acid reflux or heartburn and problem.

SHELBY: And so when we think about your stomach acid, that is supposed to be breaking down the proteins like chicken or turkey or beef or eggs, and that stomach acid breaks are proteins down into smaller molecules called amino acids. Now, most of our listeners have probably heard about the amino acid called Tryptophan, right? We eat turkey, that breaks down into the amino acid Tryptophan, and it's these amino acids that help build our muscles. They give us good energy and they create important brain chemicals or neurotransmitters, right? So if we stay along the same lines of turkey breaking down into the amino acid tryptophan, when that tryptophan is used as a brain chemical, we know that is Serotonin.

KARA: Right. A lot of people hear about Serotonin. We want more of that, right? It's the happy, feel-good chemical.

SHELBY: And really when we think about stomach acid, stomach acid is really that important piece to help our muscles, to help our energy, to help our moods once we break down that protein.

KARA: I think it's so important that you brought that up. I don't think most people are thinking, “Oh gosh, if I'm taking an acid blocker, then I don't have enough stomach acid and I might be inhibiting my muscles from building or my energy.” Yeah, utilizing that protein that we're eating right or having enough serotonin and occasionally it's difficult for clients to understand that when they take acid blockers that's destroying stomach acid and because of that they're not able to digest their food properly and so low stomach acid interferes with, like you just said, the digestion of the breakdown of proteins. These are the things that it can lead to. Depression, anxiety, brain fog, fatigue, weak, fragile bones. We're going to talk more about that, too.

SHELBY: And that's exactly why in the beginning of the show we talked about, although an acid reducing medications may work in the short term, it is really a band-aid approach. So low stomach acid can also lead to frequent infections. That stomach acid is designed to keep bacteria and yeast in check. It's also designed to make sure that we're not exposed to any food-borne illnesses. That's kind of the gatekeeper for our immune system and our digestive tract.

KARA: I have a visual of, if we have enough stomach acid, we kind of, I picture it, this is probably not how it's mechanically happening, but it's attacking the ecoli or the staff or it's attacking the strep.

SHELBY: And we hear so much about these romaine lettuce being unsafe to eat. We hear about these foods that are being pulled off of shelves because we have these foodborne illnesses. And really in the big picture, of course we don't want to be eating those things, but on a day to day basis, our body is designed to be able to kill any bacteria that we may be coming in contact with.  So when you're not having enough of that stomach acid, the defense is reduced. We may actually see an increased risk of infections. Specifically things like C. Diff.

KARA: And that's a really big problem, too. That C. Diff. can put people in the hospital. When you lack sufficient stomach acid, you can experience things like yeast overgrowth or excess bad bacteria. Kind of the ones we were just talking about, whether it's C. Diff., Ecoli, strep, staff. Not having enough stomach acid can also lead to more sugar cravings and certainly more problems with the immune system. You're more likely to catch something whether it is that virus that's going around or that bacteria that's going around, that's why it's so important to make sure that you treat acid reflux nutritionally and really get to the root cause because again, that acid blocker is a band aid approach and that is the typical medical treatment is to just take an acid blocker and a lot of them are over the counter or prescription, but they're both readily available.

SHELBY: And top selling medications here. So, Kara, when we kind of step back and think about, we've talked about the nutritional approach being kind of the safest way and getting to the root cause of that. What would be some other reasons why we would want to help people stay off of those acid blockers, those proton pump inhibitors, like Prevacid, or Nexium or Prilosec.

KARA: Great question. So, those PPIs, Proton pump inhibitors, not only block the release of stomach acid, but they also make it very like impossible to absorb vitamin B12.

SHELBY: Now why do we need to make sure we're absorbing vitamin B12?

KARA: Well, I mean we need vitamin B 12 for a lot of reasons. For our brain health, for our nervous system, we need it for moods, for energy.

SHELBY: I think of B 12 as those clients of mine who have a really hard time getting out of bed in the morning. So if you're listening this morning and you feel like you are really struggling with energy and you're experiencing heartburn or acid reflux, maybe it's time for you to make an appointment with a nutritionist to kind of see what's really going on.

KARA: I don't know if people are making these connections between the acid blockers they're on and low vitamin B12. Another thing that can happen is it can reduce the absorption of a lot of minerals that are very, very important, such as iron, calcium, magnesium. So, if we're taking acid blockers for an extended period of time, we are not absorbing magnesium, calcium, and iron.

SHELBY: So when we think about not absorbing those minerals, I mean just off the top of my head, calcium, would you say that taking a proton pump inhibitor or an acid blocker long term is going to set the stage for Osteopenia or osteoporosis?

KARA: Certainly, and there's a lot of studies showing that, that there's an elevated risk of osteoporosis when people are on acid blockers. There's  increased risk of fractures, especially from risk to spine and hip. That's actually from a Meta analysis and the analysis of family medicine from 2011. So these are all things, there can be deficiencies of zinc, vitamin D, vitamin K, we need all of that for bone health as well as people know about calcium and magnesium.

SHELBY: Well, I think after break we should give our listeners some real food ideas. So, we're going to take a break here.

BREAK

KARA: We're back from break and you're listening to Dishing Up Nutrition. Our topic today is how to reduce acid reflux and gerd with nutritional solutions. To all of our podcasts. Listeners, we invite you to come to the Minneapolis St Paul area to take a class or a seminar in person. Now, if that's not possible, we have a lot of classes available online as well. We recently updated our 12 week Nutrition 4 Weight Loss series online and Nell and Melanie both did an excellent job. Shelby mentioned earlier that Nell, who has lost 90 pounds and maintain that 90 pound weight loss. She wears clothes that are 10 sizes smaller, she's going to be on next week, but she's also one of the teachers in the Nutrition 4 Weight Loss online series, so she teaches what worked for her and how she was able to overcome those bad habits that in the past were keeping the weight on. So again, if you live out of state, the online classes are a great way to be connected to our life changing information. If your goal for 2019 is better health or weight loss or both, we encourage you to take our Nutrition 4 Weight Loss series online and you can sign up by calling 651-699-3438. You can always go to our website to sign up as well.

SHELBY: Now Kara, before we went to break, we were talking about a few of the reasons why people would be encouraged to look at nutrition as their first approach for reducing, eliminating acid reflux. So when we ask the question, how do you beat acid reflux nutritionally? I start with food. I typically have that conversation with my clients about good digestion. Now we know that protein, cooked vegetables, and real fat, those things are really quite easy to digest compared to the gluten grains, the crackers, milk and soy products, and even other beverages like soda. So when I'm talking with my clients, I know that some of them may be sensitive to gluten grains. Some of them may be sensitive to other foods. Now since each person can have a food or different foods that they're sensitive to, we know each person is unique. We ask the questions, we continue to ask questions again to try to find the root cause of their acid reflux. And oftentimes when I'm in a counseling session, I try to give people real food in terms of things that they could make. Some cooked vegetables, that would be easy for them to digest. The big picture here with food is that we want to remove the sugar and the processed foods. We want to remove the things that are hard to digest like gluten grains, and sugar, and bring in a variety of good vegetables, easy to digest protein like eggs and cooked meats and fish, and we want to make sure we have those healthy fats.

KARA: Right, and I think it's interesting when you say easy to digest proteins, that's another really big misconception out there is that proteins are hard to digest. Well, first of all, if we have enough stomach acid, they are actually one of the easiest foods to digest. So, I always tell people, if they're saying, “I just can't eat meat” or “It feels like it's just sitting in my stomach,” the first thing that comes to mind is they probably have low stomach acid. They're not able to break down that protein because protein should be very easy to digest.

SHELBY: Now, where would you start in terms of looking at the food, but then taking that next step and looking at some supplements?

KARA: Sure. Well, after the first initial conversation about food, which is where we want to start, I'll start with recommending supplements that are going to help correct the amount of stomach acid needed so that the foods can be broken down and digested. So the first thing I would do is to recommend two different probiotic, I believe just different species, so different supplements. So, we want to support the small and the large intestinal tract. So we're gonna start with a probiotic that we already talked about in this show. And this is relevant for babies to age 100 or older, it's bifido bacteria. Everyone can benefit from bifidobacteria and research has found that the concentration of bifido decreases as we age. So really the greatest decline is going to be in the elderly population and if we don't have enough bifidobacteria that can result in constipation, diarrhea, and gas. Any tummy troubles. And the extensive research conducted on the health benefits of bifidobacteria has found that it plays a really key role in maintaining immune function, cravings for sugar, and cravings for carbohydrates like crackers, cereal, bread. So our recommendation is two capsules of bifidobacteria before each meal. And that’s for someone that has acid reflux as well.

SHELBY: And then Kara, we're also talking today about another probiotic that we often to help   raise that acid level in the stomach to make sure that those foods, especially proteins, are broken down. So that one is known as Lactobacillus acidophilus. And most of the time we just call it acidophilus. Just like Bifidobacteria, you can take acidophilus in either a capsule or a powder form. I personally really like the ultimate acidophilus capsules that we carry. I normally have my clients take two of those at bedtime. But you can also take our powdered acidophilus, which is called Dophilus powder. Now, with the powder, you would be taking about a half of a teaspoon mixed into a little bit of water at bedtime. But if you think about that word, the root of that good bacteria is acid, right? So we know that it's going to naturally help us have the right amount of acid in our stomach and as a result, our digestion gets better, right? We take the Bifido during the day, like Kara said, two before each meal, and we take the acidophilus at bed time.

KARA: So that's Kinda the foundation, those two probiotics. Also, it can be really helpful to be taking digestive enzymes that have some acid in them. And so some helpful information that I've learned from being a nutritionist for over 10 years is if someone's experiencing gas, bloating, maybe they're burping after a meal or they have that acid reflux, typically people have a 30 percent decrease in stomach acid by the time they're 30 years old. They have a 50 percent decrease in stomach acid by the time they're in their seventies. So that means half the population in their seventies do not have enough stomach acid.

SHELBY: Yeah. And so when we think about the hydrochloric acid, we like to talk about a product called Ortho DigestZyme, and that's something that you can get online or in any of our seven office locations. But Kara, with the last few minutes here, how does hydrochloric acid help with acid reflux? Well, what it does is it reduces gas by helping to break down those carbohydrates before they start to bubble and kind of ferment and produce more of that gassy bacteria in the small intestines.

KARA: That's right. And so I think the supplement that you were talking about, that Ortho Digestzyme enzyme is going to be a really critical one for anyone experienced and acid reflux and we want to be taking that with meals.

SHELBY: So, thinking about real food and good digestion with probiotics and that digestive enzyme. So, our goal at Nutritional Weight & Wellness is to help each and every person experience better health through eating real food. It's a simple, yet powerful message. Eating real food is life changing. Thank you for listening.