Alexa Fleckenstein M.D.

Reflux is one of those ailments which keep people going to the doctor and take medication forever – and on the face of it, there’s no cure. And, in the long run, it can be a dangerous disease. Longstanding erosion of the esophagus can lead to Barrett’s esophagus and even cancer. Why are so many people with the diagnosis of reflux? Reflux is, in most parts, another disease with owe to SAD – the Standard American Diet. People have intolerances to certain foods and allergies, and those keep the esophagus (and possibly the stomach and the whole gut) inflamed. Instead of eliminating the offending foods, the doctor prescribes Zantac or Tagamet or even one of the stronger proton inhibitors. And has gained a life-long patient. In the long run, those stomach medications create new problems: Since they all reduce acidity, they also may hinder digestion, and further infections as the stomach acid is supposed to kill invading germs. PPIs (proton pump inhibitors, drugs lik, Prilosec, Prevacid and Nexium), the strongest anti-heartburn medications can also be addictive, can trigger food allergies, and can weaken your bones. Heartburn only comes in very rare cases from producing too much acidity for no good reason (that condition is called Zollinger-Ellison syndrome, and should be ruled out by your doctor if the burning goes on relentlessly, regardless what you do). Normally, your stomach reacts with acidity when you eat something wrong. Or if you just each too much, period. So, why fighting the acidity, if you can eliminate the underlying cause? Sometimes physicians diagnose a “hiatal hernia” – a gap in the diaphragm that allows the stomach to come a bit into the chest area. No connection has been found between HH and reflux. It seems that many people have a hiatal hernia, for reasons unknown – or for carrying a paunch that pushes the organs up into the lung cavity; for instance, it is very well known, that heartburn is extremely common in highly pregnant women. Perhaps also lacking exercise makes the diaphragm go limp. Whatever it is, hiatal hernia does not cause reflux. If you want to break that cycle – here is what you can do: Find out what your body does not tolerate. It is not difficult. Write a food journal. The most common culprits are, in my experience, • Gluten • Dairy products • Corn syrup (HFCS) • Tomatoes (and the whole nightshade family actually – peppers, eggplants, potatoes, too). • Chocolate could be the culprit. • Or nuts. • Harsh foods: alcohol, caffeine, citrus, and spicy foods. • ANYTHING can lead to a reaction. And not only burning in your esophagus; bloating, cramps, diarrhea, constipation, joint pains, migraine headaches, and many more symptoms can stem from food intolerance. • Certain medical drugs are the culprits – Fosomax, for instance, that is intended to make your bones stronger (I would not touch it because of its side-effects. Better food and more movement certainly gives you stronger bones without side-effects). • Sometimes it is not the kind of food but how it is prepared: raw versus cooked. Usually, cooked is easier on the stomach. • It might be the timing: Some people get away with a raw salad or an acidic fruit during the day, but not at night, as the last meal that lingers in their stomach. • Or a whole food group: Many people do better without sugars and white starches and reduced whole grains. • Basically, all junk foods and processed foods are under suspicion. They contain trans-fats and preservatives, coloring, stabilizers, flavorings that are alien to you body. • Drink enough water - but not with meals or right afterward. Of course, it is better, to not be indiscreet in the first place. But if you are looking for healing alternatives: • Mastic gum is my favorite; it is an agent that covers the stomach and helps if you have been indiscreet, food-wise. Unfortunately, mastic is not cheap. An alternative, paid by insurance is Carafate, with a similar action. • DGL licorice helps – it is a deglycyrrhized licorice that does not have the bumping effect on blood pressure. This comes also as a lozenge. • Other herbs that soothe the stomach are chamomile tea, aloe vera juice (or eat directly from the plant – the jelly-like inside of the leaf; avoid the green outside leaf – it is a harsh laxative), slippery elm, plantain banana, calendula and marshmallow (the real herb – not the sweet candy!), cabbage juice, artichoke extract. But watch it: I, for instance, have a chamomile allergy; that would make the situation worse. • It is always a good idea to start out with the Ayurvedic herb neem which kills all sorts of infections because, unbeknownst, germs can cause all the indigestion. Ask your doctor. • In an acute attack, sleep with your upper body a bit elevated (turns the flux downward). • Always chew your food well! Big chunks might lie in your stomach like stones. • Help your whole digestive tract with probiotics. • Eliminate stress – especially when you eat. Sit down for three meals a day – don’t gobble things down on the run! This is what to avoid – besides hurting foods: • Too big meals. • Eating after dinner. • Peppermint – as it has a relaxing effect on the sphincter that closes of the stomach. A reminder: Before you embark on a natural healing course, it is a good idea to have endoscopy – because you don’t want to overlook anything serious. And make sure your doctor looked for an H. pylori infection. On the other hand, there is evidence, that a bit of H.pylori might be necessary for normal digestion – and triple antibiotic definitely could do some harm. And then – just to confuse things: Elderly people often have too low stomach acidity, and if they are taking medications that lower it even more, one can imagine that this will lead to problems. There is a supplement for this condition: betaine HCl. And some patients with can be helped with digestive enzyme – a whole new topic. Read More