Heartburn is just a symptom

Heartburn.

Also known as pain in the chest, burn­ing in the throat, pres­sure in the chest, mucous slid­ing in the throat…it has many ways of present­ing itself.

Heartburn is not nor­mal how­ever.

Heartburn is a symp­tom of a lar­ger issue. Several times a week I have a patient who has been simply exper­i­en­cing heart­burn for years. Years! This breaks my heart. For years, their gastrointest­in­al mucosa and stom­ach lin­ing have been “voicing their dis­pleas­ure” but no one is listen­ing. Or, someone is listen­ing, but does not know what it means.

Most people have sought help and soothe their gast­ric mucosa with pro­ton-pump inhib­it­ors, redu­cing the pro­duc­tion of hydro­chlor­ic acid from the stom­ach, which can reduce their heart­burn. Often, this does improve their symp­toms, but not com­pletely. The same is also true with the use of nat­ur­al sup­ports like pep­per­mint or ginger that can be used to soothe the gast­ric mucosa. Until we get to the bot­tom of what might be ini­ti­at­ing the heart­burn, these are viable options that do improve our qual­ity of life.

What is caus­ing the heart­burn is an entirely dif­fer­ent chal­lenge.

Multiple causes of heart­burn include:

  1. Helicobacter pylori — a microor­gan­ism that fre­quently likes to bur­row itself into the stom­ach lin­ing and dis­rupt prop­er acid pro­duc­tion, often asso­ci­ated with the pro­duc­tion of gast­ric ulcers, but in some research stud­ies demon­strat­ing pro­tect­ive against gast­roeso­pha­geal reflux dis­ease (GERD). Difficult to erad­ic­ate without anti­bi­ot­ics, and an import­ant con­trib­ut­or to heart­burn symp­toms.
  2. Ulcers — Duodenal and gast­ric ulcers can increase acid pro­duc­tion, and are often best ruled out with an endo­scopy, a scope into the stom­ach to see if there are holes in the stom­ach or even the H. pylori as dis­cussed above.
  3. Relaxed eso­pha­geal sphinc­ter — There is a band of muscle between our eso­phag­us (the tube that car­ries food to our stom­ach) and the stom­ach called a sphinc­ter, and this opens and closes when food needs to enter the stom­ach, and closes when the stom­ach is full for diges­tion to stay with­in the stom­ach. Certain foods (caf­feine, alco­hol), and even lying down hori­zont­ally after eat­ing can relax this sphinc­ter, and cause acid to come out of the stom­ach.
  4. Celiac dis­ease — An autoim­mune dis­ease in which the body attacks its own cells that pro­duce hydro­chlor­ic acid in the stom­ach (pari­et­al cells), decreas­ing the pro­duc­tion of B12 and increas­ing symp­toms of GERD. When patients newly dia­gnosed with celi­ac dis­ease were put on a glu­ten-free diet, a sig­ni­fic­ant improve­ment in GERD symp­toms was noticed and is con­sistenly noticed in the before and after with pre­vi­ously undia­gnosed celi­ac patients.

Talk to your MD, ND, and gast­roen­ter­o­lo­gist about the pos­sible causes of heart­burn and acid reflux in your body. Your hap­pi­ness depends on it!

References

Enomoto S, Oka M, Ohata H, Mukoubayashi C, Watanabe M, Moribata K, Muraki Y, Shingaki N, Deguchi H, Ueda K, Inoue I, Maekita T, Iguchi M, Yanaoka K, Tamai H, Fujishiro M, Mohara O, Ichinose M. Assessment of gast­roeso­pha­geal reflux dis­ease by sero­dia­gnos­is of Helicobacter pylori-related chron­ic gast­rit­is stage.World J Gastrointest Endosc. 2011 Apr 16;3(4):71 – 7.

Nachman F, Vázquez H, González A, Andrenacci P, Compagni L, Reyes H, Sugai E, Moreno ML, Smecuol E, Hwang HJ, Sánchez IP, Mauriño E, Bai JC. Gastroesophageal reflux symp­toms in patients with celi­ac dis­ease and the effects of a glu­ten-free diet. Clin Gastroenterol Hepatol. 2011 Mar;9(3):214 – 9. Epub 2010 Jun 30

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