Paula Youmell, RN Functional Medicine RN Educator-Herbalist-Yoga Teacher (315) 212-3066 www.PaulaYoumellRN.com
Reflux Tricks & Tips Stress puts our bodies into flight or fight mode which immediately reduces gastro-intestinal juices. When we are fighting or running for our lives… digesting food is not a huge biological priority. #1: Reduce Stress:
No eating on the run, in the car, or when stressed. Focus on eating hygiene: eating only when you are relaxed and have time to chew. No eating and running out the door in 5 minutes or less. Yoga and meditation are awesome for reducing stress. This can be as simple as stopping to take 10 slow deep breaths several times throughout the day. Breathe deeply from your abdomen, with your eyes closed, focusing only on the in & out of breathing. Practice visualization of cooling downward motion in your throat & digestive tract. Perhaps a nice cool water falls or stream flowing downward from head to pelvis through the digestive tract. Let go of controlling everything. Learn to go with the flow. See above visualization. Control causes stress. Stress tenses the digestive tract like a tight fist. Tight digestive tracts cannot go with the flow, think flow of digestive juices and food being digested. Both need to flow through relaxed muscle of the digestive tract.
#2: Keep Stomach Juices STRONG while eating. Do not dilute with drinking fluids during meals. Try only sips of drinks at meal time. No drinking even moderate quantities with eating, more information below. Chewing food well helps to stimulate the release of digestive juices. Slow down and chew very, very well. #3: Sip an apple cider vinegar (ACV) drink while you are preparing dinner. This puts some extra acid into your stomach to help with digestion (see below, reflux is NOT an issue of too much acid but truly an issue of not enough acid). Put 1 ½ tsp. to 1 Tbsp. of raw ACV in ½ cup water. Build up the amount you use, slowly. Sip slowly while preparing dinner. If this is too strong to begin with, start with 1 teaspoon in the ½ cup water and work up to a tablespoon over a couple of weeks.
#4: Acid reflux soothing stoppers when in the thick of it:
Eat some raw, organic apple slices. Chemicals sprayed on apples can cause gastrointestinal irritation, destroys microbial balance, and erodes the gut lining. Aloe juice shots. This is also a healing option for Barrett’s issues and chronic reflux irritation of the esophagus. Sip the ACV drink Slippery elm bark powder or Marshmallow root powder in plain, full fat yogurt. Chew well. Try ¼ cup yogurt with a nice rounded teaspoon of one of the powders or a combo of both powders. Add a nut butter, I prefer peanut free Nuttzo. Dip the apple slices into it for a double healing reflux reducing treat. Have I ever recommended Yoga to you? No, not just Yoga poses but Yoga: breath work, mantras, relaxation… all Yoga has to offer in healing your body because Yoga tones the Vagus Nerve and putsyou into Rest & Digest mode (think peaceful) instead of the constant Fight or Flight mode (think stress).
Acid Reflux Truths and Myths In the center of your chest, there is a small, muscular tunnel that separates the end of your esophagus from your stomach. Think of it like a fist that can be closed tightly or loosely. It’s called your lower esophageal sphincter (LES). When you’re eating, the fist should be open and loose, so food can travel to your stomach. But at all other times (unless you need to vomit), the sphincter should be tightly closed. This prevents all food and digestive fluids from traveling upward. Acid reflux is just having a loose sphincter when it should be tight. It does not mean that there is too much acid.
Your stomach produces a few different digestive juices. A primary dominant one is hydrochloric acid (HCl). One of nature’s strongest acids, HCl is designed to make light work of breaking down proteins, like the tough meat in that burger you just ate. It’s also key for killing pathogens that might otherwise move in and set up shop in your intestines. If you put HCl directly on your hand, it would quickly burn you – badly. Another key “digestive juice” component is pepsin, a digestive enzyme that breaks down protein. HCl activates pepsin and starts the protein digestion. If digestive juices are in the wrong place, it hurts! Likely because of the acidity and because the pepsin is beginning to digest your tissue instead of your lunch! Animal research also shows that pepsin in the esophagus triggers an inflammatory cascade which might be the largest driver of reflux pain. The cells of your stomach lining are coated with mucus to protect them from digestive juices. The lining of your esophagus is not nearly as well coated. So when the LES is loose and these juices bubble upward, it hurts. Acid reflux is not evidence of excessive stomach acid; it’s evidence of stomach acid in the wrong place. There are many reasons why you might have acid reflux.
Top tricks for making acid reflux go away: Not because you have to pop a TUMS or use a PPI drug but because you can get rid of the true root cause(s). Long-term health depends on it! Slow Down, Sit Down, and Chew, Chew, Chew. This is what we call Eating Hygiene. The average American chews each bite of food only a few times before swallowing it down hard, often with several gulps of water as a chaser. Many of us eat so quickly that meals feel like a race – an annoying must-do to put hunger at bay. I like to teach my clients that meal time can be a meditation – a very real form of selfcare and healthcare. Yes, yoga at the meal table. Try to chew your food until it’s mostly liquid. This significantly reduces the work of your stomach. I know this seems simple. But you would be stunned to know the number of clients I’ve seen cure their reflux this way. Just by chewing their food 20-30 times per bite and not drinking too much liquid with meals (below). Remember that chewing sends messages to the gut to gear it up for digestion. The longer you chew the more geared up the GI tract gets. Avoid the Big Gulp. Certainly it’s fine to have some water along with your meals, but many people use meal time as an opportunity to tank up and hydrate. Too much liquid during meals can dilute your stomach acid and make it less potent, leading to belching and bloating. Food can hang around in your stomach longer than it should and ferment. Gas builds up and blows open your LES – causing reflux. I recommend to all clients – especially those with GERD and indigestion – focus on steady hydration in between meals and have only a small glass handy during meals to help clear the palate (e.g. 8 oz or less). Eat more often and less at once. Sometimes our LES gets blown open by the sheer volume of food we try to cram into our bellies. This is especially true when we eat at restaurants. Yes, the stomach will stretch but only so far. Research shows that people have better digestion when they eat smaller meals. Note this is not the same as “grazing”. Your body needs a break from digestion, so eating here-and-there all the time is often counterproductive (the GI tract’s cleansing waves (MMC) don’t happen while we’re digesting food). Smaller meals every 4-5 hours may help those with
GERD greatly. Then stop eating when you are 80% full. You have to leave (literal) room for digestion to take place. Example: Breakfast @ 8, lunch @ 12:30, Dinner @ 5 or 5:30. Do what works for you in your schedule without being rigid about the plan, the schedule. Rigidity causes stress and stress exacerbates reflux. Wear loose clothing around your midsection. If you wear a tight belt or waistband, you put tremendous pressure on your digestive organs. This can push food and digestive fluids physically upward and beyond your LES. Muffin-Tops and Belted Beer Bellies, take particular note of this one! Address a need for magnesium. This is a widespread issue in the US. The USDA estimates that the majority of Americans don’t get optimal intake of magnesium. Low magnesium can cause your muscles to be too tight or to spasm erratically. This includes the LES. I often recommend the glycinate form of magnesium because it’s easy to find and well tolerated and absorbed. If you also struggle with any regular constipation, consider magnesium citrate instead. Stop eating foods that cause your LES to spasm. Ok, here’s the big one. Unfortunately Americans love some of the foods which are most irritating to the LES. If you struggle with daily GERD, I encourage you to consider giving your body a break from these foods. Continuing to eat these foods with the “I’ll just pop a pill to ignore the pain” is likely to turn into a serious illness or disease some day. These are the most powerful triggers: cooked tomato sauce, citrus juices, coffee, black tea, soda, alcohol, peppery or spicy foods, fried food, chocolate, and things with mint and mint essential oil in them (e.g. gum, mints, toothpaste, and tea). Coffee spice blend to reduce and maybe eliminate the acidity issue: Blend together equal parts of cardamom, ginger, and unrefined sea salt. Keep in a small jar in your silverware drawer perhaps. Put a small pinch into your coffee and see if this helps to stop the coffee reflux issue. Don’t eat or drink anything for 2-3 hours before bedtime. Reflux can often be worst at night. This is when all of our muscles relax at least a little bit, including our LES, and then we go horizontal. If you put food in your stomach and then go to bed
before it’s fully digested, reflux is much more likely. Avoiding food for a full 2-3 hours before bed is also an excellent way for many to improve the quality of their sleep (don’t get me started about Ambien). Fight-or-Flight as a way of Life. The culture that encourages you to Go-go-go also promotes chronic mental/emotional stress. When we are in a “fight or flight” (sympathetic) nervous system mode, it is quite normal body functioning for digestive secretions and peristalsis to be reduced in order to support other body function that promotes survival (e.g. running for your life). We are intended to live primarily with our parasympathetic nervous system mode active (aka “rest and digest”). Understanding the direct connection between your stress and your chronic GERD is a powerful tool of empowerment. This is especially true at meal time and why a few calming breaths and a conscious effort to sit and relax the body prior to and after eating can help alleviate acid reflux. Pay Attention to your Truth: If you are always stuffing the words you want to say, need to say, to keep others happy you are contributing to your emotional and spiritual stress. Learn to voice your needs and concerns, with kindness, instead of ignoring your needs and feelings to the benefit of others. Be aware of common medication triggers. These include a rich variety or oral drugs such as nitrates, anticholinergics, benzodiazepines (common for anxiety or insomnia), calcium channel blockers (common for hypertension), and theophylline. Food sensitivities. In many cases, people know that certain foods trigger their reflux (beyond the LES irritants above). In some people dairy foods (e.g. milk, cheese, cream, ice cream) are a common trigger and dairy elimination from the diet brings tremendous relief. Other food sensitivities might be at play too (e.g. gluten, soy). While food sensitivity testing is available, no single test assesses all possible pathways via which the immune system can react negatively to a food. In most cases, for GERD in particular, a simple elimination experiment works very well (e.g. ~10 days before reintroduction – one food category at a time per three days). If all the above fails, rule out other physiological drivers of chronic reflux. Work with your doctor to find out if you have a hiatal hernia (a simple x-ray) or an H Pylori
bacterial overgrowth (this is a bacteria that commonly causes ulcers but can also cause chronic GERD – diagnosed with a simple breath or blood test) or insufficient stomach acid (actually very common as we age and in those with thyroid, adrenal, and/or chronic stress issues – and a strong likelihood if individuals struggle with belching all the time). Long-term use of PPI medications can be dangerous. These drugs were actually originally developed to help those with gastritis or ulcers to heal and were prescribed for a few weeks at most. PPIs can impair absorption of critical protein and minerals that, over years, can be the true root cause of ailments such as osteoporosis, arthritis, depression, heart disease, and diabetes. In particular, don’t just suddenly stop coldturkey taking these meds; that can actually do more harm than good. And GERD root causes for each unique individual should be addressed before weaning off of acidsuppressing drugs. A progressive titration downward (typically over 4-6 weeks) allows the body to adjust, and during the weaning, targeted supplements can help to fortify and soothe the protective mucosal lining in the stomach.
Websites of Functional Medicine Docs to explore for info on reflux, why to avoid the prescribed PPI medications, etc. Dr. Axe Dr. Hyman Dr. Mercola