As with many health problems, GORD is not a simple problem with an easy solution. The medications for acid reflux have a poor track record, and in many cases they don’t work at all. What people don’t realize is that acid reflux is often a sign of poor digestion – as Hippocrates said “All disease begins in the gut”. Most conventional treatments focus on symptomatic relief, which of course is a band-aid approach and overlooks the underlying causes.

Symptoms of acid reflux include a burning sensation in the oesophagus, and unpleasant taste in the mouth, hoarseness, belching, chronic throat clearing, sore throat, persistent cough, difficulty swallowing, nausea, asthma and persistent hiccoughs. In infants and children, symptoms manifest as frequent ear infections, excessive crying, nausea, vomiting, excessive coughing, respiratory problems, refusing food, and excessive belching.

Acid reflux is a condition where hydrochloric acid from the stomach escapes up into the oesophagus through the cardiac sphincter (the ring-shaped muscle between the stomach and the oesophagus, which usually stops the backwards flow of the stomach contents). It if often accompanied by the presence of a hiatus hernia, which occurs when the cardiac sphincter has been weakened, and the top of the stomach pokes up through the sphincter opening.

The problem with long term use of acid lowering medications, is that stomach acid if extremely important to good digestion and the absorption of many nutrients. Stomach acid not only helps to break down proteins and make them digestible, but also destroys food-borne pathogenic bacteria, viruses, fungi/yeasts and parasites. When the stomach acid is lowered, one of the body’s first lines of defense against harmful microorganisms becomes compromised. Good stomach acid is associated with high levels of beneficial flora (probiotics) in the intestinal tract. Good bacteria can thrive when parasites, yeasts and pathogens are kept out by hydrochloric acid.

When hydrochloric acid is low in the stomach, partially broken down food full of yeasts and other opportunistic organisms now moves into the small intestine. Without adequate stomach acid, when you eat foods that feed yeast and cause fermentation (sugar, starches, grains, processed foods, fruit and fruit juices) the yeast foams as fermentation occurs in the stomach, just like when you add sugar to yeast when you are making bread. This fermentation produces gases that force an upward pressure against the cardiac sphincter. Under these conditions the cardiac sphincter will allow stomach acid into the oesophagus, causing reflux. Thus, as a result of years of the constant pressure of this gas-forming yeast fermentation in the stomach, the cardiac sphincter can weaken and a hiatus hernia can develop.

As this cascade of events moves down into the small intestine further problems are caused due to proteins and peptides not being broken down properly, due to the lack of hydrochloric acid. A compounding problem is that digestive enzymes from the pancreas need to be triggered by adequate stomach acid, so with low hydrochloric acid there is an accompanying lack of digestive enzymes, adding to the problem of poor digestion. In addition, if the small intestine lacks a healthy flora, production of enzymes called peptidases is reduced, contributing also to poor digestion of proteins.

As yeast and other unhealthy bacteria coming from the stomach take over the small intestine, dysbiosis will develop. This causes the mucosal lining of the small intestine to become damaged, leading to leaky gut syndrome. This gut permeability allows poorly broken down protein and carbohydrates to leak from the intestinal tract to the bloodstream, and this sets the scene for allergies to occur. When undigested proteins leak into the bloodstream, the immune system sees them as foreign objects, setting up an immune response to that protein and that food. This immune response can also set the scene for inflammatory conditions in the body.

How do we prevent and treat GORD?

There are ways to improve our digestive system function, which are good habits everyone can apply to their rules of general health.

• Drinking water with meals will cause your stomach acid to become diluted and therefore less effective. Make sure you drink water away from meals, not within half an hour before or two hours after each main meal.
• When it comes to production of hydrochloric acid, providing the chloride for this is essential. Sources of chloride include good quality salt (unprocessed sea salt, celtic sea salt, rock or river salt – if it looks grey or pink it is well balanced and contains plenty of minerals), as well as celery and coconut.
• Avoid grains, starches and sugars, including fruits and fruit juices, so you are not feeding the yeast cycle and adding the gases of fermentation to the picture.
• Take supplements containing probiotic bacteria and yeasts (ask your Naturopath which supplement will suit you best – it may be beneficial to do a stool analysis via your Naturopath, which can show you the levels of good and bad bacteria and if yeast infections are present).
• An osteopath or chiropractor can help provide relief from hiatus hernia via an adjustment. This adjustment may be necessary on a regular basis until the oesophageal sphincter strengthens and heals.
• Soups made with homemade broth are healing for the digestive system and full of easy to digest nutrients. These are a great way to help the healing process and reset the digestive system. Base these on meats and vegetables and leave out the carbohydrates.
• Chew your food and relax while you are eating – the first stage of digestion is thinking about and smelling food. The next stage is chewing your food. Your food should be pureed by the time it leaves your mouth to go to your stomach. If you are stressed or rushed when you are eating, your nervous system is in “flight and fight” mode and is working more on survival than digestion. If you are not relaxed when you are eating, your digestive system will not be functioning properly.
• Oestrogens can weaken the oesophageal sphincter, so women who are pregnant or taking medication containing oestrogens are more likely to suffer from heartburn.
• A gluten free diet can help resolve reflux. Avoiding grains generally can certainly help.
• A vegetable enzyme supplements can help with digestion without interfering with the body’s natural production of hydrochloric acid or digestive enzymes.