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Heartburn & Indigestion

  • After 20 to 30 years of smoking, research shows that people have a 50 percent higher risk of dying than non-smokers.

    Now, a major new study in the British Medical Journal1 showed that people taking PPI acid blockers for two years also had a similar fifty percent higher risk of dying. Making prolonged use of acid blockers a deadly problem. Potentially as deadly as smoking for 20 to 30 years. Fortunately, it is also preventable. But this will require a paradigm shift in how we address heartburn and indigestion.

    Background:
    Multiple studies have shown that acid blockers called PPIs are associated with a dramatic increased risk of bone thinning (osteoporosis), dementia, and a host of other problems. There is a reason why most animals have evolved to create stomach acid that can dissolve their own stomach. It is because this acid is critical for proper digestion and nutrition. Without it, people can be malnourished even if they are obese.

    So it should come as no surprise that there is a high price to pay for turning off stomach acid long-term.

    What The New Study on Heartburn Showed

    This large study of over 349,000 people was led by Ziyad Al-Aly, MD, director of clinical epidemiology at the VA St. Louis Healthcare System. They compared prescription and over-the-counter acid blockers called PPIs to much safer and gentler acid blockers such as Tagamet and Zantac, as well as to people taking no acid blockers. What they found was stunning.2,3

    Although there is no significant increased risk in taking these medications for a month or less, which is how they are meant to be used, people taking them for one to two years had a dramatic 25–50 percent increased risk of dying.

    The Heartburn Problem

    Research has shown that acid blockers are highly addictive. After six weeks of use, people get a rebound acid hyper secretion when they try to stop these medications. Put simply, they have a "Niagara Falls" of acid flow. Because of this, many people dangerously stay on the acid blockers long-term.

    The Heartburn Solution

    It is important to realize that our understanding of heartburn has been faulty. It is not caused by too much stomach acid, and in fact most people with indigestion have inadequate stomach acid. This results in acid reflux when food is incompletely digested after an hour, and the stomach hits the "return to sender" button. Turning off the stomach acid keeps the reflux from causing heartburn, but aggravates the problem. Which is poor digestion.

    The solution is actually fairly simple. It is important to realize that indigestion comes not from too much stomach acid, but from poor digestion. Digestion can be improved simply by using plant-based digestive enzymes with meals, along with nutritional supplements such as DGL licorice (Called Advanced DGL) that enhances the stomach's protective lining. After six weeks of this, the person can switch from their acid blocker to Tagamet. This does not completely turn off stomach acid, so you do not get the rebound acid hyper secretion that makes PPIs addictive. After a month, they can then stop the Tagamet and stay on the natural digestion support as needed.

    That way they can be off medications and be free of heartburn pain, while having healthy digestion and improved health. Meanwhile, occasional indigestion can then be treated with chewable antacids. Research has raised a concern about taking plain calcium, and therefore it is recommended that the calcium be combined with magnesium and vitamin D and K to avoid calcium depositing in the arteries. This can be found in combination and products such as Immediate Heartburn Relief.

    Fortunately, with proper nutritional support it is likely that the problems caused by long-term PPI use can be reversed. Interesting that another large recent BMJ study showed that NSAIDs cause approximately 50,000 preventable US deaths a year. The medical approach has been to try to decrease this by giving PPIs along with the NSAIDs. This is a very deadly mistake.

    Let's look at a quick running of the numbers. In the graph at the end of the study, it showed that after seven years about 18 percent of the people had died using safer acid blockers such as Tagamet, as opposed to 27 percent in the PPI group. This translates to 180,000 deaths per million versus 270,000 deaths. With millions of people using acid blockers, this translates to over 90,000 excess and preventable deaths over the seven year period for each million people using them long-term.

    PPI Survival Probability BMJ 2017

    An alternative? Numerous studies show that natural alternatives are as or more effective than NSAIDs for arthritis, but result in "side benefits" instead of side effects. They have also been found to be safe on the stomach and not increase ulcers as the NSAIDs do. Natural treatments for indigestion are also highly effective. So using these natural options could easily prevent over 65,000 US deaths yearly.

    References:

    1. Gap in Mortality Rates Between Smokers and Non-Smokers Continues to WidenStudy
    2. Popular Heartburn Drugs May Boost Death Risk: Study
    3. Risk of death among users of Proton Pump Inhibitors: a longitudinal observational cohort study of United States veterans Study
  • Waking with a sweat?

    In three recent articles, we discussed how reproductive and adrenal hormones, as well as Candida overgrowth, can trigger night sweats. In the last of this four-part series, we will discuss the other common cause.

    If you have acid reflux, the stomach acid coming up into your food pipe while you sleep can cause you to wake with sweats. A large body of research is suggesting that longterm use of acid blockers (such as Prilosec and Nexium) can be very toxic. Zantac and Tagamet are much safer, but still interfere with digestion.

    Nighttime acid reflux is especially likely to be a problem if you have daytime indigestion as well. Although you may sometimes notice the heartburn when you wake up, other times you won't and you'll just wake up in a sweat after inhaling the stomach acid.

    My article on How to Get Off Prescription Antacids, Naturally, can be very helpful. You can also look up "heartburn" in the free Cures A-Z phone app.

    Don't try to stop acid blocker medications suddenly, as they are very addictive. The rebound acid hyper-secretion will cause indigestion from hell. Instead, follow the instructions in these articles.

    But your food pipe and GERD won't be able to properly heal until you take care of the nighttime reflux as well. Here's how!

    Getting Rid of Nighttime Acid Reflux

    Poor digestion is epidemic in this country. Daytime indigestion is largely caused because food processors learned that destroying the enzymes naturally found in food prolongs shelf life. This is because these enzymes cause the food to ripen. The problem? These enzymes are also critical for humans to digest the food properly. Without them, the food simply sits in the stomach and churns. After a while, your stomach hits the "return to sender" button, and you get acid reflux.

    But a key part of getting rid of daytime indigestion and night sweats is eliminating the nighttime acid reflux. Our stomach is built like a tank, to protect it from stomach acid. But our food pipe isn't, and the acid treats it just like another piece of meat, trying to digest it.

    Acid reflux (GERD) at night occurs because gravity is no longer holding the acid in the stomach when we lie down. If the valve that's supposed to do this isn't working, the acid flows into your food pipe (esophagus). This causes irritation that will markedly amplify daytime indigestion as well.

    How to tell if you have nighttime acid reflux causing your night sweats

    Start by taking an acid blocker medication an hour before bedtime for three to four nights. If this helps, you've identified the problem. Stop the acid blocker, as it is quite addictive and toxic when used long-term. Instead, follow the instructions below. If you need a nighttime medication for a while, use Tagamet or Zantac at bedtime instead.

    How Acid Reflux Works

    A Recipe to Get Rid of Nighttime Reflux

    After six weeks doing the below, you may find your daytime heartburn starts to settle down as well.

    • A–Bicarbonate of soda. Take 1/2 tsp of bicarbonate of soda (e.g., Arm and Hammer) in 4 oz of water at bedtime to neutralize the acid in your stomach (not for children under 16 years old). Though it's a bad idea to keep your stomach acid "turned off" during the day (you need it to digest food), you don't need stomach acid at bedtime while sleeping. I recommend one called Complete Gest. Animal-based enzymes do not help digestion. If you have high blood pressure, use potassium bicarbonate instead (not carbonate). This can be found on Amazon.com
    • B–Don't eat within two hours before bedtime and take two caps of a plant-based digestive enzyme such as Complete Gest an hour before sleep. This will ensure your stomach is empty when you sleep.
    • C–Sleep with your upper body elevated, so gravity keeps the acid in your stomach. Raise your upper body at least 6–8 inches when in bed (just raising your head with pillows won't work). One way to do this is to place a 6–8 inch brick or phone book under the legs by the head of the bed (i.e.–just the two legs by the end of the bed where your head is). Another wonderful solution is to use a sleep wedge pillow (you can find one online at www.hammacher.com
    • D–Melatonin. Take 5–6 mg of an immediate release melatonin at bedtime. Research shows that this decreases reflux.
    • E–Immediate Heartburn Relief chewable antacids.

    Keep a few at the bedside to take if needed. These are more effective and much healthier than regular calcium chewables.

    By taking the steps discussed in this four-part series, night sweats will usually be gone and you will be having a much more restful sleep!

    Disclaimer: Please be aware that medicine is complex and without actually being your attending physician we cannot give medical advice. Any information given is to be used as a teaching tool for you and your physician to work with therefore we cannot take any legal responsibility for its use. Please check with your personal physician before applying any recommendations.

  • "Many clinicians have discovered that in the overwhelming majority of individuals with heartburn, indigestion, etc., it is underproduction of stomach acid (hydrochloric acid) that is the problem, not overproduction."

    Indigestion, or dyspepsia, commonly refers to general abdominal discomfort during and after meals and may be the result of specific diseases of the stomach or the intestines. The most frequently occurring symptoms are diarrhea, heartburn, abdominal cramps and pain, gas distress, and nausea. Heartburn is a mild to severe burning pain in the upper abdomen or beneath the breastbone. It usually results from spasms of the esophagus or the regurgitation into the esophagus of the stomach contents, the gastric acid levels of which cause irritation. Heartburn typically occurs after meals, often after those containing fatty foods, or when a person is lying down. The following natural substances may be helpful in the treatment of heartburn and indigestion.

    Heartburn and indigestion treatments

    Dietary Supplements: Primary Recommendations

    Betaine Hydrochloride and Pepsin
    If our stomachs are normal, they digest food with very strong hydrochloric acid and pepsin, an enzyme active only in an acid environment. Without normal, adequate acid and pepsin production by our stomachs, we don't get all the nourishment we should from food. Many clinicians have discovered that in the overwhelming majority of individuals with heartburn, indigestion, etc., it is underproduction of stomach acid (hydrochloric acid) that is the problem, not overproduction. Consequently, the use of betaine hydrochloride, a safe supplemental form of hydrochloric acid, may be a good choice for many heartburn/ indigestion sufferers.

    Multi-Digestive Enzyme
    Both human and animal research has demonstrated that certain digestive enzymes produced by the pancreas reduces with age.1,2 In addition, pancreatic insufficiency may occur for other reasons, including pancreatic and non-pancreatic diseases— both of which may cause an impaired production of pancreatic digestive enzymes, resulting in poor digestion and malnutrition. The use of a pancreatic enzyme supplement containing has been successful in improving digestion in these situations.

    Licorice
    Licorice root is a botanical with an extensive history of medicinal use. Research shows that it protects the mucous membranes lining the digestive tract by increasing production of mucin, a substance that protects against stomach acid and other harmful substances.3

    Peppermint, Fennel, Caraway, and Wormwood
    Certain herbs are classified as carminatives—substances that relieve gas and gripping (severe pain in the bowel). Some carminatives herbs, including Peppermint, Fennel, Caraway, and Wormwood, have had good research conducted on them. For example, double-blind studies have shown that combinations of Peppermint and Caraway oil, as well as a combination of Peppermint, Fennel, Caraway, and Wormwood could help people with indigestion.4,5 It is believed that carminative agents work, at least in part, by relieving spasms in the intestinal tract.6

    Artichoke
    Besides being and healthy and delicious food (especially with a little bit of warm dipping butter—yum!), Artichoke is also a plant with medicinal qualities. In double-blind studies, extracts of Artichoke have been repeatedly shown to be beneficial for people with indigestion.7 Artichoke is particularly useful when the problem is lack of bile production by the liver.8 If you're going to try Artichoke for this purpose, it is recommended that you look for an extract providing 500–1,000 mg per day of cynarin, the main active constituent of Artichoke.

    Turmeric
    Turmeric is a bright yellow herb used in preparing some very tasty culinary dishes. Medicinally, turmeric has also been demonstrated in double-blind research to relieve indigestion problems in subjects in Thailand.9

    Dietary Supplements: Secondary Recommendations

    Lactase
    Lactose intolerance can cause many digestive problems, including gas, cramps, and diarrhea. Although lactose intolerant individuals would do best to avoid dairy products, if there are occasions when they do plan to consume some, then they should use a supplement containing the lactase enzyme. Research has shown that lactase preparations can reduce pain, bloating and total symptoms associated with lactose intolerance.10 However, one study demonstrated that various lactase products differ in their effectiveness,11 so you may need to try a two or three before you find the one that works best for you.

    Chamomile
    Traditionally, the herb Chamomile can be effective at relieving irritated or inflamed mucous membranes within digestive tract. Furthermore, since heartburn sometimes involves reflux of stomach acid into the esophagus, the anti-inflammatory properties of chamomile can also be useful in this regard.12 In addition, chamomile has been recognized for its ability to promote normal digestion.13

    Ginger
    Ginger is also a traditional carminative herb.14 Animal research has shown that ginger is capable of enhancing the activity of fat and carbohydrate digestive enzymes.15

    Aloe Vera
    Aloe Vera can be helpful for people with indigestion. In fact, Aloe Vera is one of the natural substances employed in inflammatory bowel disease therapy that has shown promise.16 Of course Aloe Vera is one of the oldest known medicinal herbs. The mucilaginous gel, the source of "Aloe Vera Juice" and "Aloe Vera Gel," is used internally as a healer and tonic, and applied externally as a burn and wound remedy.

    Diet and/or other considerations
    In a very small minority of individuals with heartburn and indigestion, stomach testing is normal or shows over acidity. In these few people, both diet changes and supplemental items can help. Elimination of caffeine, refined sugar, alcohol and cigarette smoking are all recommended, even though sometimes hard to do. For a very few, identification and elimination of food allergies or sensitivities reduces heartburn and indigestion. There are other problems that may cause or be associated with heartburn, bloating and belching after meals, and indigestion. These can include peptic ulcer, malfunction of the sphincter muscle at the end of the esophagus and other much more rare problems. If you have these symptoms, it's best to work with a doctor to establish what the cause might be before accepting the popular but usually-mistaken belief that indigestion, bloating and heartburn are all just due to "too much stomach acid."

    References:

    1. Laugier R, et al, Digestion (1991) 50(3 4):202 11.
    2. Wang CS, Floyd RA, Kloer HU, Pancreas (1986) 1(5):438 42.
    3. Goso Y, et al, Biochem Physiol (1996) 113C:17–21.
    4. May B, et al, Arzneim Forsch (1996) 46:1149–53.
    5. Westphal J, Hörning M, Leonhardt K, Phytomedicine (1996) 2:285–91.
    6. Forster HB, Niklas H, Lutz S, Planta Med(1980) 40:303–19.
    7. Kraft K., Phytomedicine(1997) 4:370–78 [review].
    8. Kirchhoff R, et al, Phytomedicine(1994) 1:107 15.
    9. Thamlikitkul V, et al, J Med Assoc Thai (1989) 72:613–20.
    10. Lin MY, et al, Dig Dis Sci (1993) 38(11):2022 7.
    11. Ramirez FC, Lee K, Graham DY, Am J Gastroenterol(1994) 89(4):566 70.
    12. Matricaria flos. ESCOP monograph, Oct 1990.
    13. Mills SY. Out of the Earth: The Essential Book of Herbal Medicine.(1991) London: Viking Press, pp. 448–51.
    14. Blumenthal M, et al, (eds), The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. (1998) Austin: American Botanical Council and Boston: Integrative Medicine Communications, 425–26.
    15. Platel K, Srinivasan K, Int J Food Sci Nutr (1996) 47(1):55 9.
    16. Robinson M, Eur J Surg Suppl (1998) (582):90 8