DON’T FEEL THE BURN
We help you understand (and treat) that burning sensation in your chest
You’ve established that the burning sensation in your chest isn’t a heart attack (phew!). Must be heartburn then, right? Wrong. It could be acid reflux or GERD. But aren’t they the same thing? Wrong again – understanding their subtle differences can go a long way to helping you find relief.
It’s 2am. You’re lying awake, hoping that sharp pain in your chest is not the first sign of a heart attack. When you swallow it feels like there’s a golf ball stuck in your throat. Sound familiar?
These symptoms are most often linked to a digestive concern and not signs of a heart attack. So what’s the cause? If not a heart attack it must be heartburn, right? Wrong. Heartburn isn’t classified as a condition on its own but rather a symptom of acid reflux. If you experience ongoing symptoms of acid reflux, you may have gastroesophageal reflux disease (GERD). Distinguishing between heartburn, acid reflux and GERD is difficult because they feel similar, but understanding the differences will help you find the right treatment.
ACID TRIP
The pH of gastric acid in the stomach is between 1.5 and 3.5, and it is therefore able to withstand acid. The food pipe, however, is not. So when acid is released and leaks into the oesophagus, that burning sensation kicks in. When the muscle at the bottom end of the food pipe, called the lower oesophageal sphincter, becomes weak or loose, stomach acid finds its way into the oesophagus. This is acid reflux.
Heartburn is a burning sensation in your chest or abdomen and is the most common symptom of acid reflux. It often occurs after eating and begins with a sharp pain behind the breastbone that gets worse when sitting or lying down. Other symptoms of reflux include nausea or vomiting, difficulty or pain when swallowing, breathing problems and halitosis.
Structural problems in the abdominal area can trigger heartburn as a result of increased pressure on the abdomen – that’s why acid reflux is common in people who are overweight, obese or pregnant. Other causes include smoking, excessive alcohol consumption, a hiatal hernia, eating large meals, eating late at night or just before bed, and acidic drinks. Various medications for asthma and hypertension, sedatives, antidepressants, antihistamines and pain relievers such as aspirin or ibuprofen also trigger acid reflux.
If you experience symptoms of acid reflux more than twice a week for six weeks or more, it’s likely you have GERD. The symptoms are the same as acid reflux, only more frequent and often more intense.
SO WHAT'S THE TREATMENT?
The good news is that acid reflux and GERD are both treatable with medication and/or lifestyle changes. Many doctors believe that symptoms should be regularly managed and treated with the use of prescription and non-prescription medications. These include antacids or histamine H2 receptor antagonists and proton-pump inhibitors.
However, a growing number of healthcare professionals take a more functional medicine approach, addressing the underlying causes of the disease by shifting the traditional disease-centered focus of medical practice to being more patient-centered. New evidence has revealed that with extended use of common proton-pump inhibitors, patients have experienced a decrease in absorption of certain key vitamins and minerals, gut dysbiosis (microbial imbalance), rebound stomach acid hypersecretion, and increased reflux-like symptoms and hypergastrinemia (excess gastrin, a hormone that induces the secretion of gastric juice, in the blood).
CUT THE CARBS
Many practitioners of functional medicine believe acid reflux and GERD are the result of insufficient acid production, and that acid should be replaced with supplements such as betaine hydrochloric acid (HCL) – not the same stuff you use to clean your pool! – or apple cider vinegar. It must be emphasised that functional medicine practitioners aren’t opposed to using chronic medications where necessary.
If you suspect that you have GERD or have suffered with bouts of acid reflux, it’s likely that you have insufficient stomach acid to fully digest carbs. Treating and preventing the formation of gut fermentation syndrome involves avoiding carbs and taking probiotics.
Following a low-carb diet can also help alleviate some of the gas and increased abdomen pressure associated with GERD. Several anecdotal reports indicate that avoiding foods such as coffee, tomatoes and tomato products, spicy food, peppermint, and citrus fruits and juices can also be beneficial in treating GERD.