By Richard Malik, ND
As published in the Lakeville Journal, Millerton News, & Winsted Journal
23 November 2006

While most Americans enjoy the traditional Thanksgiving feast, many people experience indigestion and heartburn after meals. For some, these pains occur after eating a large meal, when lying down, or after eating specific aggravating foods. There are many over-the-counter products – marketed to us through numerous television and print advertisements – to help with this problem. Most of us know about the use of specific colored pills or products with unique names that we can use to treat or prevent indigestion and heartburn.

There are many natural approaches to treat and prevent stomach complaints, but the first step in finding a solution is determining the underlying cause of the problem or the contributing factors. Three main factors contribute to heartburn, according to common medical understanding of the condition.

The first, and most important, is a loosening or relaxation of the muscular valve that separates the very acidic stomach from the esophagus. The esophagus is the tube in the body that actively moves food from the mouth to the stomach after it is swallowed. The stomach has special defenses that protect it from getting burned by acid; the esophagus’ defenses against acid are much less robust. If the valve is open when it should be closed, the esophagus can get burned by stomach acid and become painful.

While most of the pharmaceutical and over-the-counter medications for heartburn lower stomach acidity, heartburn is NOT caused by excess stomach acidity! On the other hand, the acid in the stomach is very important for appropriate digestion. Stomach acid breaks down proteins and kills many bacteria – acting as an important part of the immune system of the gut. For optimal health, I think it is important, when possible, to treat heartburn without lowering stomach acidity.

Some people note that their heartburn is brought on by consuming certain foods. Substances commonly known to contribute to heartburn by causing relaxation of the lower esophageal valve include coffee, chocolate, alcohol, fatty meals, sugar, onions, peppermint, spearmint, and tobacco. Foods that contribute to heartburn can vary from person to person. The good news is that some of the items on this list may not aggravate your condition. The bad news is that foods not included in this list may aggravate your condition even though they are not common culprits.

The two other factors contributing to heartburn are: 1) An increase in the pressure in the stomach that may overcome the ability of the valve to separate the stomach environment from the esophagus; and 2) a decrease in the ability of the esophagus to move contents down to the stomach which can cause refluxed material to linger in the esophagus.

Eating small meals will limit the pressure in the stomach and thoroughly chewing food will support the movement of food through the esophagus. Remember not to lie down after meals as it increases the pressure against the lower esophageal valve and encourages stomach contents to reflux into the esophagus. These are basic measures for preventing heartburn.

Heartburn may actually be caused by low stomach acidity as the lower esophageal valve is encouraged to tighten by the acidity normally found in the stomach. Bitter foods have traditionally been used before meals to stimulate digestion and increase stomach acidity. Consuming small amounts of lemon or vinegar before meals promotes healthy digestive function and may help prevent symptoms of heartburn. For greater effect, bitter herbs may be used, however they can be very potent and small doses can substantially increase stomach acidity. Believe it or not, but some patients benefit from supplementation with hydrochloric acid prior to meals. Whenever increasing stomach acidity in patients with heartburn, I am very cautious because the treatments can aggravate the symptoms of heartburn or stomach ulcers.

To soothe damaged gastrointestinal tissue, whether in the mouth, esophagus, stomach, or intestines, herbalists commonly use licorice (look for deglycyrrhinized licorice also known as DGL as it will not increase blood pressure), slippery elm bark, marshmallow root and other herbs that protect and coat the mucous membranes of the gut. These act as a band-aid, helping to heal and protect the tissue but do not address the underlying cause.

As you can see, there are many natural ways of alleviating the pain of heartburn without turning off stomach acidity and digestive function. While heartburn may seem to some like a simple inconvenience, it is an important health issue to address as it may lead to serious problems of the lower esophagus.