Heartburn: fix the root cause

Heart attach or heartburn?

Heartburn is humbling.  Bad heartburn is even crippling: it feels like a heart attack in process.  Living with that day after day is not a good recipe for quality of life.  It would be awful to be making it worse because you think you’re doing the right things.

Managing the causes of heartburn is often counter-intuitive.  That’s why you manage the symptoms, because that seems intuitively right until you understand the process.  That also why the heartburn doesn’t go away and you have to keep on managing the symptoms, because the cause is still there, messing with you.


Follow the logic – why do you have heartburn?

If you have a physical problem like a hernia or a collapsed valve, your treatment will have to be more ‘mechanical’, but that is only true for a small percentage of people.  In most cases heartburn can be resolved back to your chemistry: enzymes or allergens. Because correct enzyme management seems counter-intuitive, keep some logical facts in mind so that you understand why the answer to normal heartburn is not popping antacids.  You need to take a step back to what happens in your body before the burning feeling.

Heartburn feels like you’re dealing with excessive acidity, but actually what you’re probably dealing with is lower acidity.  As you age, the enzymes that form your stomach acid decrease, so your stomach acid decreases.  That’s bad because you need that acidity to digest and, by extension, absorb your food.

# Logic check 1

Logically, our stomach acid is unlikely to increase because our enzymes decrease as we age.  If it does increase, it is probably because we are eating something we don’t tolerate which causes the acidic reaction.  First step then is to determine whether the cause of your pain is your stomach acid levels, or, by exclusion, something you are eating.

# Logic check 2

The next question you’ll be asking is why does it burn if I have too little acid?  The answer is in your digestive process.  When we chew our food, the starch starts breaking down in our mouth – only the starch.  Starch continues to digest until it reaches the higher acidity in our stomach, then those enzymes are neutralised.  The more acidic enzymes now start breaking down the protein molecules.  There is a signalling process between stomach acid and your lower oesophageal valve which is where you feel the burn.  As soon as there is enough acid in your stomach to digest your food, it sends a signal to the lower oesophageal valve to close.  Not enough acid, and that valve doesn’t close.  The open valve allows food mixed with extremely acidic hydrochloric acid to escape back up into it your oesophagus and burn it. It is not built to cope with acidity, and long term acid exposure could cause serious health problems.

Stomach acid test

Not sure you have low stomach acid?  Try one or both of these tests.

Bicarbonate of soda test

Drink a ¼ teaspoon of bicarbonate of soda first thing in the morning for 4 days.  Then time yourself until you burp.  If you burp within three minutes, then your acidity seems to be good.  Burping within five minutes means your acidity could tend towards the low side.  Continue for the next 3 days to ensure there aren’t fluctuations.  If you’re good for the four days, then your stomach acid seems fine, and you’ll need to investigate dietary related causes for your heartburn as your next step.  Excessive burping in the beginning might mean higher stomach acid.

Betaine HCl (Betaine Hydrochloride) test

Buy Betaine HCl with pepsin in it.  Have a meal of only meat, and take a Betaine HCl pill in the middle of your meal.  Keep a note of your symptoms for the next hour or so after your meal.  If you feel normal, you probably needed the Betaine HCl to digest the protein in your food.  If you feel discomfort, like burning heaviness or a flush, then you might not need it as your acidity level is adequate.  Either way, repeat the test once or twice to be sure.  If you do feel bad after the Betaine HCl, you can neutralise the feeling by drinking the bicarbonate of soda mix recipe from the Bicarbonate of Soda  acid test above.

Choosing your next step

If your stomach acid is low or borderline according to these home tests, you have 3 options:

  1. Decide to confirm your test(s) and ask your doctor to test your stomach acid pH;
  2. Accept you’re probably low in stomach acid and make the tweaks to your lifestyle to see if they work;
  3. Ignore it all, but know that you are only addressing the symptoms of your heartburn. Your absorption of nutrients will be doubly compromised, first by potentially lower stomach acid and secondly by the inhibitory effect of the antacids on nutrient absorption.

Simple steps to improving your stomach acid levels

  1. Take good quality enzymes daily.  It should contain Betaine HCl and, if you aren’t vegetarian, Ox Bile.  (The one Solgar Digestive Enzyme has both, but check the label.)  Build up slowly, or you could easily have a reaction.  Start with a quarter to a third of a tablet before meals and build up to the full recommended dose.  If you still have some heartburn, you can even take it a little higher.  If you do have a reaction like a flush, then lower your dose down to where your body is comfortable.  Your body has to learn how to deal with adequate enzymes again.  The idea is to taper your antacids as you build healthier stomach acid levels, not to leave them cold turkey at the beginning.  There are contraindications for taking Betaine HCl, so it’s best to work with a good therapist or coach when doing this.
  2. Apple Cider Vinegar is also a good tool to use to stimulate your own production of enzymes. You can use it with the Digestive Enzyme supplement for maximum effect.  Have anything from a teaspoon to a tablespoon in a quarter glass of water half an hour before you eat.  Try to find raw apple cider vinegar because then it has a probiotic benefit as well.  Again, build up slowly and read your body’s reactions.  If you get a flush or a burn, take it down a little and build up gradually.
  3. Avoid drinking water or cold drinks with meals – they will further dilute your stomach acid, and you can’t afford that.
  4. You will achieve success faster if you can manage your heartburn with some apple cider vinegar in water rather than with an antacid.

You can perform your Bicarbonate of Soda or Betaine HCl home test for low stomach acid every few weeks to check that you are still improving and to guide you in adjusting your dosage.

Contra-indications for taking Betaine HCl supplements
  1. Betaine HCl is highly corrosive.  Use it with respectful caution. A good therapist with an in-depth understanding of nutritional and enzyme therapy guiding you is always better;
  2. Certain medications contra-indicate HCl, so check really carefully both online and with your prescribing doctor;
  3. Betaine HCl digests proteins, so if you are having a vegetarian meal or one with very little protein, reduce your amount dramatically.
  4. Too much Betaine HCl is worse than too little – proceed with caution.
Caution with Apple Cider Vinegar (ACV)

When not to take apple cider vinegar?

If you have a known histamine problem, then moderate your use of ACV.  It could increase your symptoms as it is a fermented product.

If you have a perfectionist, overachiever type personality with a touch of OCD, watch for signs that apple cider might not be a good tool for you.  This personality type often has an underlying DNA level chemistry called under-methylation, and the acetyl-CoA in apple cider vinegar competes with your methyl compounds at DNA level, meaning you could become even less methylated.  This is supported by this study: https://www.ncbi.nlm.nih.gov/pubmed/21359531

Taking ACV if you are under-methylated might influence your mood, response to seasonal allergies or other OCD or addiction type symptoms you might experience. For anyone else, apple cider vinegar is likely to relieve other pains like joint pains as well as digestive discomfort.

Taking good health choices a step further

If things are going your way, eating a healthy diet and supporting your enzymes as above might be all you need to resolve your stomach acid problem.  You might naturally start producing enzymes adequately on your own again.

If not, you should consider taking another step in supporting your health and chemistry.  Taking pills for digestion, even enzymes, means you still have a path to go to discover the real cause of your lack of enzymes.  There you need a practitioner guide.  Each enzyme has a production process.  It needs certain chemicals to be readily available for it to build itself, and it follows a certain build process.  If you are missing nutrients in your food, or if you have a production pathway that’s blocked, you’re not going to be able to produce those enzymes as effectively as you need to.  This is moving to a more complex nutritional level, but it’s still one that can be addressed and resolved with some refined bio-detection work.