In the center of your chest, there is a small, muscular tunnel that separates the end of your esophagus from your stomach. Think of it like a fist that can be closed tightly or loosely. It’s a muscle called your lower esophageal sphincter (LES). When you’re eating, the fist should be open and loose, so food can travel to your stomach. But at all other times (unless you need to vomit), the sphincter should be tightly closed. This prevents all food and digestive fluids from traveling upward. Despite many myths otherwise, acid reflux is just having a loose sphincter when it should be tight.
Your stomach produces a few different digestive juices. But the dominant one is hydrochloric acid (HCl). One of nature’s strongest acids, HCl is designed to make light work of breaking down the tough meat in that burger you just ate. If you put HCl directly on your hand, it would quickly burn you – badly. The stomach acid produces pepsin, a digestive enzyme that breaks down protein. The cells of your stomach lining are coated with mucus to protect them from acid and pepsin (otherwise, they would digest your stomach). The lining of your esophagus, however, is not coated. So when the LES is loose and acid bubbles upward, it hurts and can damage the tissue.
There are many reasons why you might have acid reflux. But let me put one myth to rest: having too much overall stomach acid production is actually an extremely rare cause of acid reflux (I’ve only seen it once in my practice across hundreds of clients and many dozens with acid reflux). Remember that reflux is just a matter of having acid and pepsin in the wrong place (the esophagus). For almost everyone, there are controllable drivers for reflux that can bring you lasting pain relief without the side effects of drugs. I’m going to share some of my top tricks for making your acid reflux go away. Not because you have to pop a TUMS or use a PPI drug, but because you can get rid of the root cause(s). And your long-term health depends on it!
Slow Down and Chew, Chew, Chew. The average American chews each bite of food only a few times before swallowing it down hard. Often with a gulp of water as a chaser. Most of us eat so quickly that meals feel like a race. Try to chew your food until it’s liquid. This significantly reduces the work of your stomach. I know this seems simple. But you would be stunned to know the number of clients I’ve seen cure their reflux this way. Just by chewing their food 20-30 times per bite and not drinking much liquid with meals (below).
Drink as little liquid as possible with your meals. Yes! In between meals is by far the best time to hydrate. Liquids during meals just dilute your stomach acid and make it less potent, leading to belching and bloating. Food can hang around in your stomach longer than it should and ferment. Gas builds up and blows open your LES – causing reflux. Have only a small glass handy during meals to help clear your palate (e.g. 4 oz). Too much liquid during a meal can also increase the pH of your stomach juices and make your esophageal sphincter work less effectively.
Eat more often and less at once. Sometimes our LES gets blown open by the sheer volume of food we try to cram into our bellies. This is especially true when we eat at restaurants. Yes, the stomach will stretch. But only so far. Research shows better digestion and better healthy weight maintenance for people who eat smaller meals 4-5 times per day. Note this is not the same as “grazing”. Your body needs a break from digestion, so eating here-and-there all the time isn’t helpful. But small meals every 3-4 hours is ideal. Then stop eating when you are 80% full. You have to leave (literal) room for digestion to take place. Think about how hard it would be to stir a pot of soup if it was full to the very top of the rim!
Wear loose clothing around your midsection. If you wear a tight belt or waistband, you put tremendous pressure on your digestive organs. This can push food and digestive fluids physically upward and beyond your LES. Muffin-Tops and Belted Beer Bellies, take particular note of this one!
Fix your magnesium deficiency. Magnesium deficiency is widespread in the US! Low magnesium can cause specific (or all of your!) muscles to be too tight or to spasm erratically. This includes your LES. If you also struggle with any regular constipation, headaches, irritability, leg spasms, or tight muscles, be sure to give this supplement a try (start with 400mg magnesium citrate).
Stop eating foods that cause your LES to spasm. Ok, here’s the big one. Unfortunately many people love some of the foods which are most irritating to the LES. If you struggle with daily GERD, I highly encourage you to consider giving your body a break from these foods.
Yes, I know you love them! But continuing to eat them and just pop a pill to ignore the pain is likely to turn into a serious illness or disease for you some day. These are the most powerful triggers: cooked tomato sauce, citrus juices, coffee, soda, alcohol, peppery or spicy foods, fried food, chocolate, and things with mint in them (e.g. gum, mints, toothpaste, tea).
Don’t eat or drink anything 2-3 hours before bedtime. Reflux can often be worst at night. This is when all of our muscles relax at least a little bit, including our LES. If you put food in your stomach and then go to bed before it’s fully digested, reflux is much more likely. The goal is to eat throughout the day such that you just go to bed with an empty stomach – but not hungry. Not eating a full 3 hours before bed is also an excellent way to improve the quality of your sleep (don’t get me started about Ambien).
If all the above fails, rule out other physiological drivers of chronic reflux. Don’t settle for suffering – or for a long-term medication that will harm you. Make sure you get solid answers from your physician. Nobody knows your body better than you. Work with your doctor to find out if you have a hiatal hernia (a simple x-ray), food sensitivities (through an IgG food antibody panel blood test), an H Pylori bacterial overgrowth (this is a bacteria that commonly causes ulcers but can also cause chronic GERD – diagnosed with a simple breath and blood test), or insufficient stomach acid (actually very common as we age – and a strong likelihood if you struggle with belching all the time). I have successfully supported many clients in working through all of these – including how to approach your doctor about testing.
Long-term use of PPI medications (more than a few months at most) is dangerous – and often has systemic consequences. Give yourself a gift of real healing and take steps to get rid of acid reflux permanently – by addressing its cause at the root. You deserve to savor your food without fearing repercussions!