The burning question—what is (and isn’t) acid reflux?Acid reflux and heartburn are different beasts. Heartburn produces a painful sensation in the gut, around the bottom of your ribcage. Acid reflux is caused by partially digested food sneaking up from your stomach into your throat. They have stomach acid in common as a partial cause, so I’m focusing on acid reflux—but will cite heartburn research when it’s relevant. Be sure what you’re dealing with isn’t food allergies, by the way. The symptoms can be similar. That’s why the first thing I make sure of is that my patients with symptoms are allergy free.
It takes muscle to guard this borderThe lower esophageal sphincter (LES) is a small muscle between the bottom of your throat, or esophagus, and the top of your stomach. Normally tightly sealed, its job is:
- To relax when you eat, to let your food travel down into your stomach
- To tighten selectively when you eat, to keep your food from rising back up out of your stomach—as acid reflux
A lazy, incompetent LES?Not at all. Once upon an ancient time, everything we ate was natural. Our LES was happy. Then came processed foods, environmental toxins, and bad habits. Today? Your poor LES has to battle:
- Too much food in the stomach (overeating)
- Too much pressure on the stomach (frequently caused by gas, obesity, pregnancy, or constipation)
- Diets high in unhealthy fats and oils
- Unnatural un-foods
- Stress and lack of sleep
- Citrus fruits
- Sedatives, anti-depressants
- Iron supplements
- Blood pressure drugs
- Osteoporosis drugs
- Potassium supplements
Melatonin—working the night shiftMelatonin has sailed through boatloads of the most rigorous and conclusive studies researchers could throw at it. Results? A mountain of research tells us that melatonin:
- Helps to significantly relieve heartburn and acid indigestion
- Helps seal off your LES, preventing that “slosh-back” of acid
- Helps promote long-term LES health
- Helps keep your LES from opening after eating
- Helps protect the mucus membranes of the esophagus
That’s one smart hormone. How does it work?A major cause of acid reflux is damage to the esophageal wall. Over time, acid exposure, even a little at a time, can reduce the production of protective esophageal mucosa. This says “Hi, c’mon in” to inflammation, the origin point of nearly every disease in the book. It’s thought that melatonin acts as an antioxidant, protecting the mucosal layer from damage, as well as stimulating additional production of protective mucosa. Melatonin also reduces the inflammation, making it an important anti-inflammatory, as well as an antioxidant, that can work both down in the gut and up in the esophagus.
Give your LES a break
- For safe, temporary relief, drink half water, half aloe vera
- Chew gum. It increases saliva production and reduces the amount of acid in the esophagus (but avoid spearmint or peppermint, which can relax the LES)
- Sit up straight while eating. It gives gravity a chance to help food travel downward
- Don’t lie down for at least two hours after eating—same reason
- Don’t eat and run—to bed. I recommend no sleep for at least 2 hours after dinner, but four or even six hours would be better.
- Fresh, organic, local fruits and vegetables, except citrus
- Lean protein, like eggs, lean meat that you grill, poach, broil, or bake—never fry
- Complex carbohydrates—steel-cut or rolled oats, 100% whole grain bread, brown rice, and couscous
- Potatoes and other root vegetables for their good carbs and digestible fiber (but never prepared with onion or garlic)
- Good monounsaturated fats, from fish and plants, from olive, sesame, and sunflower oils, and from avocados, peanuts, and peanut butter, and many nuts and seeds
- Good polyunsaturated fats—oils such as safflower, soybean, corn, flaxseed, and walnut; and fatty fish such as salmon, mackerel, and trout
De-stress(!!!)I don’t have to tell you again, but I will—stress sickens, and sickness kills. Even moments a day of more exercise, meditation, yoga, tai chi, a pleasurable bath, counseling…there’s a world of choices within our reach. Make some of them part of your routine and add healthy years to your life.
Sleep tight—literallyRemember that melatonin regulates our body clocks, promoting restful sleep—but only when we produce it in sufficient amounts. Indeed, research shows that melatonin deficiency comes at a price. Just for example, people with heartburn tend to produce 24 percent less melatonin, and overweight people who wake up at night to eat tend also to produce less. It stands to reason that more melatonin would mean less heartburn and less midnight snacking—which, by the way, is a habit that surely messes with your body clock. I recommend my reflux patients take 6 mg of melatonin about 30-60 minutes before bedtime. This is a much larger dose than I would recommend to help you just get to sleep, but it’s the amount shown most effective for heartburn/acid reflux, in human clinical studies. So make sure that you’re ready to lie down and drift into dreamland before when you take it—never during the day or before working or driving. That’s a big part of taking good care.
- “Melatonin and Heartburn – How it Helps?” Best Heartburn Remedies. Published NA. Last accessed April 29, 2017.
- Mann, Denise. “Feeling Stressed? Why You May Feel It in Your Gut” Health.com. Updated April 30, 2012. Last accessed April 29, 2017.
- Richards, Byron. “New Insights on How Stress Causes Acid Indigestion” Health Resources. Published NA. Last accessed April 29, 2017.
- “Melatonin” WebMD. Published NA. Last accessed April 29, 2017.
- Story, Colleen and Kinman, Tricia. “Can Stress Cause Acid Reflux?” Reviewed September 8, 2015. Last accessed April 29, 2017.