Acid reflux bothering you? Here's a gut expert's guide to handling the digestive issue
If you want to get dosed up on the intricacies of acid reflux, you're in the right place. Because, with the intention of giving you the most detailed advice on handling the digestive issue, WH has tapped up gut expert Dr Megan Rossi (@theguthealthdoctor) for her knowledge.
Let's get into it.
Firstly, what is acid reflux?
'If we think about the structure of the intestine, we’ve got the food pipe, (AKA the oesophagus) that connects to the stomach,' Dr Rossi says.
Now, a lot of acid is produced in the stomach – along with enzymes – so that your food can be broken down. Joining the oesophagus to the stomach is a little flap door that’s called the oesophageal sphincter.
This allows food to go slide down from the oesophagus into the stomach. 'If, during the blending process in the stomach, some of the acid tries to whirl back up the food pipe, food goes in the that little sphincter. And, much like a trap door, it shuts.'
'But in some people, that sphincter can be a bit... leaky. As a result, the acid can go up the wrong way – from the stomach to the oesophagus. This can cause that bitter taste you get in your mouth when you experience reflux.'
Now, unlike your stomach – which is used to having an acidic environment – the oesophagus is quite sensitive to it. 'This can create the sensation of heartburn (to clarify: this has nada to do with your heart. It feels like the central pain in that area, but it’s just because the heart and the oesophagus overlap in this region of your body,' explains Dr Rossi.
Anyone who goes a bit OTT on their cacio e pepe with a side of garlic focaccia can fill their stomach so much that they create a lot of pressure in the stomach, which pops open that trapdoor.
But there are levels of severity, here. 'Some people's is bad enough to be classified as gastroesophageal reflux disease (GORD),' she adds.
Right. So what's GORD?
'It's a digestive disorder that's an ongoing sort of acid reflux. It affects around 10% of people in the western world,' says Dr Rossi.
For some people, it can be caused by a hernia, when the stomach bulges out the top of their oesophagus. That extra lump of pressure then makes the oesophageal sphincter really loose. This can be genetic, but it can also be messed with by your lifestyle, like straining a lot when you go to poo.
'Being overweight is another risk factor, as extra weight can put a lot of pressure on your oesophageal sphincter. Smoking, also, can make the oesophageal sphincter a bit loose and leaky.'
And do any foods cause acid reflux?
It pays to think about how you're eating, as well as what. Taking meals really late at night, when you're about to lie down, is a bad idea if you're prone to reflux, Dr Rossi advises. Doing this can put a little more pressure on that sphincter.
In terms of specific foods, we know that the below can be triggers for some people.
Really fatty foods (think: pastries and fatty meats)
Spicy foods
Caffeine
Alcohol
Some people also have issues with citrus fruits and juices – but there's not much evidence to support this
How should I deal with acid reflux, in the moment?
If acid reflux is troubling you right now, here's Dr Rossi's techniques to help calm the issue.
1. Try diaphragmatic breathing exercises
'These can really relax that oesophagus and stop it from contracting so much. It can also calm your nerves down so it can activate the parasympathetic nervous system which is that rest-and-digest versus the sympathetic nervous system which is the fight or flight, kind of really panicky nervous system.'
Sit in the upright position
Place one hand on your upper chest and the other on your belly
Breathe in slowly through your nose. The hand on your chest should be still; the one on your belly should rise.
Tighten your abs and let them fall while you breathe out.
2. Take some meds
'Some people find that over-the-counter medications can help to neutralise the acids that may have come up – things like Rennies, which can provide the short term relief.'
'If you're having to take them twice a week on-goingly, go to your GP. Short story: it’s not good to rely on these meds that decrease the acid nature of your stomach, because said acid nature is important for things like fighting off bad bacteria and helping with digestion.'
If I am dealing with acid reflux all the time, what should I do?
If acid reflux is an on-going problem for you, Dr Rossi recommends taking the following action:
1. Keep a diary
'I would recommend you keep a seven day food and symptom diary (check out the 'My gut diary template in Eat Yourself Healthy) so you can look at any associations with things you've eaten, as well as lifestyle factors like stress, that could have triggered that reflux – because it does seem to be quite personalised.'
2. Get on top of your constipation
'One biggie to note is that, for some people, constipation and bloating element lower down your intestine, can cause reflux.'
'How? Because if you create more pressure lower down, that can build up and pop open that trapdoor as well. If you’ve had long-term issues with constipation or bloating and then now, you have also started to experience reflux, try getting your constipation and bloating under control – check out my guide to the former, here.)'
3. If you're overweight, work towards a healthy BMI
'If you are overweight, trying to lower your bodyweight can alleviate the reflux on it’s own, irrespective of necessarily what you are eating.'
4. Loosen your belt
'Some people also find that actually wearing really tight clothes like high-waisted things or a bra can put more pressure on the intestines. Again, anything that puts on pressure can push that flap door open.'
5. Maintain general good gut health
'Eating a diet rich in diverse plant foods and trying out gut-friendly yoga moves can help to precent the reflux coming up and can lower the overall sensitivity of that oesophagus.'
I've heard that medications can affect acid reflux..?
There is a slightly higher risk of acid reflux in people who have a lot of anti-inflammatory drugs like ibuprofen or aspirin.
This is because these can affect the sensitivity of the intestinal tracts – if you are having them all the time, sometimes cutting them back can relieve the reflux or the heartburn.
Is acid reflux something to worry about?
It’s just that every now and again, I wouldn't be massively concerned. But if it is chronic, i.e. you get it at least once a week and it’s ongoing, then it is worth investigating.
One side effect of the H. pylori stomach infection, for example, is reflux – which you need to see your GP to rule out as the cause of your reflux.
Also, if you are getting ongoing reflux, so ongoing acid going up in your oesophagus, that increases your chance of getting oesophageal cancer, because that acid irritating the lining on-goingly can make the cells of the oesophagus turnover a lot faster.
This can increase the risk of getting the cancer growths, which are the mutations of the cells.
Any massive acid reflux alarms?
If you are experiencing:
Difficulty swallowing
lumps and tenderness in your throat or belly
Have a family history of oesophageal or stomach cancer
Then these are red flags to head to your GP and get checked out.
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