Indigestion and heartburn can spoil the best of dinners. What is it all about?
This is a condition that is not serious for the majority of sufferers, unless you start to
take antacids regularly, in which case you will get a vitamin B12
deficiency. That is serious. Tingling in arms and hands and legs is a sign.
Nearly one half of Americans complain of severe heartburn at least once a month; and one in five a serious form of the disease called GERD; that is a huge number of people. There are a heap of medications on the market, all with their side effects. Does it have something to do with what we are eating perhaps?
Or is something eating us?
Perhaps you have been prescribed a common medication called a proton pump inhibitors like Prevacid that reduces acid production in the stomach in an effort to quell the fiery stuff in your oesophagus. But calcium absorption is dependent on strong acid in the gut, so there is a significantly higher incidence of osteoporosis and hip fractures associated with PPIs.
The Journal of the American Medical Association reports there is a 44% increased risk of hip fracture if you take proton pump inhibitors such as Nexium, Prevacid and Prilosec for just one month; that is huge.
This page was last updated by Dr Barrie Lewis on 22nd April, 2021.
Sometimes the cure is worse than the disease. Is there a more natural way, with no side effects, that we could use?
But it does cause sufferers untold grief in the early hours. John Barrymore was certainly not the first to complain, and going by the number of antacids sold, it is on the increase.
Oddly, antacids only aggravate the underlying problem which is only rarely TOO MUCH acid, mostly it is TOO LITTLE. That causes poor digestion.
It is no coincidence that Barrymore mentions stew. It probably contains a large amount of fat, certainly onions and, if he also enjoyed a bread roll and a tankard of beer with his meal, that is the end of the story; indigestion heartburn.
Indigestion and heartburn in essence are a disturbance of the normal function of the stomach. It could be pathological, like an ulcer or a tumour, but usually it is not. It could be anatomical, like a defective valve that should prevent the contents of the gut refluxing back up the oesophagus. It could be emotional, like anger or bearing a grudge.
But most usually, it is a mixture of foods that do not agree with you; and especially a refined carbohydrate like a bread roll or white rice.
That incidentally is not all true, but she makes her point; is there a psychosomatic factor to your heartburn?
The contents of the stomach is extremely acid to enable the enzymes to effectively digest protein, which must occur before they enters the next part of the gut, the duodenum. High acid content is also essential for absorption of vitamin B12, extremely important for your nervous system. This is quite normal and it should not be concluded that too much acid is the cause of your indigestion and heartburn.
Quite the contrary, too little acid, leaving poorly digested
The other effect of taking antacids is to allow those partly digested proteins through into the small intestine. If these chains of amino acids are absorbed into the blood stream, they will cause obscure allergic reactions like hayfever, asthma and autoimmune diseases in the body when your immune system thinks they are foreign matter. Whole proteins should not be found in the small intestine where the absorption occurs.
The lungs and heart of the chest cavity are separated from the stomach and intestines by a large muscle called the diaphragm, through which the oesophagus must pass on the way to the stomach; a weak lower sphincter is often called a hiatus hernia.
A portion of the stomach bulges through the diaphragm into the chest cavity, allowing reflux and causing indigestion and heartburn.
In some people, the hiatus or hole in the diaphragm weakens and enlarges. It is not known why this occurs. It may be hereditary, or it may be caused by obesity, exercises such as weightlifting, or straining at stool.
Whatever the cause, a portion of the stomach herniates, or moves up, into the chest cavity through this enlarged hole. Hiatus hernias are very common, occurring in up to 60 percent of older folk causing GERD, or gastro-esophageal reflux disease. Your dinner ends up in your mouth and, worse, into your lungs.
What is interesting is that in some people this reflux causes acid burns, erosions of the oesophageal lining (which may be pre-tumour), but in others there is no erosion at all leading to the diagnosis of NERD; non-erosive reflux disease.
Clearly it is complex, and there are many things at work. Could simple dietary changes make a difference, without the use of pills? Yes, do not be afraid to experiment.
The stomach is lined with a thick mucus to prevent the acid from attacking the stomach wall. However the oesophagus is not so protected.
Should the valve that seals off the stomach be defective, then strong acid refluxes back into the oesophagus where it may attack the lining which has no protection, causing indigestion and heartburn. Even so, antacids are not the solution to the problem; dealing with the muscle called the diaphragm which forms the valve is another bet.
The contents of the stomach is the critical subject. This is mediated by many different processes such as the amount of fluid in the stomach, the mixtures of different foods that you have just enjoyed, the nerve supply to the both the muscles and the glands that produce both acid, and enzymes and other substances, and so on.
FROM THE COAL FACE
'Doctor, do you think you can help my dad. He has terrible backache.'
'That is an odd question, Minky. I treat bad backs all day long. You know that.'
'Yes, of course, but his doctor says his problem is far too serious for a chiropractor.'
'Well, is his doctor's treatment helping?'
'No, he has been getting terrible indigestion and heartburn and now blood in the stool, and his doctor says he has to stop taking the medicine. Now he is a bear with a sore back and so much pain in his tum.'
Minky had been a patient for nearly two years. She suffered from regular miserable Headache Chiropractic that put her to bed for several days in the month before she started consulting me.
'Suggest your dad comes for a free consultation, Minky. It will involve an abbreviated examination, but no treatment, to help him decide if Chiropractic could help him. Tell him to bring his X-rays, if he has any.'
The upshot was that Minky's dad had a very routine problem
in the low back. Once he had a course of about ten treatments, was
doing all his exercises, and came for an occasional visit every two or
three months, his problem became only a minor irritant in his life. He no longer needed those nasty life-threatening pills.
His eyes opened wide when I told him that 14 000 people had died in the USA in one year from gastric bleeds from taking anti-inflammatory medication.
It remains a mystery to me why doctors can think a back too serious for a chiropractor, but they are prepared to risk the patient's life with medication that their own research declares kills tens of thousands every year.
ANTI-INFLAMMATORY DRUGS should be a last resort, or prescribed only for a short period.
The point I feel sure is clear. If you have indigestion and heartburn and you are taking anti-inflammatories [aka NSAIDs], see your doctor immediately for a stool test. Are you passing blood? Blood from the stomach makes the stool black, not red. At the same time, make an appointment with your chiropractor to treat the cause of the pain in your back. Treating symptoms, in general but especially with NSAIDs, is plain bad management.
VITAMIN B12 - have you been taking antacids regularly?
Vitamin B12 is vital for the nervous system; do you know what Pernicious Anemia is? TINGLING IN ARMS AND HANDS AND LEGS is the symptom and a marginal deficiency is now recognised in about a quarter of people over 50. There are various causes, but the most common is too little stomach acid, and it is gravely worsened by antacids taken on a regular basis.
more common cause of deficiency of B12, especially in older people, is a
lack of stomach acid.
Many folk find that lying on the right side gives them significant indigestion heartburn at night, and often frank pain. A bubble of gas may be trapped in the fundus; the solution is either to stand up, and try to burp, or to turn and lie on the left side.
A bubble of gas may collect in the fundus of the stomach.
Notice in the graphic below that while lying on the left side the yellow gastric juice is far less likely to seep into the oesophagus and cause irritation of the mucosa which is not protected as the stomach has to be.
Hiccuping is a reflex contraction of the diaphragm muscle, causing a sudden intake of breath that snaps the epiglottis closed; a hic. Irritation of the Phrenic nerve roots (C3-C4-C5) or one of the tissues supplied by the nerve are the usual causes. Read more … WHY DO WE HICCUP?
There is only anecdotal evidence that chiropractic help may contribute to indigestion heartburn.
Ask your chiropractor to check your
Follow one or all of these simple rules if you suffer from Indigestion heartburn:
Kefir is an ancient drink emanating I believe from Bulgaria; it is really what we would today call a probiotic. Made from milk, raw or pasteurised, it consists of over 30 different strains of friendly bacteria and yeasts.
I have all my life suffered in one way or another from indigestion and heartburn. Astonishingly, within days of starting to enjoy kefir benefits, I have been virtually free of many years of pain and discomfort. It takes only five minutes each day to strain the little florets and top up the bottle with fresh milk.
The culture grows quite quickly so, if you have been helped, then one tends to pass it on. Here is what a close friend had to say:
Hi Doctor B,
Thanks so much for the kefir culture. I have made quite a lot, and the plant has grown to about three times the size. I am already giving some away. We like it very much and since I have been drinking it, I have had not heartburn at all.
That sums it up. Initially I thought the real benefit of kefir had to do with the colon rather than the stomach, but on further reading it has also been shown to inhibit the growth of heliobacter, the bug that causes ulcers; I had a proven infection of this noxious bacterium after a gastroscopy. It did not respond to medication and proton pump inhibitors where then recommended which I refused of course.
Like I said, in only five minutes each morning you too can make the culture; I now take a maintenance dose several times a week and am largely free of pain. I still have to sleep on my left side in the early part of the night.
If you enjoy reading then you will enjoy books by chiropractor Bernard Preston. He will keep you laughing as he retells his short stories from the clinic. Stories that will also help you be healthier and happier, and able to look forward to old age, instead of dreading it. Sound good?
Soon Frog in my Throat will be available as an ebook at half the price. Or less, and no postage. Watch this space. But first, Stones in my Clog, Preston's third chiropractic short stories. Rivetting stuff, like Priest in my Bed...
Two types of foods
Professor Robert Russell, MD, states there are two different processes occurring:
1. Foods that increase the pressure in the stomach placing pressure on the valve that separates the oesophagus from the stomach. This would include:
2. Foods that irritate the lining of the oesophagus, and hence the nerves.
In short, rather than taking masses of pills, all of which have their side effects, perhaps it's time to start being the detective. Which of these are the spoke in your wheel? It may be just one of them, or several.
Yours truly suffered terribly with indigestion heartburn several nights a week having to sleep upright until about five hours after the meal.
Many of the above triggers were involved.
Finally, faced with gastroscopes, medication, threat of cancer of the oesophagus, he took the bull by the horns. Giving up several beers before dinner TOTALLY, COMPLETELY, COMPREHENSIVELY cured the problem.
I can now have a soup with bread, fatty stews, a cup of milo after dinner before bed, chocolate, fruit puddings, all without a problem. Beer was my problem. What's yours?
I have now been off all alcohol for nearly four months, and am much the better person for it.
There is nothing simple about surgery to fix a hiatus hernia. In my own case, the surgeon warned me that all burping would stop, and the gases would instead have to travel the length of the alimentary canal, causing considerable lower bowel discomfort and bloating.
Giving up beer was a much simpler solution. Since taking kefir, I can now enjoy my tipple in moderation again.
"He was woken early by borborygmus as his insides fermented and his intestines ballooned with gas beyond their capacity."
- Ruth Dudley Edwards
Having started this page by saying that indigestion heartburn is not usually serious, affecting nearly half the population, but there is one very serious exception. Chronic acid reflux into the oesophagus sometimes causes abnormal changes in the cells of the lower part of the tube which is strongly associated with a very malignant disease.
As always don't assume that it happens only to other people. Seek out the cause of your indigestion heartburn. That is why I decided to give up beer, for a period.
Rather than taking pills, rather than being an ostrich, be the detective and find out whether some simple changes in your lifestyle cannot make the difference. Or even difficult changes. Nothing simple about giving up alcohol or losing ten kilograms, but faced with the alternative surgery, I would try anything. Kefir is my saviour.
For many folk bread is the devil, particularly if eaten with an onion or tomato soup. A roll with dinner may be the beginning of a nightmarish evening.
A possible solution is to look out for, or bake yourself, sourdough bread. During the long exposure to lactobacillus in the leaven, the stubborn amino acid, proline, with its ring structure, is broken and made digestible.
Following an easy sourdough bread recipe may be the solution to your miserable night pain. I now bake it four times a week, and it takes only five minutes. It's half the price of anything you can buy in the super market, and ten times as tasty. More important, no indigestion heartburn.
Links @ Indigestion Heartburn