Indigestion heartburn

Indigestion heartburn can spoil the best of dinners. What's 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'll get a vitamin B12 deficiency. That's serious. Tingling in arms and hands and legs ...

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's 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 something eating us?

Perhaps you've 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 stomach, so there's a significantly higher incidence of osteoporosis and hip fractures associated with PPIs[1].

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's huge. 

Hiatus hernia.

This page was last updated by Dr Barrie Lewis on 3rd January, 2019.

Sometimes the cure is worse than the disease. Is there a more natural way, with no side effects, that we could use?

"I would like to find a stew that will give me indigestion heartburn immediately, instead of at three o'clock in the morning."

- John Barrymore

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's on the increase.

Oddly, antacids only aggravate the underlying problem which is only rarely TOO MUCH acid, mostly it's TOO LITTLE. That causes poor digestion.

It's 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 stew, it's end of story; indigestion heartburn.

Indigestion heartburn in essence is a disturbance of the normal function of the stomach. It could be pathological, like an ulcer or cancer, but usually isn't. It could be anatomical, like a defective valve that should prevent the contents of the stomach refluxing back up the oesophagus. It could be emotional, like anger or bearing a grudge.

But most usually, it's a mixture of foods that don't agree with you; and especially a refined carbohydrate like a bread roll or white rice. 

"You don't get ulcers from what you eat. You get them from what's eating you."

- Edith Baum

The contents of the stomach is extremely acid to enable the enzymes to effectively digest protein in the stomach, 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 Heartburn. Quite the contrary, too little acid, leaving poorly digested proteins ...

The other effect of taking antacids is to allow those partly digested proteins through into the small intestine. If these long chains of proteins 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 shouldn't be found in the small intestine where the absorption occurs.

Hiatus hernia

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 oesophageal sphincter is often called a hiatus hernia; a portion of the stomach may bulge through the diaphragm into the chest cavity, causing indigestion heartburn. 

In some people, the hiatus or hole in the diaphragm weakens and enlarges. It's 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's interesting is that in some people this reflux causes acid burns, erosions of the oesophageal lining (which may be pre-cancerous), but in others there's no erosion at all leading to the diagnosis of NERD, non-erosive reflux disease.

Clearly it's complex, and there are many things at work. Could simple dietary changes make a difference, without the use of pills? Yes!

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 heartburn. Even so, antacids are not the solution to the problem - dealing with the muscle called the diaphragm which forms the valve.

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 in the stomach, the nerve supply to the both the muscles and the glands that produce both acid, and enzymes and other substances.


'Doctor, do you think you can help my dad. He has terrible backache.'

'That's 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's been getting terrible Indigestion Heartburn and now blood in the stool, and his doctor says he has to stop taking the medicine. Now he's a bear with a sore back and so much heartburn indigestion!'

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 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.

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-inflammatories.

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 ...

The point I feel sure is clear. If you have indigestion 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 health care.

VITAMIN B12 - 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... 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's gravely worsened by antacids taken on a regular basis.

"Inadequate stomach acid. A much more common cause of deficiency of B12, especially in older people, is a lack of stomach acid, because stomach acid is required to liberate vitamin B12 from food. An estimated 10 to 30 percent of adults over the age of 50 have difficulty absorbing vitamin B12 from food. (1) People who regularly take medications that suppress stomach acid—such as proton-pump inhibitors, H2 blockers, or other antacids—may also have difficulty absorbing vitamin B12 from food. Even people who lack adequate stomach acid can typically absorb vitamin B12 from fortified foods or supplements, however, providing yet another reason to take a multivitamin."


And avoid Antacids.

Google appears to frown on too many links, so phrases in bold, like that tingling page above, need to be copied and pasted into the Site Search function in the navigation bar on your left if you want more information.

Lying on the right side

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.

Indigestion lying on right 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.

Location of the gastric juice while side-lying at night.

Why do we hiccup?

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), the nerve itself or one of the tissues supplied by the Phrenic nerve are the usual causes. Read more … WHY DO WE HICCUP?

Chiropractic help

There's 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:

  1. Don't drink any fluid with the offending meal (usually dinner) or for an hour afterwards.This applies to any fluid, including water or coffee, but alcohol and especially beer may be the the real problem, causing fermentation. Fluids dilute the acid in the stomach, resulting in poor protein digestion, and much worse possible auto-immune problems. Furthermore, fluids drunk after a meal, left on top of solid food, are more likely to be refluxed.
  2. Drink soup at the beginning of the meal, perhaps with a break before the rest of the meal, so the fluids can start to pass through into the small intestine.
  3. Drink only very small quantities of water and no other liquids before going to bed. On lying down, any fluids in the stomach may reflux, carrying strong acids back into the oesophagus where there is no mucus protection, causing indigestion heartburn.
  4. Avoid bread, rolls and fruit puddings at dinner. 
  5. No chocolate after dinner.
  6. Soups are healthy and delicious, but for some people have to be eaten with care.
  7. Too much onion or leek and tomato (a fruit) can be an absolute nightmare for some people. A PRIME CAUSE, particularly if it is eaten with bread rolls. Try starting the meal with a large chopped salad. For many people this alone will reduce 95% of the symptoms of indigestion heartburn.
  8. Too much fat is another common cause of indigestion heartburn. Avoid rich fatty stews at dinner. Scrumptious at lunch if your cholesterol is okay, just not every day. Too much fat in the diet has been linked to bowel cancer.


Kefir benefits.

Kefir is an ancient drink emanating I believe from Bulgaria; it's really what we would today call a probiotic. Made from milk, raw or pasteurised, it consists of over 30 different strains of healthy bacteria and yeasts.

I have all my life suffered in one way or another from indigestion heartburn. Astonishingly, with 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've been helped, then one tends to pass it on. Here's what a close friend had to say:

Hi Bernie,

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 eating/drinking it, I have had not acid reflux at all.



That sums it up. In theory the real benefits of kefir have to do with the colon rather than the stomach and, at this stage, I have no idea of the physiology behind the relief that indigestion heartburn sufferers get from kefir benefits. Like I said, in only five minutes each morning you too can make the culture.

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...

Frog in my Throat cover

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: 

  • Simply too much food in one meal.
  • Liquid with the meal
  • Especially carbonated drinks
  • Fatty foods
  • Onions
  • Chocolate

2.  Foods that irritate the lining of the oesophagus, and hence the nerves.

  • Fruit after dinner, especially citrus. Fruit drinks. OJ or apple juice for example. Wine.
  • Very spicy foods.

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's 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!

"He was woken early by borborygmus as his insides fermented and his intestines ballooned with gas beyond their capacity."

- Ruth Dudley Edwards

Barrett's oesophagus

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's 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...

Sourdough bread

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.

Sourdough bread recipe

Links @ Indigestion Heartburn

› Indigestion heartburn

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I have left alone. After seven treatments his pain and stiffness is 50 percent better, and he is happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti-inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He is doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost pain-free. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he is well pleased; sixty-five percent better after three treatments.

5. Mr T is a wise man; he has taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily stroll has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift; he has a short leg.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. X-rays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65-year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88-year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done. 

10. Mr X is a 71-year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a few months ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It is a non-complicated upper cervical facet syndrome, and she is doing well.

12. Mr D is a 38-year old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he could not sleep on that shoulder.

13. Mr D, a 71-year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors should not be treating the elderly most medical sites state but that is so much bunkum.

Do you have a problem that is not getting better?

Are you looking for a different slant on your pain?

Do you want to pose a question?

Interesting questions from visitors

CLS writes:

Greetings, Dr B.

You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70 percent of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there is a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong. Give plenty of detail if you want a sensible reply.

You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what a DC does.

The quickest and most interesting way is to read one of my eBooks of anecdotes. Described by a reader as gems, both funny and healthful from the life and work of a chiropractor, you will love them. Priced right at $2.99, though Kindle fiddles the amount without telling me.