Acid reflux and acid indigestion
What’s the difference between acid reflux and acid indigestion?
Is acid reflux the same thing as acid indigestion?
If you suffer from acid reflux you may find much of the information and advice available on it quite contradictory. Are certain foods the cause of acid reflux? Can particular diets ‘cure’ it? Why does it happen sometimes and then not trouble you at others?
There’s often a basic confusion as to what is causing acid reflux, so let’s tackle this first.
What is acid reflux?
Acid reflux is the burning sensation caused by stomach contents travelling back out of the top of the stomach into the oesophagus, which is the pipe along which food travels from the mouth and throat down to the stomach. The stomach contents may even come up as far as the throat.
The stomach contents are highly acidic at this point, as stomach acid and digestive enzymes have been working hard on them, breaking down proteins. The oesophagus and throat are not designed to deal with anything so acidic – food is not supposed to boomerang, but should always travel in the same direction, from mouth to anus – so it is painful.
Rather than refluxing from the top of the stomach into the oesophagus, food should empty from the bottom of the stomach into the small intestine, where the acidity will continue to help with digesting it.
The stomach and small intestine are specially designed to withstand the high degree of acidity necessary to break down food. Their walls are structured far more robustly than those at the start of the digestive tract, above the stomach.
So why should our food decide to turn around and come back?
What keeps the stomach contents in the right place is a sphincter at the top of the stomach, called the oesophageal sphincter. Food passes through this to get into the stomach, and then the sphincter should close to stop it coming back.
A sphincter is a ring of muscle that can open and close. You have several along the length of your digestive system and will be most familiar with the one that you can control – the one that allows stools to leave your body.
Several things can interfere with this process:
- If you don’t chew your food thoroughly, you don’t produce a hormone called gastrin, which helps to tone the oesophageal sphincter and keep it strong and flexible, able to open and close properly.
- Once the oesophageal sphincter is weak and flabby, it isn’t nearly so good at keeping the stomach contents down.
- If you eat a large quantity of food at one time, it is more likely to push up on the oesophageal sphincter and a weak sphincter will find it hard to keep it in place.
- If you drink a lot of liquid with your meals the volume of the stomach contents will be far greater, which again makes it harder for a weakened sphincter to work properly.
- Your stomach is situated under your ribcage. If you hunch or slouch over your meal (or after your meal) the physical pressure on the stomach increases, once more showing up any weakness in the oesophageal sphincter. Bad posture will often also restrict your waist area, making it harder for food to leave the lower end of the stomach and progress into the small intestine.
The conclusions that can be drawn about avoiding reflux are therefore:
- Sit down to eat your meals
- Don’t eat a large amount at one meal
- Don’t drink with (or immediately after) your meals
- Sit up and observe good posture during and after meals
All of these steps are free to do and very easily accomplished, with a little thought and practice. They work quickly to improve all but the worst reflux, which is encouraging.
As further steps, you may wish to ensure that your evening meal is taken at least 3 hours before bed and is relatively small – have a larger lunch instead. You may also benefit from raising the head of your bed a little, if you experience reflux at night.
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What about indigestion? How does it influence acid reflux?
Given these facts about reflux, you will see that anything that increases the pressure in the stomach is likely to show up weaknesses in that all-important oesophageal sphincter. Acid indigestion is therefore a very likely trigger, as it involves inflammation, fermentation, and misbehaving on the part of the stomach walls.
Acid indigestion triggers
Acid indigestion is more likely if:
- You eat on the run rather than sitting down calmly
- You wolf your food down and therefore don’t produce gastrin
- You eat when stressed (adrenalin switches off digestive triggers)
- You drink with your meal and dilute your digestive enzymes so that they are less effective
- You drink caffeine or alcohol, which triggers adrenalin production and impedes digestion
- You eat fruit with other food (fruit prefers an empty stomach)
- You eat a lot of fatty foods that require the liver to produce bile efficiently, which is difficult if you haven’t chewed thoroughly to start with
- You eat spicy foods that irritate an already sensitive stomach lining
None of these factors may affect you if they only happen occasionally, or if you are young enough for the adverse effects not to have built up. Once your stomach has become inflamed and sensitive, though, any of these factors will be enough to cause indigestion and increase the likelihood of reflux.
Acid indigestion: why is it happening?
When you eat, the action of chewing triggers the production of gastrin, a hormone that prompts the stomach to produce acid and digestive enzymes, and which tones the oesophageal sphincter. It also instructs the stomach walls to move correctly, tossing food around to mix it up with the digestive juices (acid and enzymes).
If food hits the stomach without proper preparations being made, it will have to wait there for ages until the stomach produces the correct juices to break it down. This gives you the uncomfortable feeling of food lying heavily under your ribcage.
Until the acidity levels in the stomach rise to a certain level, the sphincter at the lower end of the stomach – the pyloric sphincter – won’t open to let food out into the small intestine. It hangs around and may ferment, causing belching and discomfort.
Ironically, many people think that acid indigestion is caused by too much acid, and take antacid medication. This makes it harder to break down proteins, and also takes away the trigger for the opening of the pyloric sphincter. Confusion and chaos all round.
What foods really impact on acid reflux?
Any foods that promote acid indigestion will increase your chances of experiencing reflux.
- Highly processed, salty or sugary foods
- Lots of raw food – go for warm, cooked foods instead until things improve
- Fatty food (including full fat dairy products)
- White bread, white pasta, and white rice
- Fruit mixed up with other foods – have it at a separate meal and preferably have it cooked and warm until things improve
Stomach aid not stomach ache
A little attention to your eating habits – sitting up straight, chewing, having sensible portions and sticking to warm and cooked foods for a while – and you’ll be feeling better.
To kick-start the improvements, take herbal bitters such as Centaurium, Yarrow, or Artichoke before meals. The bitter taste triggers the proper production of digestive enzymes, which not only ensures you break your food down efficiently but also tones the sphincter at the top of your stomach to stop food refluxing. They work very quickly and aren’t contraindicated with any medications.
If you have white flecks on your nails you may be low in the mineral zinc, which you need to make digestive enzymes. Take 15mg daily with breakfast until your nails are spotless again.