Acid Reflux and the Bariatric Client

Acid Reflux happens sometimes.  We have all had an episode of this but I want to discuss what is acid reflux and why it happens and what we can do to prevent it.

I want us all to understand acid reflux because a good understanding will empower us to make better food decisions.  If we can truly understand reflux, we will take the steps to be able to free ourselves from this very uncomfortable condition.

What I want to point out in a very important way is that contrary to popular belief, acid reflux is caused by having too little (not too much) HCI or hydrochloric acid in our stomach.   If you ask most acid reflux sufferers “why do you have acid reflux”, they will tell you that they have too much stomach acid.  That’s what the pharmaceutical companies tell us on those fancy TV commercials while they are selling us their magic cure for acid reflux.  

HCI stomach acid declines with age and acid reflux increases with age.  This tells us that we are not producing sufficient HCI as we age.  Over 90% of people over 40 years of age have inadequate acid production.   We should be taking steps to improve acid production in our stomachs instead of taking medication to treat the symptoms of acid reflux.  This is a vicious circle of events. 

The symptom of acid reflux is not the cause of acid reflux.  This is such an important statement.  So what I want to say with this is the following: When I am speaking with bariatric clients about their acid reflux, and I explain that it’s probable that their reflux is caused by not sufficient HCI (stomach acid), rather than too much HCI, they sometimes doubt this.  The reason they want to doubt my theory is that their antacid medications do provide some temporary relief.

I am not saying that their symptom of acid reflux is not caused by acid moving upwards into the esophagus.  I am not saying that the medications they are taking for the acid reflux don’t help to reduce their symptoms.

What I am trying to explain is that even a tiny amount of acid reflux in the esophagus is going to hurt and cause issues.  We do not have the mechanics in the esophagus as we do in the stomach to protect us against this very powerful acid.

When your symptoms are relieved, that doesn’t mean that you have addressed the real and true cause of the problem.  You are only suppressing these symptoms and not getting to the root cause of the issue which is acid reflux.

No two cases of acid reflux are the same.  It is likely that it is a combination of things that are contributing to your painful, annoying condition.    

We have to remember that acid reflux is the symptom.  We need to figure out why we are getting this symptom and to get to the bottom of it in order to resolve it.  I feel that taking medication to cover up the symptoms is not getting to the root cause of “why do we have acid reflux”.   We need to dig deeper in order to find the cause so that we don’t need to take medications to cover symptoms.

Recent studies show that the damage from poor stomach function not only moves upwards and gives us the symptom of acid reflux, it also moves downwards and contributes to IBS which is irritable bowel syndrome. 

Let’s begin.  What is acid reflux?  Acid reflux is the backward flow of HCI – hydrochloric acid or stomach acid up into the esophagus.  The esophagus is the long tube that joins the throat and stomach together.   The acid in the stomach refluxes back up the esophagus because the valve at the top of the stomach is not closed tight enough to prevent it.  

When we have reflux, there is a sour, burning liquid that sits at the back of our throat.  Some of us have a burning feeling in our chest.  This can also be called heartburn.

If we don’t take care of acid reflux, it can then progress to what is called GERD. GERD stands for Gastro-Esophageal Reflux Disease.   Is it considered to be a digestive disorder that affects the lower esophageal sphincter.  

Why do we get acid reflux?  There are lots of causes of acid reflux.  Some of them include weight, posture or the medications that you take.  But, three of the main reasons people suffer from acid reflux is due to low hydrochloric acid, the timing of meals and diet.

If you get acid reflux at night only, it will be important to time your meals and snacks better.  You want to try to allow at least 3 to 4 hours between the last meal and your bedtime.  

One cause of acid reflux is due to a hiatal hernia.  If you feel that you may have one, you need to get this repaired.  When you have a hernia, the HCI, hydrochloric stomach acid can move up and into the esophagus.  This will cause acid reflux.

The main medications which can cause acid reflux are aspirin and aspirin products, ibuprofen, muscle relaxers, and some blood pressure medications.  If you take any of these medications and you have acid reflux, you can discuss this with your doctor.

Last week in my blog and during my FB live video, I discussed coffee culture.  Coffee is a big culprit when it comes to acid reflux.  Giving up your morning ritual of coffee may be what you need to do in order to combat reflux.  Once your reflux is under control you can try drinking coffee again to see how it affects you.  Coffee is a drink which irritates the esophagus and it weakens the esophageal sphincter. When this is relaxed, it can lead to a backward flow of the stomach contents – this is acid reflux.  

It’s not the actual coffee that is causing the reflux. It is the caffeine in the coffee that loosens the stomach valve and enables the HCI to reflux up into the highly sensitive walls of the esophagus which causes pain.

I know that this is not what you want to hear but if you have acid reflux, making this one change can be sufficient to be able to conquer it in a fast and relatively easy way.  You may just need to take a little break from coffee.  

Spicy foods may just be the culprit for your acid reflux.  Are you eating hot peppers or dishes which contain spice which may be irritating you?  When you eat spicy foods, your stomach needs to break it down.  In this process, the spicy foods natural acids can, in turn, increase your stomach’s acid production.  This will decrease the pressure in the stomach and the next thing you know, you have acid reflux again.  

Carbonated drinks and alcohol may be the culprit for you?  Don’t be disappointed because many of my clients are when they hear about how alcohol and carbonation can cause acid reflux.  What happens is that the acid and the carbon dioxide which is used to make these drinks can cause the stomach to bloat.  When the stomach is bloated, it irritates the esophagus and this can lead to acid reflux.  Try removing these from your diet to see if this may be what is causing your symptoms.

Carrying excess weight can be the cause of your acid reflux.  Excess weight puts pressure on your abdominal area.  When you eat, the stomach contents can be pushed upwards and into the chest and the esophagus.   If you lose weight, it can make digestion easier and you will be more comfortable and have less trouble with acid reflux.

Eat smaller meals because when we overeat, this puts a lot of pressure on the digestive system.  It needs to work so much harder to digest, assimilate and absorb the food.  To make it easier on the digestive system, eat a smaller meal.  

When you sleep, try elevating your head just a few inches higher.  This can give you some relief if you are suffering at bedtime.  When your head is in a higher position to your stomach, this can reduce any pressure on the esophageal sphincter and can prevent food and acid from moving in the wrong direction.

Stay away from the foods which trigger your acid reflux.  The most common food culprits are tomatoes, tomato sauces, citrus fruits, fruit juices, fried foods, chocolate, and spicy food.

So now that we have a grasp of what acid reflux is and what we can do to avoid it.  How can we increase HCI (stomach acid) in order to have better and stronger digestion?  

My favorite way is to take a capful of apple cider vinegar in a half glass of lukewarm water first thing in the morning.   Raw apple cider vinegar can help increase stomach acid levels due to its acid property.  It introduces more acid into the digestive tract.

Another suggestion I have for you is to take digestive enzymes.  You can take these before you eat.  These digestive enzymes will help you to better break down the foods you consume.  You don’t need to take them for the rest of your life but it’ a good idea to take them until your stomach acid has a chance to balance itself.  

Make sure you are chewing your food well, eating small meals and not drinking and eating at the same time.  

In conclusion, I do hope that you have a good understanding of acid reflux and what you can do to prevent further bouts of it in the future. We need our stomach acid to be at a balanced level in order to properly digest, absorb and assimilate the food that we eat.  Stomach acid is our friend. 

Here’s to you and your health!

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About the Author: Sheri Burke is a Registered Holistic Nutritionist and Bariatric Surgery Coordinator at International Patient Facilitators in Tijuana and Cancun, Mexico. She has worked with bariatric surgery clients for over 10 years and especially enjoys providing nutritional guidance to pre and post bariatric clients.  In her free time, she enjoys spending time with her husband and two teens and cooking up a nutritional storm in the kitchen.

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