Cindy Crandell is a well-known RN, Functional Medicine Nutritionist, she is renowned for addressing root cause of illness and restoring health. Voted "Best of the Best" for 10 consecutive years. Cindy's expertise has been featured on Fox News, WJR, WNZK and in local publications.
Heartburn, often described as a burning sensation behind the chest bone, has become an all-too-common complaint. This discomfort, which can strike after meals or when lying down, is more than just an annoyance. It’s a signal from your body that something isn’t quite right. In this article, we’ll explore what causes heartburn, the digestion and absorption process, why stomach acid is essential, the risks of long-term acid-blocking medications, and natural ways to calm the fire by improving gut health and digestion.
What causes heartburn?
At its core, heartburn is a symptom of a bigger problem. It occurs when stomach acid escapes from the stomach and into the esophagus. This acid reflux can be triggered by:
Eating large meals or lying down immediately after eating
High-fat or spicy foods
Caffeine, alcohol, and carbonated drinks
Obesity, pregnancy, or wearing tight clothing
Stress and poor digestion
Sugars and Chocolate
Too much liquid before, during, and after a meal
Decreased stomach acid
While acid reflux can feel like your stomach is producing too much acid, the truth is that low stomach acid is often the culprit. When stomach acid levels are insufficient, the lower esophageal sphincter (LES), the valve that keeps acid in the stomach, can relax too much, allowing acid to back up into the esophagus.
For more insights, check out Dr. Axe’s article on heartburn symptoms, causes, and
treatments.
How digestion and absorption works: A journey through the gut
Proper digestion and nutrient absorption involve a complex process that begins in the mouth and ends in the intestines. Here’s a breakdown of the key stages:
Mouth and saliva: Digestion starts in the brain when you smell and see food. This stimulates the mouth to produce saliva that releases gastric juices in the stomach. Chewing breaks food into smaller pieces, while our saliva starts breaking down the carbohydrates, beginning the physical digestion process.
Stomach acid and enzymes: Once food reaches the stomach, hydrochloric acid (HCl) initiates the breakdown of proteins and activates digestive enzymes like pepsin. This acidic environment is essential for further food breakdown.
Small intestine and bile: In the small intestine, enzymes from the pancreas and bile from the liver break down fats, proteins, and carbohydrates into smaller components. Vitamins and minerals are also released at this stage for absorption.
Nutrient absorption: Nutrients are absorbed through the walls of the small intestine into the bloodstream. Key nutrients like iron, calcium, and vitamins require adequate stomach acid to be absorbed effectively.
Large intestine and gut bacteria: Any undigested material moves to the large intestine, where beneficial bacteria further ferment food and produce vitamins like B12 and K2. The large intestine absorbs various nutrients and reabsorbs some remaining water.
Waste elimination: Finally, after this journey through the GI tract, the body excretes unusable portions of food and toxins. Waste products are excreted, completing the digestive process.
When any part of this process is disrupted, such as low stomach acid or poor enzyme production, digestion becomes incomplete. This can lead to gas, bloating, malabsorption, nutrient deficiencies and the development of conditions like reflux.
Stomach acid: A key factor of the digestion journey
Contrary to popular belief, stomach acid is not the enemy it’s essential for proper digestion. Stomach acid (hydrochloric acid or HCl) plays several critical roles:
Breaking down food: Acid helps digest proteins and unlocks vital nutrients like B12, magnesium, and iron.
Preventing harmful bacteria: A healthy, acidic environment keeps harmful bacteria and yeast at bay, reducing the risk of infections.
Supporting enzyme activity: Acid primes the stomach to release enzymes for digestion.
After age 40, our stomach acid starts to deplete and over time our acid bucket becomes empty. When stomach acid is chronically low, it leads to improper digestion, nutrient deficiencies, and gut imbalances creating a perfect storm for bloating, gas, constipation, diarrhea and reflux.
What slows or disrupts digestion?
Several factors can interfere with smooth digestion and nutrient absorption, leading to issues like heartburn, bloating, and malnutrition:
Stress: Chronic stress activates the “fight or flight” response, which slows down digestive processes, reduces stomach acid production, and disrupts gut motility.
Low-fiber diets: Fiber helps keep digestion moving smoothly. Diets low in fiber can lead to sluggish digestion and constipation.
Foodborne illness and Microbiota changes: Infections and antibiotics can disrupt the balance of good bacteria, leading to gut imbalances (dysbiosis) that impair digestion.
Decreased pancreatic enzyme production: Insufficient digestive enzymes make it harder for the body to break down food, leading to malabsorption.
Poor dietary choices: Diets high in processed foods, sugar, and unhealthy fats are harder to digest and can trigger acid reflux and inflammation.
Use of PPIs and Acid blockers: Long-term use of proton pump inhibitors reduces stomach acid, impairing the breakdown and absorption of nutrients like calcium, magnesium, and vitamin B12.
These factors can create a vicious cycle, where poor digestion leads to inflammation and discomfort which then exacerbates reflux symptoms.
The key to restoring balance is addressing these root causes, improving gut health, and supporting the digestive system holistically.
To learn more related to gut and digestive health, take a look at Dr. Hyman’s lesson on
supporting a healthy digestive system.
The hidden risks of long-term acid-blocking medications
Proton pump inhibitors (PPIs) and antacids are common treatments for heartburn and acid reflux. These medications manage symptoms but do not correct the underlying issues. In fact, these medications will make the situation worse and are exactly the opposite of what is needed to correct the issue.
Long-term reliance on these medications can come with significant risks:
Reduced nutrient absorption: Blocking stomach acid reduces the body’s ability to absorb calcium, magnesium and B12, increasing the risk of osteoporosis and anemia.
Increased gut infections: With less acid to kill harmful bacteria, users of PPIs are more susceptible to infections such as Clostridium difficile (C. diff), H-Pylori, parasites, viruses and other bad bacteria that disrupt health over time.
Disrupted microbiome: Acid blockers can contribute to dysbiosis, an imbalance of gut bacteria that impacts digestion and immunity. Food needs HCL to break down when this process is blocked. Food will sit, ferment, rot and turn into bad bacteria in the gut.
Rebound heartburn: When people stop taking acid-blocking drugs, they often experience worse heartburn as their body tries to overcompensate by producing more acid. The longer you are on a PPI, the harder it is to remove it and get the stomach to produce acid again. These medications were approved for a 2-week usage period. These medications are overused, over prescribed and patients are allowed to be on them long-term, which goes against the medication usage guidelines. If you have been on an acid blocker long-term you will need to seek help from a professional functional medicine provider to be successful in removing the acid blocker and replenishing HCL and restoring proper digestion.
Long-term effects: Include osteoporosis, dementia, SIBO, nutrient deficiencies, and kidney disease.
If you are using this medication make sure you read the package insert and understand the recommended time frame to use this medication. Typically it is 2 to 6 weeks. It is always best to address the root cause.
To learn more about the concerns surrounding proton pump inhibitors and their effects on health, click here.
4 secrets to calm the fire naturally: Improving gut health & digestion
Rather than suppressing stomach acid, the key to long-term relief lies in supporting gut health, improving digestion, and reducing inflammation. Here’s how:
1. Balance stomach acid naturally
Apple cider vinegar. Try a teaspoon of apple cider vinegar diluted in water before meals to stimulate stomach acid production.
Digestive bitters: Herbal bitters can encourage the body to release stomach acid and digestive enzymes.
Chew food thoroughly: Eating slowly and chewing well reduces the burden on the stomach, promoting smoother digestion. Eliminate drinking liquid 30 minutes before a meal, during the entire meal and 30 minutes after a meal. This can really help, as you will not be diluting the enzymes or HCL as you eat.
2. Strengthen the gut lining and microbiome
Probiotics: Restore the balance of good bacteria by including fermented foods like yogurt, sauerkraut, and kimchi.
Prebiotics: Support healthy bacteria growth with prebiotic-rich foods like garlic, onions, and asparagus.
Bone broth: Rich in collagen and amino acids, bone broth can help repair the gut lining.
Zinc Carnosine: 75 to 150 mg of zinc carnosine twice a day between meals; this has been extensively studied.
Glutamine powder: Take 3 to 5 grams of glutamine powder in water twice a day to help heal the gut lining
DGL (a form of licorice): Chew 2 to 3 chewable tablets 15 minutes before meals.
Magnesium citrate or glycinate: Try 200 to 400 mg of magnesium citrate or glycinate twice a day.
3. Reduce inflammation in the gut
Anti-inflammatory foods: Incorporate foods rich in omega-3 fatty acids (like salmon, walnuts, and flaxseeds) to reduce inflammation.
Herbal remedies: Ginger, turmeric, and aloe vera can soothe the digestive tract and reduce irritation.
Eliminate triggers: Identify and avoid foods that trigger your symptoms, such as caffeine, processed foods, dairy, sugar or gluten.
4. Support digestive enzymes and motility
Digestive enzyme supplements: Help the body break down food and ease the digestive load.
Hydrate properly: Drinking water between meals (rather than during) prevents dilution of stomach acid.
Movement after meals: Light walking after eating can improve digestion and prevent reflux.
Nothing 2 hours before bed: Cut out all food and liquid about 2 hours before bed, so that everything will be out of the stomach and moving into digestion. You will sleep better and will not have reflux when lying down.
Discover Dr. Hyman's effective steps to eliminate heartburn and acid reflux by following this link.
The bottom line
Heartburn is a signal that your digestive system needs attention, not a sign that you should block stomach acid indefinitely. Instead of suppressing acid, focus on balancing and supporting your gut health through better nutrition, and adapting to a whole food nutrition plan. Support digestion with enzymes and HCL. Improving your body’s ability to absorb nutrients, preventing the overgrowth of harmful bacteria, and reducing gut inflammation will lead to long-term relief.
I have restored thousands of guts over the past 25 years, even for those who have been on proton pump inhibitors (PPIs) long-term. There is hope for recovery! We guide clients off medications, helping them restore their gut health, digestion and absorption, so they can live medication-free. This approach also ensures the proper absorption of vital nutrients needed to prevent illness later in life.
By addressing the root causes and calming the fire within, you can regain digestive harmony and leave heartburn behind for good!
Cindy Crandell, Functional Medicine Nutritionist
Cindy Crandell, RN a leader in the functional medicine industry with over 25 years of experience, began her journey after overcoming her battle with Fibromyalgia. Through holistic healing, she reversed her condition and many other health challenges. Now, as the CEO of Wholesome Health, Cindy dedicates her life to helping others achieve optimal health and vitality. She is a passionate advocate for wellness, leading nutritional workshops and speaking publicly on the power of functional medicine to transform lives.
