3 Ways To Manage Heartburn Naturally

When we typically think of heartburn, we assume that we have an excess amount of acid in our stomach that's causing this acidic, burning sensation. Makes sense, right? Going along with this theory, then, the treatment option is to use medications that turn off or suppress the acid production in our stomach using medications called proton pump inhibitors or PPIs to get relief.

The really interesting thing about stomach acid is that most of us don't actually have this crazy, huge, overproduction of it as we are led to believe. Contrary to popular belief, many cases of heartburn or acid reflux are not caused by the overproduction of stomach acid but rather from having too little stomach acid. The current literature shows that gastroesophageal reflux disease (GERD) is caused by a dysfunction of the muscular valve that separates the lower end of the esophagus and the stomach. This is known as the lower esophageal valve, or LES [1].

So what causes dysfunction of the LES? One major factor is having too little stomach acid. Insufficient stomach acid can lead to a host of different conditions that encourage the increase in intra-abdominal pressure (IAP). As IAP increases, it pushes against the LES. When the LES opens because of the pressure and even a microscopic amount of acid touches the inside of your esophagus it can produce large amounts of pain and burning. This is because the esophagus is not protected like the stomach from high acid levels.

We actually want our stomach environment to be really acidic for proper digestion to occur. When we take PPIs we completely turn of the production of this stomach acid. For some people experiencing acute digestive issues that's the desired effect. But long term misuse of these acid suppressing drugs can cause issues overtime and alter our ability to properly digest our food which is a BIG deal.

If you experience symptoms like:

• Acid reflux

• Heartburn

• Burping

• Gas or bloating

• Excessive feelings of fullness or desire to skip breakfast

• Nausea after eating

…you might be experiencing symptoms as a result of low stomach acid. The pH or level of acidity in our stomach is meant to be between 1.5 and 1.7, which is very acidic because we need to break down all of the food we eat into a form that can be absorbed by our small intestines [1].

I work as a holistic health coach, but I'm also a cardiac RN and the majority of patients that come into my clinic are on a PPI like Pravacid, Nexium, or Prilosec. They’re everywhere! These medications are typically intended to be used if you are experiencing really severe stomach acid issues and inflammation or a gastric ulcer. Additionally, there are studies that show that timely use of PPIs can protect people from getting ulcers that can develop as the result of non-steroidal anti-inflammatory (NSAID) use [2]. There are definitely indications for these drugs to resolve acute gastrointestinal issues if used in an appropriate manner. If your gut is highly inflamed you may need this type of support in addition to changing your diet and using holistic methods, and it’s best to work with a doctor to get you on the right medication for your needs.

These drugs, however, are highly over-prescribed. More than 60 million prescriptions for GERD were filled in 2004 and Americans spent $13 billion on acid stopping medications in 2006 to give you an idea of the magnitude [3, 4]. These medications are actually available for over the counter purchase as well which allows patients to self-medicate without reporting their condition to a doctor. It’s important to note that these medications were only approved by the FDA for 8 weeks of use. They were never intended to be prescribed for years or even decades, as is often done today. Many people I see as private health coaching clients who are experiencing symptoms of heartburn have been on these acid suppressing drugs for 10 to 20 years! Since these drugs aren’t getting to the root cause of the issue (and are often times making things worse overtime), people become reliant on them to control their symptoms and get stuck in a vicious cycle.

In fact, the FDA has issued a series of reports cautioning against the prolonged use of PPIs, citing increased risk of infection, bone fractures, and life-threatening infections (clostridium difficile). [5, 6] As with any medication, it’s really important to take a critical look at what they are really doing and how they are affecting our digestion and whole person health.

Why is stomach acid important?

When we take medications that turn off our ability to produce stomach acid we have to consider how this is impacting our overall digestion and then, downstream, our overall health. Proper levels of stomach acid are needed to adequately absorb many nutrients, including minerals (iron, copper, zinc and calcium), vitamin B12, folic acid and proteins. Stomach acid is also a crucial part of the immune system. The acid barrier of the stomach during normal states of health easily and quickly kills bacteria and other bugs that enter the body. It also prevents bacteria in the intestines from migrating up and colonizing the stomach [7]. When we don’t have adequate levels we are more susceptible to these types of infections, nutrient deficiencies, increased bacterial overgrowth in the intestines and more.

If you are someone that’s been on PPIs for a long period of time, it’s worth starting a dialogue with your doctor about your need for these drugs. It’s important to note that if you have been on them long-term, you do need to taper off of them to avoid experiencing a rebound effect. Avoid self-diagnosing and work with your doctor to assess your need and create a plan for tapering while considering the natural ways to optimize your digestion below.

You’ll first want to start by considering your diet. It’s a good idea to remove the following inflammatory foods to aid in gut healing [8]:

• Gluten, dairy and sugar (can be very inflammatory to the gut)

• Raw vegetables (they are harder to digest and can irritate the gut lining). Focus on more cooked foods temporarily as they are easier to digest.

• Caffeine (coffee, tea, soda, chocolate, etc.)

• Processed or fried foods

• Consider removing all grains temporarily (can impair digestion and add to inflammation in a compromised gut)

• Consider removing nightshades temporarily (white potato, eggplant, peppers, tomatoes) or cooking them to reduce the alkaloid content

• Individual food sensitivities

Food to include:

• Cooked vegetables (especially leafy greens)

• Good quality proteins (meat, salmon, etc.)

• Easy to digest soups and stews

• Gut healing foods like bone broth and collagen

Three simple ways to help optimize your digestion:

These interventions may seem simple or obvious, but it’s amazing how many of us can benefit from putting mindful attention not only to what we are eating, but how we are eating it to improve the process of digestion! I’ve coached many clients through these simple steps along with making dietary changes and I can tell you they have a huge impact.

1) Slow down before meals in order to activate the enzymes necessary for proper digestion. The process of digestion starts in the brain (also known as the cephalic phase of digestion). When you simply look at food or think about food it actives the production of saliva, stomach acid and enzymes needed to properly break it down. So if you're on the go, running, eating in front of the computer (my own hand is raised over here…), your body is not ready to start this process of digestion so it's not going to effectively break things down.

2) Chew your food thoroughly to help break down food so that's it's easy for your stomach and other digestive organs to process and absorb. When we chew, we help break down these bigger food particles into something smaller that our body can further break down and absorb. If you're experiencing issues such as bloating, burping, nausea after meals or heartburn, try chewing your food very well. Aim for 20 chews per mouthful and see how you go!

3) Optimize your stomach acid. Try drinking one of the following before meals:

• 8oz glass of water with a generous squeeze of lemon

• Apple cider vinegar: Start with 1 tablespoon diluted in 1/4 cup water and drink before meals

• Digestive bitters: dilute one dropper-full of digestive bitters in a glass of water 15 minutes before meals to help naturally stimulate digestion. I like this brand >>

• You may require more stomach acid support (in the form of HCL supplements) but it’s advised to work with a practitioner to help you with this protocol. HCL should never be taken by anyone who is also using any kind of anti-inflammatory medication such as corticosteroids, aspirin, Indocin, ibuprofen (e.g. Motrin, Advil, etc.) or other NSAIDS. These drugs can damage the GI lining that supplementary HCL might aggravate, increasing the risk of gastric bleeding or ulcer.

  If you feel burning when drinking lemon or vinegar proceed with caution and consult with a practitioner as it might be a sign you have some irritation and damage and need some soothing supplements or herbs prior to starting.

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If you suffer from heartburn and want to talk more about how to optimize digestion I always offer free 30-minute discovery sessions to get clear on your major health concerns and what’s standing in your way. Contact me to set up a consultation and we can create a plan of action specifically for you! 

In Health, 

Christina Tidwell, MN, RN, CHC

 Resources

[1] https://scdlifestyle.com/2012/06/hypochlorhydria-3-common-signs-of-low-stomach-acid/

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773617/

[3] https://www.forbes.com/2006/02/27/pfizer-merck-genentech-cx_mh_0224topsellingdrugs.html#189668266662

[4] http://www3.niddk.nih.gov/Burden_of_Digestive_Diseases/index.shtml#CHAPTER14

[5] http://www.fda.gov/Drugs/DrugSafety/ucm245011.htm

[6] http://www.fda.gov/Drugs/DrugSafety/ucm290510.htm

[7] https://fxnutrition.com/shore-up-your-stomach/

[8] https://www.ncbi.nlm.nih.gov/pubmed/11712463

LIVE WELL PODCAST | EPISODE 7 - DR. STEVE OVERMAN ON HOW TO COLLABORATE WITH YOUR DOCTOR

Dr. Steve Overman is a clinical professor at the University of Washington and a recently retired Rheumatologist and founder of the Seattle Arthritis Clinic. He's also the co-author of the book, You Don’t Look Sick! Living Well with Chronic Invisible Illness.

In episode 7 of the Live Well Podcast, Dr. Overman speaks about the difficulty of diagnosing autoimmune disease and how to best collaborate with your doctor to get the most out of your care.

LISTEN BELOW (AND DON'T FORGET TO SUBSCRIBE SO YOU'LL NEVER MISS OUT!)

Click here to listen in iTunes

Click here to listen in Stitcher

Or if you’d like to play the episode right now in your browser, use the player below:

Show Notes:

• 0:00 Introduction

• 0:21 Introducing Dr. Steve Overman

  • Dr. Overman’s Book: You Don’t Look Sick!: Living Well with Chronic Invisible Illness

• 0:60 The importance of finding a coach

• 0:90 Why is it so difficult to diagnose autoimmune diseases?

• 0:95 What is autoimmune disease

  • Organ vs. systemic

• 1:30 Autoinflammatory diseases - not specific antibodies to measure

• 1:55 Allergies - mast cell activation

• 1:80 Difficulty to get a diagnosis

  • Lack of time

  • Lack of education

• 2:30 How to communicate your story to your doctor to get the most effective care

  • “Don’t read the last chapter first”

• 3:00 Bring one piece of paper to your office visit

  • Download my Appointment Checklist >>

• 4:00 Autoimmune disease as an invisible illness

• 4:30 Fibromyalgia information

  • Amplification of symptoms seen on MRI

• 5:09 Frustration with getting taken seriously by your doctor

• 5:60 Using a response to treatment to help with an ongoing diagnosis

• 7:45 “A Snake in the Mist” - feeling like you’re going to die before you get a diagnosis

• 7:60 Three strikes to firing a doctor

• 8:15 Current treatment of Autoimmune Disease in our healthcare system

  • Dr. O’s Big 5

    • Toxins

    • Sleep

    • Diet

    • Exercise

    • Stress

• 9:90 Advice for those going through the healthcare system with a chronic illness

  • Phases of illness

  • Find support - get a coach

• 10:56 Outro

If you loved this episode, I'd be honored for you to give me a rating on iTunes. This helps me to get content out to others who are interested in getting control of their health through diet, lifestyle shifts and personal empowerment.

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P.S. I always offer free 30-minute discovery sessions to get clear on your major health concerns and what’s standing in your way.

We're all unique and will implement each of these strategies differently, so contact me to set up a consultation and we can create a plan of action specifically for you.

In Health, 

Christina Tidwell, MN, RN, CHC

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Is Your Poop Normal?

I know, I said poop. I’m a Registered Nurse and Nutrition Coach you guys, poop is a big part of the job. Our digestive function is absolutely critical to our overall health. Food does not simply go in your mouth and out the other end.  There are many complex processes that play a role in how food is broken down, absorbed and assimilated into the body.  Elimination give us so much information about how our digestive system is working as a whole and is definitely something we need to pay attention to.  

So today, we’re talking about poop.

Every nutrition coaching client I have fills out a 5-Day Food Diary complete with symptoms and details about bowel movements using the Bristol Stool Chart as a guide (I really am a nurse).

In this chart the ideal poop is a Type 4. Anything above it indicates some level of constipation, and anything below it means loose stools.

Where do your bowel movements measure up? When evaluating your poop you want to look at color, consistency, presence of undigested food particles etc. to tell you what is going on in your digestive system.

When it comes to troubleshooting elimination everyone is so very different and there are many underlying factors that it takes time to figure out. However, here is a quick and dirty guide with a few tips to get you to a Type 4.

If you are Type 1-3:

You should be having 1-3 bowel movements a day (yes, really!). If you are not having (regular) daily bowel movements, or find yourself straining, having pain or incomplete bowel movements - you are likely constipated.  

Common underlying causes of constipation:

• Food allergies/ intolerances

• Dehydration

• Lack of “good” bacteria in the gut

• Impaired digestion/ absorption

• Certain prescription drugs

• Stress or anxiety

• Lack of fiber in the diet

• Thyroid or hormone imbalance

A few general tips to improve constipation:

• Stay hydrated

• Consume more fiber (in the form of colorful fruits and veggies): Insoluble fiber from these sources helps to move stool along the digestive tract to be eliminated.

• Eat good fats: Good fats (olive oil, avocados, salmon, coconut) help to lubricate the digestive system and keep things moving.

• Try probiotic rich foods or supplements to help balance the good and bad bacteria in the gut.

• Exercise is key to keep things moving!

If you are Type 5-7:

If you are having loose, watery stools that occur more than 1-3 times per day and experience urgency, cramping or pain with elimination - that’s diarrhea. (I probably don’t have to tell you what diarrhea is, I feel like when you know you know am I right?) Diarrhea is a symptom of an underlying issue. Loose stools are usually a way to get rid of something the body views as toxic.

Common underlying causes of diarrhea:

• Food allergies or sensitivities

• Food poisoning or viral infection

• Lack of “good” bacteria in the gut

• Lactose intolerance

• Impaired digestion/ absorption (especially with fats)

• Antibiotics

• Stress and anxiety

To improve diarrhea you need to find the underlying cause (if you are experiencing severe, chronic diarrhea stop reading this blog and definitely talk to a doctor as you can experience dehydration and malnutrition).  Here are a few common examples:

• Stress and anxiety: The gut brain connection is a powerful thing. To address stress as the underlying cause first evaluate sources of stress and implement real stress reduction techniques such 4-7-8 breathing.

• Food intolerance: work with a practitioner to obtain food sensitivity testing or go through an elimination diet to uncover potential intolerances in a systematic way.

• Antibiotic use: antibiotics happen. They kill the bad bacteria making us sick or infected, but wipe out the good guys too. During a round of antibiotics make sure to repopulate the gut with probiotics rich foods or supplements.

Alright you guys, thanks for talking about poop with me. Here’s to perfectly consistent Type 4’s all the time!!!

If you want to talk more about optimizing digestion and finding the right foods for your body, I offer free, 30-minute discovery sessions.  Schedule yours by clicking on the button below!

On Gratitude for Illness

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What if today, instead of diagnosing, monitoring, analyzing, treating and trying to fix your chronic illness you took a moment to step back, do nothing and simply be thankful for its place in your life. Yes, thankful for the thing that causes you pain, fatigue, confusion, loss of control and at times suffering. If you’re all “Yeah whatever lady, I didn’t ask for this, you don’t know what it’s like,” hear me out.

Illness is our body telling is that something is out of balance. It’s our body trying to get our attention so we can work towards fixing the imbalance. Having an illness in any form is not something anyone asks for, but if we can view illness as an opportunity to slow down, quiet down, and listen to what is going on internally it can be used as a great tool for healing and personal growth. 

Illness, when simply observed with kindness and viewed without judgement can provide us with huge insights into the very core of ourselves.  It can act as a catalyst for personal awakening and growth because it forces us to become really aware of what is going on in our bodies and our lives at the most basic level.  As a busy society, we get pretty good at ignoring the subtle signals our bodies send us when we are burnt out and trying to keep up with the pace of life, and dulling them down when they become inconvenient. As Lissa Rankin eloquently states in her book Mind Over Medicine,

“Illness offers us a precious opportunity to investigate our lives without judgement, diagnose the root cause of what might be contributing to an illness, realign ourselves spiritually, and do what we can to make our bodies ripe for miracles.” - Lissa Rankin, MD

More often than not in life great catalysts of change come in the form of tragedy or sadness.  Illness can be one of these powerful vehicles of change if we let it.

Those who have chronic illness, whether you like it or not, have to become masters at identifying subtle cues in the body and strengthening this mind body connection as a survival mechanism.  This can come in the form of paying attention to food and what we put into our bodies, identification of environmental triggers for disease, knowing when to rest and when to keep moving, etc. Although this vigilance can be tiring, annoying, and cumbersome at times it’s ultimately one of the key pieces of living a healthy, robust life.

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Here are a few things that having a chronic disease has given me personally:

• A strengthened connection between how I feel and what is going on in my body in order to detect imbalances before they become unmanageable.

• My life calling and career path in health and wellness.

• The ability to be a better nurse and healer for others because of a deeper understanding of the illness experience.

• A true appreciation for food and how it’s the key to good health.

• Greater connection to nature and the world around me through using food as nourishment and medicine.

• A more grounded outlook on life and the things that truly matter.

• The deeper ability to understand who I am and what I value at my core (a work in progress).

• The ability to know when I need to slow down and take care of myself rather than push through and the wisdom to not judge myself either way (another work in progress).

• An open mind about the myriad methods of healing, conventional and alternative.

• Connection to a community of like-minded individuals who want to change the way chronic disease is managed in our current health care system.

• A fierce appreciation for health, energy and good times!

So today I give you permission (you may totally not need it from me but, hey, sometimes it’s nice to hear!) to give yourself a break, do nothing, and know that what you are doing is enough. Because, OMG it can get overwhelming to be in charge of monitoring and healing these complex bodies of ours on or own.  I encourage you to take a moment today to think about or write down what you are thankful for about having an illness.   Or if not an illness just something traumatic that happened to you where you made it out alive (and if you're reading this you are most certainly alive). If anything just this act of positive thinking can pull you out of a rut if you are feeling stuck. As my girl Lissa Rankin says,  

“Gratitude keeps you optimistic, and as we’ve seen, evidence shows that optimism improves your health. When you focus on gratitude, positive things flow in more readily, making you even more grateful. As long as you keep your gratitude vessel full, you’ll avoid the unhealthy plunge into dark places.” - Lissa Rankin, MD

You may not be in a place where gratitude feels possible right now. Maybe the burden of your disease is greater than anything else and that is ok. No matter where you are today, simply try to take one moment to listen to what your body is telling you without judgment. See if you come up with something you weren’t aware of before and see if there is a tiny space for gratitude just for having this moment. One day you will be able to find one shred of it and it may make all the difference.  

In Health, 

Christina Tidwell, MN, RN, CHC

PS: If you do make a gratitude list be sure to share it with me I would love to see it! As always, if you want to chat more about your health and how you can strengthen this mind body connection I’d love to support you.  Click the button below to schedule a complementary Discovery Session with me and we’ll have a chat.

Eating well is one of the main pillars of living well with autoimmune disease! If you're wanting to eat heathy but have trouble know what to eat and finding the time to make it, I've put together an easy, FREE, meal plan to get you started. Click here to download my free guide to batch cooking >> 

You’ll get:

+ 7 day meal plan

+ Step by step instructions for how to cook an entire week’s worth of food in just two 2-hour sessions (life changing)

+ Grocery lists

+ Twelve of my favorite, easy recipes!

Enjoy making delicious and nutritious meals in way less time!