Your Burning Questions About Heart Burn Answered

By Duke Lifestyle & Weight Management Medical Team

GERD is the medical term for Acid Reflux, and the common description is’ heartburn.’ This condition has nothing to do with anyone’s heart burning. GERD is the acronym for gastroesophageal reflux disease. For various reasons, the stomach’s acidic contents leak into the esophagus, where acidity is not tolerated by this tissue. When this happens, one experiences acid burning on the lining of the esophagus. Many people suffer from GERD, and several ways exist to improve or eliminate the symptoms.

” All disease starts in the gut”
Hippocrates (the Father of Medicine)

Here are some common questions people have when trying to understand pH levels in the stomach and GERD and ways to improve this condition:

Question: Why does our stomach environment remain acid when we eat foods?

Answer: The stomach is at an acidic pH level of 2-3, whereas a neutral pH level is about 7, which is close to the pH level of our blood. An acidic environment in the stomach is the best environment for absorption and assimilation of the nutrients we ingest. In this environment, proteins can be broken down into parts that we can absorb for nutrition. This acid environment is also beneficial for absorbing other nutrients such as vitamins and minerals that are co-factors in many biochemical pathways to keep your body running efficiently, especially while working to release extra pounds.

Question: Are there other benefits to having an acidic environment in our stomachs besides absorption of nutrients?

Answer: Yes, an acidic stomach functions as one of the initial processes of immune defense.
Another very important function of an acidic environment of the stomach is an initial line of defense against bacteria or viruses that we might encounter when eating or drinking. The acidic stomach takes away those bacterial and viral proteins and renders them harmless to the body, helping prevent infections. The acidic stomach assists our defense ability through our nose with the hairs and mucous helping trap airborne bacteria or viruses. Salivary antibodies in our mouths are another assisting line of defense. Our bodies are always working to keep us well.

Question: How does normal digestion occur?

Answer: The answer is in the physiology of digestion. First, LES, the Lower Esophageal Sphincter, is a circular muscle at the bottom of the esophagus. It is located at the junction of the stomach and is made up of smooth muscle. The LES is a muscle that sometimes contracts and closes the space between the esophagus and the stomach and sometimes stays open for short periods. The LES serves as a barrier so that acid-containing stomach contents normally do not come in contact with the esophagus. When functioning properly, it naturally only opens long enough to allow food to pass through.

Question: What happens when the LES (Lower esophageal sphincter) stays open for too long?

Answer: If the timing for the opening mechanism after swallowing is disrupted, it can stay open for too long. Often extra weight in the middle of the body creates pressure on the stomach, and LES is forced to open too long mechanically. Foods, drugs, and medical conditions can cause this laxity as well.

Question: Are there other contributing factors to treating GERD?

Answer: Yes, eating late at night and then lying down flat with a full stomach can contribute to the upward flow of acid contents of the stomach into the esophagus. Combined with lying down, the effect of gravity and excess acid will weaken the LES and worsen GERD. Spicy or acidic foods like tomato sauces that stimulate digestive juices and lower pH levels can contribute to GERD symptoms in some people.

Question: What ways to avoid GERD or acid reflux, i.e., heartburn?

Answer: Healthy eating changes such as:

• Avoiding spicy foods, especially late at night or during evening meals
• Avoiding upside-down positions after a meal
• Avoiding alcohol if you experience GERD symptoms
• Smoking tobacco

Lifestyle changes such as:

• Taking steps to reduce stress and stress hormones in the body
• Learning Mindfulness Meditation can be very effective at lowering the physiology of stress
• Losing Weight

About Medical Weight Loss at the Duke Lifestyle & Weight Management Center

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• Your weight increases your risk for a medical condition such as diabetes, high blood pressure, or heart disease.
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• You do not qualify for weight loss surgery.
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