Heartburn, sometimes referred to as acid reflux, or GERD (gastrointestinal esophageal reflux disease), is one of the most common digestive disorder affecting North Americans. After Lipitor (a cholesterol reducing medication), acid suppressing medications are the most common medication prescribed for this condition.
Problems with taking acid suppressing drugs (e.g. nexium, zantac, prilosec):
From The Journal of Gastroenterology (2):
“Treating GERD with acid inhibition will not work because acid secretion is NOT the primary underlying defect.”
The primary underlying defect; Not too much acid, but too little acid.
Most people assume heartburn is caused by too much stomach acid production. This is a common misconception due to the fact that GERD prevalence increases with age, while stomach (hydrochloric) acid production decreases with age (3). In fact, 40% of women over 80 years of age do not produce stomach acid at all. If GERD was caused by excess acid, more children and teenagers would have GERD than the elderly.
Heartburn is caused by stomach acid coming into the esophagus (see image above). The esophagus does not contain a lining that protects it from stomach acid, like the stomach does, and the presence of this acid in the esophagus causes the acid reflux and burning sensations associated with heartburn or GERD.
The esophagus is separated from the stomach by a muscular valve or sphincter known as the LES (lower esophageal sphincter). This LES should only open when swallowing foods/liquids to allow them in the stomach for digestion. GERD is caused by a dysfunction of this LES, which opens when it shouldn’t, allowing stomach acid into the esophagus from the stomach.
Low Stomach Acid
Stomach acid is required for maintaining a low pH in the stomach which prevents bacteria from overgrowing. Thus, low stomach acid causes bacterial overgrowth in the stomach as well as further down to parts of the intestine. Bacterial overgrowth causes maldigestion of carbohydrates, which leads to gas production. This gas increases the pressure in the abdomen and stomach, causing the lower esophageal sphincter (LES) to malfunction (4). The malfunction of the LES allows acid from the stomach to enter the esophagus, thus producing the symptoms of heartburn and GERD (5).
Summary of the Mechanism of Heartburn
Low Stomach Acid —> Maldigested Carbohydrates —> Gas —> Increased Abdominal Pressure —> LES Malfunction —> Heartburn
Other contributing factors to heartburn:
Healing from Heartburn
GERD and heartburn are easily prevented and cured by addressing this underlying defect using dietary and lifestyle changes. There are three steps I use to treat without medications, applied in the following order:
CALM Inflammation of the esophageal lining caused by stomach acid
As stated above, the reason people feel heartburn or acid reflux is because of the presence of stomach acid in their esophagus. The esophagus is not meant to store stomach acid as it does not contain the protective lining that the stomach does. Thus the presence of stomach acid in the esophagus causes inflammation in the esophagus leading to symptoms of heartburn. The first objective is thus to calm the inflammation to help alleviate symptoms, so that steps 2 and 3 can be addressed as well. The following supplement and dietary suggestions are recommended:
Deglycyrrhizinated Licorice (DGL) (6)
DGL has been shown to be effective in treating gastric and duodenal ulcers and works as well as zantac with no undesirable acid suppression or side effects. It works by promoting mucous secretion, and stimulating new cell growth which contribute to a health gut lining.
Zinc Carnosine (7)
Zinc carnosine benefits by restoring the gastrointestinal lining through it’s anti-inflammatory and antioxidant functions. Evidence supports the safety and efficacy of zinc carnosine for maintenance, prevention and treatment of the mucosal lining. It is approved for use of treating gastric ulcers in Japan and most conditions of the upper GI tract.
Mastic Gum (8)
Mastic gum has been used for more than 2500 years in traditional Greek medicine for treating several diseases such as peptic ulcers and gastritis. Modern science has justified it’s benefits by revealing its activity against bacteria such as H Pylori, which is the main cause of gastric ulcers. Studies confirm its anti-inflammatory, antioxidant and anti-microbial actions which makes it a valuable treatment tool for heartburn.
Reduce inflammatory foods
It is suggested to avoid the following foods to calm the inflammation from GERD:
gluten, dairy, spicy foods, citrus foods, tomatoes, coffee, peppermint, chocolate, alcohol
REMOVE the factors causing low stomach acid and bacterial overgrowth
The factors causing low stomach acid and as a result, bacterial overgrowth, can include: acid-suppressing and antibiotic medications, H pylori bacterial infection, chronic stress and malnutrition. An additional cause, as mentioned above, is age, as production of stomach acid reduces with age (1). Bacterial overgrowth is often a cause of low stomach acid as sufficient stomach acid reduces the pH in the stomach, providing a non-hospitable environment for bacteria to survive. Eradication of bacterial overgrowth often includes the rotation of anti-microbial herbs such as oil of oregano, garlic, berberine, and mastic gum.
REPLACE stomach acid and beneficial bacteria
As low stomach is connected to GERD, the last step is to increase stomach acid levels. If this is done too early on, it can aggravate heartburn symptoms. Increasing stomach acid can be done through:
Due to bacterial overgrowth being a major factor in heartburn and GERD, establishing a beneficial balance of bacteria is an integral part of treatment. After eradication of bacterial overgrowth, replacing beneficial bacteria can involve the use of fermented foods such as kefir and sauerkraut, and/or the use of probiotic supplements. Not all probiotics are created equally, and some can aggravate digestive symptoms if SIBO is present. To be safe, probiotics without acidophilus are recommended.
Heartburn and GERD are easily prevented and cured with a Naturopathic approach as outlined above. The mainstream medical approach of taking acid-suppressing medications unfortunately has its risks and side effects which can be easily avoided by following a more natural approach.
9 Naturopathic, Evidence-Based Approaches to Supporting Our Immune System, especially during COVID19
Keeping our immune systems strong is the most important thing we can do to protect ourselves against COVID-19. There is always a risk of exposure, no matter how hard we try to avoid it, but building up our body’s natural resilience is key.
Enhance your immune system with some of these 9 natural, well-researched approaches! Link to studies included.
1. Serious Hand Cleaning – it’s the most simple tip, but it’s certainly the most critical. Twenty full seconds of scrubbing is what it takes to lift germs off skin and carry them away when you rinse. Also, social distancing (at least 2 meters away) and avoid touching your face.
2. Vitamin C - a potent antioxidant and antiviral. Currently administered intravenously in NYC, China and South Korea to COVID-19 patients to reduce intensity and duration of symptoms. Recommended oral preventative dosing is 1000 mg 3 - 4x/day (spread out through the day as the body only absorbs a certain amount of vitamin C at a time) and should be in a buffered (alkalinized) form. https://isom.ca/vitamin-c-coronavirus/
3. Vitamin D - increases immunity and has been shown to reduce vulnerability to respiratory tract infections (viral especially). Most Canadians are deficient in vitamin D based on their bloodwork levels. The recommended preventative dosing is 1000IU/day (see your ND or doctor to see your bloodwork levels if a higher dose is required (often is) to ensure your vitamin D is in the optimal range. https://www.mdpi.com/2072-6643/12/4/988
A Naturopathic Approach to Urinary Tract Infections (UTIs) and the association with Irritable Bowel Syndrome (IBS) and Small Intestine Bacteria Overgrowth (SIBO)
Over 50% of women will suffer from a urinary tract infection (UTI) during their lifetime. One-third to one-half of these women will have a recurrent UTI within one year. Recurrent UTI’s are defined as three or more UTI’s in a 12 month period (1). The most commonly used conventional therapies for these conditions are antibiotics. There is increased awareness and concern about antibiotic resistance with repetitive use of these medicines. This growing concern has created an interest in alternative treatments for UTI’s. The purpose of this article is discuss this conditions, the causes, and alternative treatments for cure and further prevention.
This article will also illuminate the link between UTI’s and an imbalanced gut microbiome, otherwise known as dysbiosis. Gastrointestinal conditions associated with dysbiosis such as Irritable Bowel Syndrome (IBS) and Small Intestine Bacterial Overgrowth (SIBO) are common in those with bladder infections.
Interstitial cystitis (IC) is a condition of the bladder that affects millions of women, men, and children worldwide. Also known as bladder pain syndrome (BPS), IC is a chronic inflammatory condition that results in recurring discomfort or pain in the bladder and the surround pelvic region. Other symptoms may include increased pressure in the pelvic region, increased urgency, and/or increased frequency to urinate.
Diagnosis of IC
The American Urological Association defines IC/BPS as follows:
“An unpleasant sensation (pain, pressure, or discomfort) perceived to be related to the urinary bladder, and associated with lower urinary tract symptoms of more than six weeks duration in the absence of infection or other identifiable cause.”
Iron deficiency is the most common nutrient deficiency in the world (1). Many women are iron deficient, especially those who are menstruating, pregnant, post-partum or breastfeeding. Iron deficiency is also commonly seen in those with chronic blood loss and/or gastrointestinal absorption issues. Untreated iron deficiency can lead to iron deficiency anemia, which occurs when the body lacks sufficient amounts of iron to form normal red blood cells. Without enough iron, the body can’t produce enough hemoglobin for red blood cells to deliver oxygen from the lungs to the tissues.
These are some of the symptoms that one may experience with iron deficiency or anemia (2):
A health-related New Year’s resolution can be so powerful, whether it’s a goal to get stronger, give up a bad habit or lose some weight. Here are some tips to help create and sustain your health goal for 2017.
1. Make one resolution only. Making too many resolutions can be overwhelming and often hard to follow through with.
2. Make sure it’s your goal, not someone else’s. Ask yourself:
What’s one important thing I could be doing right now that I haven’t been?
3. Use SMART goals: Specific, Measurable, Attainable, Realistic and Time sensitive.
Some examples: Run a 5K race on May 7th, Consume 5 servings of vegetables every day until February 1st.
4. Be accountable to someone. Tell a friend or family member about your goal and ask them to check in with you. Also tell your ND about your new goal. Those who care about you want to help you succeed.
5. Make it visual. Write down your goal, use visual reminders to help keep them fresh in your mind (i.e. a bikini, or a photo of a time you were more physically fit or healthy, a marathon route you are planning to run). Keep these visuals around your living or office space as constant motivators.
6. Last but not least, reward yourself along the way. As you are working hard towards your resolution, treat yourself! Some ideas could be: a massage, a new fitness outfit, a new kitchen appliance, etc. Staying motivated requires some incentive.
Here's to a healthy and happy 2017 :)
Bloating is not fun. We've all been through it, looking 9 months pregnant can make us feel unpleasant, uncomfortable and unattractive. Bloating can come with other symptoms like constipation, gas, stomach or lower abdominal pain, feeling swollen and more. So what causes bloating? Here are 6 of the most common causes of bloating I see in practice.
1. Eating Habits - eating or drinking too quickly, eating too much food, not properly chewing our food can result in bloating. The reason for this is that our body is not able to secrete the proper amount of enzymes and stomach acid to effectively break down our food. Another reason is that eating too quickly increases the likelihood of swallowing air.
Take away: eat mindfully, do not have liquids with your meal, and watch your portions. I really like the 5-10-15 rule: take 5 deep belly breaths before a meal, put down your utensils for 10 seconds after every bite, and make sure your meal takes no less than 15 minutes.
Acne vulgaris is the most common dermatological issue seen by physicians. It is a condition that can cause a lot of distress, resulting in lowered self-esteem in some. Often patients will seek pharmaceutical treatments such as the oral contraceptive pill, spironolactone or Accutane in order to seek some relief for their skin, which can come with nutrient depletions, risks and side effects. Naturopathic medicine aims to target the cause of acne from the inside out and offers safe and effective treatments for long-term resolution of this skin condition.
Our hormone system (medically known as our endocrine system) is complex. Our endocrine system consists of 6 different organs (our pituitary gland, pineal gland, thyroid, pancreas, ovaries/testis, and adrenal glands) and each of these glands is responsible for producing certain hormones (i.e. the ovary producing estrogen and progesterone, the adrenal glands producing cortisol). What makes our hormones complex is not just the individual organs and the hormones they produce, but how these systems affect each other and result in certain hormonal conditions.
Common signs of Hormonal Imbalance include:
Part 1 - Your Digestion from an Eastern Perspective
According to naturopathic medicine, our digestive system is the key to balanced health and vitality. Naturopathic medicine is a combination of Western, modern scientific knowledge with Eastern traditions. Eastern traditions include: Traditional Chinese Medicine (TCM), which was the first formalized system of healthcare in modern civilization, along with Ayurvedic Medicine, the ancient medical system from India. Both of these traditions understand that in order to extract the nourishment we need from food, there needs to be balance and integrity in both the body and mind.
Constipation is a condition that affects 1 in 4 Canadians and is defined as having a bowel movement fewer than four times per week. Chronic constipation can sometimes be managed with diet and lifestyle including extra fluid intake, exercise, increased dietary fibre and more. For some of us though, these changes either make a small difference or the effect doesn’t last and the constipation returns!
Allergies are the fifth-leading cause of chronic disease in the world and are affecting up to 30% of adults and 40% of children globally. According to the Asthma and Allergy Foundation, the prevalence of this condition has increased each year over the past decade.  Allergy sufferers may experience runny or itchy noses,congestion as well as watery and itchy eyes.
Naturopathic physicians are well trained at helping both to manage these symptoms naturally and potentially eliminate allergies, avoiding the use of over the counter medications to keep those symptoms at bay. This article will review the top naturopathic strategies for managing and potentially eliminating allergies.
When people ask me what I do, my response is often met with a confused look and the questions “so you’re a nutritionist?” “A herbalist?” “A what type of doctor?” I actually didn't know what a Naturopathic Doctor (ND) was until a couple years before applying for naturopathic medical school when I experienced first hand the benefits of seeing an ND. Read more for ways an ND can help you!
According to the Canadian Mental Health Association, at this very moment, 3 million Canadians are suffering from depression and on any given week, more than 500,000 Canadians will not go to work because of mental illness. In the spirit of Bell’s Let’s Talk day last week (which made an incredible impact on Canada’s mental health care system, way to go Bell users:), I thought I’d share some of what the research has shown on ways to improve brain health.
Dr. Lara is a Naturopathic Doctor who is passionate about helping and empowering her patients in their journey towards lifelong health and wellness