Patient Profile: Overcoming Occasional Heartburn
By Danielle Huntsman, MS CNS LDN
Occasional heartburn is one of the most common gastrointestinal complaints in the US population, with traditional methods often yielding minimal results or improvement. Typically, patients show up in your office for one of two reasons: they just started experiencing symptoms of occasional heartburn or have tried several other options with minimal improvement. The general symptoms of occasional heartburn can include: burning pain in the throat, feeling full after eating, food coming back into the mouth, and/or pain behind their sternum.
Conventional options are often trying to support in one of three ways:
- Neutralize stomach acid.
- Block the body’s signal to produce acid.
- Block secretion of acid into the stomach.
These solutions often provide short-term relief, with statistics showing 30% of patients continue to experience symptoms after treatment.[1] Comorbidities are often a risk with long term use.[2] While heartburn is often attributed to excess acid production, occasional heartburn is often a symptom of impaired digestion. Four main pillars come to mind when developing a natural remedies or alternatives to occasional heartburn.
Lifestyle Modifications
Diet, body mass index (BMI), exercise routine, sleep hygiene, and environmental factors can all influence gastrointestinal health and symptoms of occasional heartburn. Routine exercise and a healthy sleep schedule are often regarded as first-line therapy for our health. A healthy diet is second; this can include avoiding alcohol and assessing the intake of foods that can aggravate the esophagus, such as fat, chocolate, and peppermint. These foods can decrease LES pressure and force food back into the esophagus.
Soothe and Support Gastric Cells*
The mucosal barrier within your gastrointestinal tract serves as the primary line of defense against the passage of pathogens and unwanted substances from entering the body. Maintaining a healthy structure of mucosal cells is necessary for overall health but especially needed for a healthy gastrointestinal tract. Enzymes can support normal digestive health and ensure the proper absorption of nutrients.* Plant enzymes offer a unique advantage as they remain stable in various pH conditions.* Zinc Carnosine is a unique combination of elemental zinc and the dipeptide, L-carnosine.[3] This combination has been studied for years for supporting intestinal barrier function and increasing the natural defense mechanisms within the mucosal lining.*[4]
Support Acid production within the stomach*:
While traditional methods often reduce acid production within the stomach, hydrochloric acid is necessary for proper digestion and nutrient absorption.* The acid in the stomach serves several purposes, including degrading and breaking down protein molecules and activating several different enzymes and hormones. Hydrochloric acid is necessary for absorbing minerals, including calcium, iron, vitamin B6, and vitamin B12.*[5] Stomach acid also kills unwanted bacteria and microorganisms. Betaine HCI taken before meals can promote the healthy pH of the stomach and support healthy digestion and nutrient absorption.*
Accelerate gastric emptying*:
Occasional heartburn and delayed gastric emptying often go hand in hand, yet often overlooked. These patients feel stomach distention or “fullness” for a prolonged period, as well as bloating, nausea and lethargy. They may turn to remedies that accelerate bowel emptying, which can often be harsh on the stomach; promoting food transport through the GI tract should be the focus. Prokinetic agents such as ginger and artichoke extracts (Cynara cardunculus and Zingiber officinale) support intestinal motility and stimulate bile secretion.* [6][7]Combining these herbs has been shown to increase gastric emptying while reducing gastric fullness and bloating.*[8]
The primary goal or focus is to support the body’s ability to function optimally; all of these natural agents support the gastrointestinal health.* The recommended dosage is dependent on individual’s need for healthy gastric support; dosing for betaine HCI is often titrated. Each of these ingredients can be used independently or for added benefits for a synergistic approach.
*These statements have not been evaluated by the Food and Drug Administration. This is not intended to diagnose, treat, cure, or prevent any disease.
References:
[1] Fass R, Shapiro M, Dekel R, Sewell J. Systematic review: proton-pump inhibitor failure in gastro-oesophageal reflux disease--where next? Aliment Pharmacol Ther. 2005;22(2):79-94.
[2] O'Connell MB, Madden DM, Murray AM, Heaney RP, Kerzner LJ. Effects of proton pump inhibitors on calcium carbonate absorption in women: a randomized crossover trial. Am J Med. 2005 Jul;118(7):778-81.
[3] Mahmood A, Fitzgerald A, Marchbank T, et al. Zinc carnosine, a health food supplement that stabilizes small bowel integrity and stimulates gut repair processes. Gut. 2007;56(2):168-175.
[4] Arakawa T, Satoh H, Nakamura A, et al. Effects of zinc L-carnosine on gastric mucosal and cell damage caused by ethanol in rats: correlation with endogenous prostaglandin E2. Dig Dis Sci. 1990;35:559-566.
[5] Russell RM, Krasinski SD, Samloff IM, Jacob RA, Hartz SC, Brovender SR. Folic acid malabsorption in atrophic gastritis. Possible compensation by bacterial folate synthesis. Gastroenterology. 1986 Dec;91(6):1476-82.
[6] Ernst E, Pittler MH. Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials. Br J Anaesth. 2000 Mar;84(3):367-71.
[7] Kirchhoff R, Beckers C, Kirchhoff GM, et al. Increase in choleresis by means of artichoke extract. Phytomedicine. 1994 Sep;1(2):107-15.
[8] Lazzini S, Polinelli W, Riva A, Morazzoni P, Bombardelli E. The effect of ginger (Zingiber officinalis) and artichoke (Cynara cardunculus) extract supplementation on gastric motility: a pilot randomized study in healthy volunteers. Eur Rev Med Pharmacol Sci. 2016;20(1):146-9.
