Do you feel a burning sensation in your chest after meals or at night? It could be caused by gastroesophageal reflux disease (GERD).
When you feel that burning sensation in your throat, you may be tempted to grab a TUMS or baking soda for heartburn. But before you do, you might want to consider the underlying cause of your reflux.
It’s a common misconception that excess stomach acid is the cause of all cases of GERD or heartburn.
In truth, excess stomach acid is rare, and most people actually have low stomach acid at the root of their acid reflux. If that’s the case, TUMS or baking soda for GERD is a bad idea because it blunts already-deficient stomach acid, which can make your symptoms worse in the long run.
Keep reading to learn more about what GERD is, its various causes, and options for long-term symptom relief.
Heartburn, GERD, Reflux, or Indigestion?
The terms heartburn, GERD, reflux, and indigestion are often used interchangeably to describe the same set of symptoms.
However, indigestion describes a broader set of symptoms affecting digestion, like constipation, gas, or diarrhea.
The other terms—acid reflux, heartburn, and GERD—all refer to the same condition. GERD and reflux describe the cause of the condition, whereas heartburn refers to a symptom.
Throughout this article, you will see heartburn, acid reflux, and GERD used interchangeably.
What Is GERD?
GERD describes the condition wherein stomach acid moves up and into your esophagus (the tube that connects your throat to your stomach).
Most people experience heartburn symptoms every once in a while. But you may have GERD if you have symptoms more than twice a week.
GERD is one of the most common digestive conditions in the U.S., affecting about 20% of people.1
Acid reflux ranges from mild symptoms, which occur infrequently and only lead to discomfort, to severe symptoms. Severe GERD can damage the esophagus and can even lead to holes in the esophagus if left untreated.
Symptoms of acid reflux include:
- Burning sensation in your chest or throat (symptoms may be worse after eating, at night, or when lying down)
- Sour or bitter taste in the back of your mouth
- Chest pain
- Trouble swallowing
- Feeling like there’s a lump in your throat
- Chronic cough
- Asthma
- Trouble falling or staying asleep.
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Causes Of GERD
The cause of GERD can often be challenging to pinpoint. Here are some of the potential causes of GERD:
- Weak lower esophageal sphincter (think of the sphincter as a door between your stomach and esophagus)
- Hiatal hernia
- Poor stomach muscle mobility
- Low stomach acid.
It’s commonly believed too much stomach acid causes heartburn, but this is actually only true for a small portion of the cases.
One study estimates about 21% of GERD cases are caused by high stomach acid.2 This means that for 4 out of 5 people, GERD it isn’t caused by too much stomach acid.
For these people, medications or drinking water with baking soda for heartburn to lower stomach acid doesn’t help the actual cause of their symptoms, and may cause more harm than good (more on this soon).
It’s important to find the root cause of GERD, instead of turning to quick fixes that can wind up making symptoms worse over time, and have additional negative effects.
Does Baking Soda Help Heartburn?
Baking soda, also called sodium bicarbonate, naturally acts as an antacid.
Baking soda can help to temporarily reduce the symptoms of heartburn by lowering stomach acid leaking into your esophagus.
If you’re looking for immediate symptom relief, you can dissolve one teaspoon of baking soda in eight ounces of water. Drinking baking soda water for heartburn will help neutralize stomach acid. But be aware that this may not be the best solution.
Baking soda for GERD may offer you some short-term relief from heartburn, but for many people, it may make symptoms worse in the long run.
How to Stop Heartburn
Low stomach acid is extremely common, and it causes digestive issues more often than high stomach acid.
Your stomach acid is essential for:
- Digesting food
- Absorbing nutrients
- Killing pathogens (i.e. bacteria)
- Preventing digestive symptoms and conditions, such as leaky gut and heartburn.
Many of the symptoms caused by low stomach acid are commonly mistaken for high stomach acid.
The popular treatments of proton pump inhibitors (PPI) to reduce stomach acid production, chewing TUMS, and drinking water with baking soda for heartburn may actually make your symptoms worse. This basic treatment plan prescribed to almost everyone only helps a small portion of people.
Symptoms of low stomach acid include:
- Stomach pain
- Weight loss
- Heartburn
- Nausea
- Bloating
- Diarrhea
- Abdominal pain
- Feeling full quickly
- Vomiting
- Constipation
- Glossitis or inflammation and swelling of the tongue.3
Diagnosing Low Stomach Acid
If you or your doctor suspects you have low stomach acid, tests can assess your stomach acid pH and find the causes of low stomach acid:
- Biopsy of the stomach
- Gastric pH testing
- Testing serum gastrin levels
- Testing for H. pylori infection
- Testing for anti-intrinsic factor antibody.4
You can also try taking hydrochloric acid capsules (HCl) at the start of eating meals. If you feel better, you may have low stomach acid. (More on HCl supplements soon.)
Not all doctors will dive deeper into the root cause of your symptoms. If you’re struggling to get relief from your heartburn symptoms, advocate for yourself so you can go deeper with testing to find the root cause of your acid reflux.
Risk Factors For Low Stomach Acid
You’re at a higher risk for low stomach acid if you:
- Take proton pump inhibitors (PPIs), TUMS, or baking soda for heartburn
- Are 65 years or older
- Have consistently high-stress levels
- Are zinc deficient
- Have a history of stomach cancer or surgery
- Have hypothyroidism
- Have or have a history of H. pylori infection.
Low Stomach Acid Treatment and Preventing GERD Symptoms
The treatment for low stomach acid depends on the underlying cause. Instead of using TUMS or baking soda for heartburn, consider trying some of these methods to prevent heartburn:
Review Medications
Take a close look at any of the medications you’re taking to see if they could be affecting your stomach acid production. Long-term medication use, especially antacids and proton pump inhibitors, can impair your body’s ability to produce enough stomach acid.
Talk with your doctor about the medications you’re taking and always discuss any possible changes with them.
Treating H. Pylori
The bacteria H. pylori is only able to overgrow by interfering with stomach acid production. Normal stomach acidity and healthy pH levels naturally limit the growth of H. pylori bacteria.
The treatment of this bacterial infection with antibiotics (natural or prescription) is an important step to restoring healthy amounts of stomach acid and limiting H. pylori growth.
HCl Supplements
A healthy stomach produces 1.5 liters of stomach acid every day (a lot more than more people realize!). When there isn’t enough stomach acid produced, taking hydrochloric acid (HCl) supplements may help replace stomach acid and improve digestion.5
It’s sometimes recommended to start with one capsule of HCL (around 650-750mg) with a meal that includes protein to see how your body responds to the additional acid.
If tolerated, the HCL dose may be increased. The highest dose tolerated without symptoms then becomes your recommended dose.6
Personally, I take 2,000-3,000mg HCl before a meal and consider this a target range. Though I worked my way up when I started using this supplement years ago because my gut lining was more inflamed and I felt irritated. Fortunately, I was educated and aware enough at the time to not mistake the irritation I felt with the idea that the HCl was bad for me. In fact, it was exactly what I needed, but I also needed to focus on repairing gut-lining integrity. So HCl was part of a multi-pronged approach and worked (and still works) beautifully.
Shot of Vinegar
Like HCL supplements, apple cider vinegar may help to increase stomach acid because it contains hydrogen. A teaspoon to a tablespoon can be mixed with water and taken before meals to help digest food.7
For some people, a shot of vinegar increases irritation in their throat. Severe GERD can leave your throat very irritated and drinking vinegar may increase this irritation.
Also, most people don’t realize apple cider vinegar contains a lot of histamine (because it’s the product of fermentation), which is contraindicated for many people.
Digestive Bitters
Digestive bitters are a blend of bitter herbs and are available in dropper or spray form. Bitters help to stimulate stomach acid production and help with digestion.
Taking digestive bitters before you eat can increase your stomach acid, bile, and digestive enzymes. The effects of bitters may relieve symptoms of indigestion and heartburn.
Just make sure to choose a non-laxative-containing type of digestive bitters. I don’t advocate the regular use of herbal laxatives. Good news: if you’re constipated, bitters may help with regularity because it supports gastric secretions and normalize digestion.
Artichoke extract (sometimes found in digestive bitters) as a standalone supplement also supports healthy bile flow, which also helps digest food, especially fat.
I personally use digestive bitters spray prior to meals, in addition to HCl capsules and artichoke extract.
Diet Changes
Don’t forget the importance of a healthy diet for your health. Processed foods and eating a lot of sugar can increase inflammation, reduce stomach acid, and reduce the tone of your gastroesophageal sphincter. (Read more about blood sugar in my article Stop Wondering Why “I Eat Almost No Carbs And My Blood Sugar Is Still High.”)
Foods that are high in fat take longer to digest and may stay in your stomach longer. If you notice heartburn after eating high-fat foods, try to eat fat in smaller portions and avoid overeating. You may also want to support fat digestion by supporting bile flow with digestive bitters and artichoke extract (see above). And lecithin (ideally non-GMO sunflower lecithin) helps break down fats. You may also want to further explore your liver and gallbladder function.
Stress Management
High stress levels limit the production of stomach acid.8 Try to find ways to reduce or manage your stress levels to help restore your digestive health. Try these stress management techniques:
- Remove sources of stress from your life
- Exercise or go for a walk
- Spend time in nature
- Practice meditation and mindfulness exercises
- Try breathing exercises
- Practice Yoga (especially Yin Yoga)
- Talk with loved ones
- Spend time with a furry friend/family member
- Try out therapy or support groups.
Breathing Exercises
In addition to helping manage stress, deep breathing exercises may help to reduce GERD symptoms.
Research shows that deep breathing exercises can increase the tone of the gastroesophageal sphincter and prevent stomach acid from move up into your esophagus.9
Breathing exercises can also stimulate the activity of the vagus nerve, which controls a wide range of functions in the body.
Stimulating the vagus nerve through deep breathing exercises can help to increase stomach acid production and help treat GERD caused by low stomach acid.10
Deep breathing practices that focus on holding the exhalation produce a calming effect.
Key Takeaways
- GERD or acid reflux is a condition wherein your stomach acid moves up into the esophagus.
- GERD symptoms include burning in the chest or throat, bitter taste in mouth, nausea, chronic cough, and trouble sleeping.
- Baking soda for heartburn may be helpful for temporary relief from symptoms, but it may be counterproductive for long-term symptom management.
- It’s more common for GERD to be caused by low stomach acid than high stomach acid.
- Stomach acid is essential for digesting food, absorbing nutrients, and fighting off pathogens.
- HCl supplements, a shot of vinegar, or taking digestive bitters before meals may help to replace low stomach acid and reduce heartburn symptoms.
- Lifestyle changes like diet changes, stress management, breathing exercises, and stopping medications that affect stomach acid production may help resolve GERD symptoms.
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References
- https://www.ncbi.nlm.nih.gov/books/NBK441938/
- Ibid.
- https://www.ncbi.nlm.nih.gov/books/NBK507793/
- Ibid.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991651/
- Ibid.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702398/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC26223/
- https://pubmed.ncbi.nlm.nih.gov/33009052/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5859128/
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Feature image copyright Erika Herman.