4 Surprising Things Your Heartburn May Be Telling You
Your body is always talking to you. I work a lot with my clients on tuning into what their body is saying and then what to do with that information. So with heartburn, the body is really talking. It feels awful. You can’t sleep. Those chalky tablets do nothing. Let’s get into it.
While we think heartburn happens because our bodies are producing too much stomach acid so it’s creeping up into our esophagus, that’s not always the case…
Heartburn isn’t necessarily caused TOO MUCH stomach acid. It’s caused by stomach acid in the wrong place (1).
So how did it get in the wrong place?? This has to do with the metaphorical “door” between our esophagus (the long tube connecting our throat to our stomach) and the stomach itself. This “door” is called the lower esophageal sphincter, but it goes by LES for short and it is essentially a circular muscle. The LES opens to let food into the stomach and then it *should* be closed when our stomachs do the work of breaking down our food.
When all is going well, this “door” gets closed by a mix of neurotransmitters, hormones, acid concentration, and pressure.
When it’s not going so well, this “door” is left a little bit open (aka the muscle stays relaxed) and we feel the BURN.
So let’s see what might give our LES a little trouble…
1. You don’t have enough stomach acid
I know this sounds like the opposite of everything you thought heartburn was, but the symptoms of too much and too little stomach acid can look very similar. Let’s bring it back to the LES. Remember that one thing that helps “close the door” is the acid concentration in our stomach. When our stomach starts secreting hydrochloric acid, this acidic environment signals that it’s time to digest, so the LES closes. SO this means if we don’t have enough stomach acid, that signal isn’t as strong and the LES may not close all the way, allowing our very strong stomach acid to make its way into the esophagus, giving us acid reflux.
So how do you know if your issue is too much or maybe too little? You can look for certain signs like undigested food in your stool (aside from corn), feeling like food just sits in your stomach (or getting really bloated) after your meals. Your best bet is to work with a functional health care practitioner or nutritionist like me, who can assess for signs that may point one way or the other and who can guide you in the right next steps.
2. Peppermint around mealtime
Certain herbs may or may not be a heartburn trigger for some people. Things like peppermint and spearmint are tricky – while they have been used for some digestion-related ailments like gas and nausea, they also tend to relax muscles – including our lower esophageal sphincter, which can increase acid reflux (1;2)... so put down the peppermint tea before and after meals!
3. You’re not sleeping well
Melatonin is an antioxidant and hormone that tells our bodies it's time to sleep. It also helps reduce levels of stomach acid and helps “close” that LES door, by strengthening that muscle (Lipski). The irony here is that heartburn is what often keeps us up at night too, so the relationship goes both ways. Being mindful of mealtime and sleep position may help. And add “may help with heartburn” to your list of reasons to get a good night’s sleep.
4. You’re stressed
Believe it or not, stress can play a large role in heartburn… actually in digestion overall! When we’re stressed, our bodies are in “fight, flight, or freeze” mode, which means all of our bodies’ energy is sent to the parts that will help us do those things; so the arms, legs, lungs, eyes, things like that. Digestion is not the priority here – survival is. So the blood flow is not directed to our digestive system and this could mean we aren’t secreting all of the digestive juices we need during stressful times (including stomach acid) (3).
The picture of why you’re experiencing heartburn is nuanced and no two people are the same. There are other factors to consider as well like how fast you eat, if you’re triggered by certain foods, if you have a hiatal hernia or a bacterial infection, what time your last meal of the day is, or you may be triggered by certain medications you’re taking.
If you’re frustrated and ready to try to do away with that burning in your chest, then reach out to a nutritionist or integrative health care practitioner who can support you on your journey in a safe way.
Be well,
Nina
References
Lipski, E. (2020). Digestive wellness: Strengthen the immune system and prevent disease through healthy digestion. McGraw-Hill.
Hoffmann, D. (1998). The herbal handbook: A user's guide to medical herbalism. Healing Arts Press.
Sapolsky, R. M. (1998). Why zebras don't get ulcers. W.H. Freeman and Company.