Indigestion, heartburn, dyspepsia and acid reflux are all common names for unpleasant symptoms associated with food. Changing your diet, and taking food-based natural remedies are one of the most effective ways to improve indigestion, heartburn and acid reflux. Below I’ve covered the most effective dietary and natural remedies that are most likely to soothe heartburn, indigestion and acid reflux.
Symptoms of indigestion
Indigestion, or dyspepsia, is a general term used to describe any discomfort, felt centrally in the upper abdomen, as a result of eating. This includes feelings of distension from swallowing air, flatulence from excessive wind, nausea and abdominal pain and can also include acidity and sensations of burning.
Heartburn is a more specific term referring to hot, burning sensations, felt behind the chest bone,
What heartburn feels like
Heartburn feels like a hot, burning sensation in the area of the heart, which may spread up into the throat. Heartburn is due to the acidic contents of the stomach coming up into the oesophagus. This can also irritate the throat or larynx to cause hoarseness, coughing or even wheezing. You may experience excessive salivation and find you swallow a lot, or regurgitate some saliva that has accumulated in the lower part of the oesophagus (water brash). You may also notice a hot, bitter taste if acid juices reflux up as far as the mouth.
In severe cases, heartburn can mimic the chest pain of a heart attack and it has been estimated that 20% of people admitted to coronary care units may actually have gastro-oesophageal reflux disease rather than a heart problem.
If you experience chest pain however, don’t delay seeking medical help on the assumption that it might be heartburn instead.
Causes of indigestion
Indigestion may be due to:
- Irritation of the stomach lining by acids, enzymes and food substances
- a build-up of ‘wind’ eg from swallowing air
- excessive contraction of the stomach wall
- slowed emptying of stomach contents
- reduced production of pancreatic juices (pancreatic insufficiency)
- reduced production of bile.
Reduced secretion of stomach acid and enzymes, pancreatic enzymes or bile are common causes of indigestion after middle age. The stomach lining naturally becomes less active as you get older, so there is reduced production of stomach acid (hypochlorhydria) or even a total lack of acid production (achlorhydria), which can result from inflammation of the stomach lining (atrophic gastritis).
Atrophic gastritis affects as many as 19% of people in their 50s, 24% in their 60s, 32% of those in their 70s and 40% of those aged 80 plus – an overall prevalence of 31.5% in people aged 60 or more.
Causes of heartburn – GERD
The main cause of heartburn is acid reflux in which the stomach contents pass up into the tube connecting the mouth and stomach. Acid reflux is known medically as gastroesophageal reflux disease, usually abbreviated to GORD or GERD.
Acid reflux brings stomach acid and digestive enzymes into contact with the sensitive lining of the oesophagus, and causes irritation and painful spasm of muscles lining this part of the gut.
Normally, acid reflux is prevented by downward contraction of muscles in the oesophageal wall, by a special valve-like mechanism, and by contraction of the diaphragm which pinches the lower oesophagus closed. GORD only develop when these anti-reflux mechanisms fail.
Acid reflux may develop due to poor muscle co-ordination, weakness of the valves, a hiatus hernia (in which part of the stomach slips up through the natural hole in the diaphragm through which the oesophagus passes, to enter the chest cavity) or increased pressure on the stomach – for example from being overweight, pregnancy or wearing tight clothes.
Symptoms of acid reflux usually come on within 30 minutes of eating and may be triggered by eating too much, taking exercise, bending or lying down.
Meals containing fat (eg pastry), chocolate, coffee or alcohol are the commonest culprits.
Smoking cigarettes is also associated with heartburn and indigestion.
Silent acid reflux
The severity of heartburn symptoms is not necessarily reflected by the degree of underlying oesophageal irritation or damage. In fact, between 6% and 43% of people with acid reflux do not experience symptoms and this is referred to as ‘silent reflux’.
Silent reflux may contribute to some cases of hoarseness, vocal fatigue, voice breaks, cough, sensations of a lump in the throat, cough and repeated throat clearing.
Nutritional treatment heartburn and indigestion
When it comes to dietary treatment heartburn and indigestion can be improved by following a bland, non-acidic diet. Foods such as white rice, oats, scrambled eggs, ripe bananas, well-cooked green leafy vegetables, water melon and chicken broth are recommended, along with milk and yoghurt which provide calcium salts to help neutralise excess acid.
- Aim to lose some excess weight, especially if you tend to store fat around your middle; this will reduce the pressure on your stomach so that acid reflux is less likely
- Eat little and often throughout the day, rather than having three large meals
- Eat slowly and chew food thoroughly
- Avoid hot, acid, spicy, fatty foods
- Avoid foods that are smoked, pickled or salted
- Drink fluids little and often, rather than large quantities at a time
- Avoid acidic fruit juices
- Avoid coffee
- Cut back on alcohol intake
- Drink herbal digestive teas (eg mint tea, chamomile tea, artichoke tea)
- Avoid late-night eating
- Avoid stooping, bending or lying down after eating
Coffee increases heartburn
Researchers have found that drinking coffee affects the ring of muscle between the stomach and oesophagus, to reduce its pressure when closed. This can make acid reflux more likely and explains why many people find that coffee causes or aggravates their heartburn. Normal tea does not seem to increase gastro-oesophageal reflux (GERD) so it is not the caffeine that causes the acid reflux although caffeine does stimulate gastric acid secretion.
Losing some weight improves heartburn
Acid reflux symptoms, or GERD, affect at least 37% of people who are overweight. In a study involving over 200 men and women who were overweight or obese, 38% initially experienced severe heartburn. After six months of following a weight loss diet, only 16% still experienced heartburn due to gastroesophageal reflux.
Researchers have found that even a small amount of weight loss, of around 4kg, can reduce the severity of heartburn and acid reflux by 75%.
If you experience unexplained weight loss, together with digestive symptoms or difficulty swallowing, however, see your doctor as soon as possible, to investigate the underlying cause.
Focus on chewing
Digestion starts in the mouth with chewing which mechanically breaks down food and mixes it with salivary enzymes. If you chew food thoroughly, you are less likely to develop indigestion and heartburn.
An Ayurvedic herbal remedy contains a blend of seeds traditionally chewed to aid digestion, including:
- Dhania dal (shelled coriander seed) – a herbal medicine for dyspepsia
- Ajwain (caraway seed) – antispasmodic and traditionally used to reduce intestinal cramps, flatulence and ‘nervous’ stomach disorders
- Fennel seed – which reduces intestinal spasms and increases motility of the smooth intestines
- Sesame and flaxseed – for fibre and omega-3 fatty acids
- Peppermint – analgesic, antispasmodic and one of the most effective treatments for indigestion and irritable bowel syndrome
- Liquorice – a traditional treatment for peptic ulcers and a breath freshener
- Hari patti (bitter leaf) – an Ayurvedic digestive herb.
Thoroughly chew half a teaspoon of D’Mix seeds, three times a day, after food. A digestive tea containing peppermint, licorice, cinnamon, fenugreek seeds, cloves is also available.
Consider digestive enzymes
Enzymes are proteins that speed up the rate of specific chemical reactions. You produce as many as 22 digestive enzymes, of which those classed as proteases break down dietary proteins, amylases digest carbohydrates while lipases break down fats.
Everyone produces different levels of enzymes depending on their genes, diet, lifestyle, gender and age. As you get older, you tend to produce less intestinal enzymes, less pancreatic enzymes, and less bile, so your ability to absorb nutrients decreases.
If you have had your gallbladder removed due to gallstones, for example, bile will trickle down into your gut continuously, rather then being squirted in when needed, which can lead to indigestion when eating a high fat meal.
Lack of digestive enzymes is linked with a number of indigestion symptoms, from bloating and wind to heartburn. Digestive enzymes can be replenished by using plant enzymes with similar actions that are found in fruit and vegetables, as well as cellulase enzymes that digest fibre.
Getting digestive enzymes from food
Enzymes are proteins, and heating them changes their shape so they lose their enzyme activity. One way to increase your intake of plant enzymes is to eat more raw fruit and vegetables which have not been heated above 42 degrees.
Not all food is suitable to eat raw, so continue to cook potatoes, rice, beans, lentils and chickpeas – these contain substances that interfere with digestive enzymes or which could cause indigestion.
Raw food advocates recommend eating 80% of your food raw, and 20% cooked using poaching, steaming and baking rather than frying or grilling.
Tips to increase your intake of natural plant enzymes
- Eat a small amount of fresh pineapple or papaya as a starter, before a meal, for natural enzymes that help to break down proteins in the stomach.
- Start the day with fruit – enjoy a bowl of berries or add a banana to your normal breakfast.
- Make a smoothie by blending together a banana, some berries (eg fresh or frozen strawberries, raspberries, blackberries or blueberries
- Add a handful of spinach or kale to your smoothie – you won’t taste it and it’s a great way to increase its digestive value.
- Make soups from raw vegetables and just warm through before serving
- Accompany your lunch and dinner with a large, crisp and juicy salad
- Soak almonds or seeds overnight to make a healthy snack that is more easily digested
- Sprout your own pulses and seeds to add to salads, soups and rice dishes
- Treat yourself to some raw chocolate.
Sprouted seeds are easily produced at home in jam jars or customised germinators which provide the correct warmth and humidity for optimal growth. Suitable seeds include alfalfa, radish, mung bean, broccoli, white radish, red-clover, wheat, lentil, quinoa, mustard, cress.
Rinse 4-6 tablespoons mixed organic seeds in water. Sprinkle lightly over a germinator or add to a glass jar, and allow to germinate for 3 – 5 days.
Add sprouted seeds to salads, stir-fries, rice, soups and all kinds of chicken, fish and vegetarian dishes.
Digestive enzyme supplements
Digestive enzyme supplements help to solve indigestion that’s due to reduced production of stomach acid and enzymes.
Most digestive enzyme supplements are derived from plants such as the pineapple, papaya, kiwi or some fungi. Animal enzymes are also available, such as extracts from pig pancreas. However, nutritional therapists generally believe that plant enzymes are superior as they are more stable over a wider range of acidity, and less likely to be broken down by stomach acid.
Some digestive enzyme supplements also contain additional ingredients to promote enzyme action such as betaine HCL (which increases stomach acidity), extract of ox bile (which stimulates intestinal movements) and fructo-oligosaccharides which promote the growth of probiotic bacteria in the bowel.
How to select a digestive enzyme
Select a digestive enzyme supplement based on your symptoms and whether or not you are intolerant to particular food groups (fats, proteins, carbohydrates), particular foods (eg fruit, milk, yeast, gluten-containing cereals).
If you feel bloated after eating carbohydrate, for example, select a product that contains carbohydrate-digesting enzymes such as amylase and cellulase.
If milk causes a problem, consider a product containing milk-digesting enzymes such as bromelain (from pineapples), papain (from papaya), lipase (to digest milk fat) and lactase (to digest milk sugar).
If eating gluten-containing foods trigger indigestion, then a product supplying gluten protease, cellulase and amylase may help (NB if you have coeliac disease avoid gluten containing foods).
If you want to improve general digestion or are not sure which food group is causing your indigestion, select a mixed digestive enzyme supplement containing lipase (digests fats), amylase (digests carbohydrates), protease (digests protein), lactase (digests milk sugar) and cellulase (digests cellulose).
Check labels for ‘activity units’ as these show the potency of the enzymes present in a supplement. This with the highest number of activity units are the most active.
How to take digestive enzymes
Digestive enzymes are normally taken at the beginning of a meal to prevent indigestion and heartburn. Don’t take an antacid or indigestion remedy within two hours of taking the digestive enzymes as this may reduce the effectiveness of the enzymes.
Doses normally range between 1 and 4 capsules – you may need to experiment to find the best dose to help your symptoms. If your symptoms do not improve within two weeks of starting a digestive enzyme supplement, or if they get worse, stop taking them and seek medical advice.
Apple cider vinegar supplements are also used to aid digestion.
Probiotics for heartburn and indigestion
Probiotic bacteria play an important role in intestinal health. They help to promote good digestion, boost immunity and increase resistance to infection. To maintain a high population of probiotic bacteria in your intestines, eat live bio yoghurts or probiotic drinks daily, or take a probiotic supplement. Eating live Bio yoghurt or taking probiotic supplements can inhibit the growth of Helicobacter pylori as well as maintaining overall intestinal health.
Probiotic supplements are added to some digestive enzyme blends, although the probiotic is better taken separately (eg at night before bedtime) so the bacteria themselves are not deactivated by the enzymes.
Aloe vera juice for heartburn and indigestion
Aloe vera juice has a soothing, antacid and analgesic action. Select Aloe vera products that are declared aloin-free to avoid a laxative effect.
Marshmallow and Slippery Elm for heartburn
Marshmallow and slipper elm are traditional herbal medicines which contain mucilage, a substance forms a protective coating over an irritated and inflamed stomach lining.
Milk thistle for indigestion
Milk thistle seed extracts are a traditional herbal medicine for the relief of over-indulgence, indigestion and an upset stomach.
Artichoke for indigestion
Globe artichoke stimulates bile production and can reduce indigestion, bloating and flatulence. I regularly drink Artichoke Digestion herbal tea as a delicious way to prevent or relieve indigestion.
Peppermint for indigestion
Peppermint oil is one of the most effective treatments for wind, indigestion and bowel spasms. On average, 75% of people with digestive symptoms who take peppermint oil experience a greater than 50% reduction in symptoms compared with 38% taking inactive placebo.
Fennel for indigestion
Fennel tea is a traditional remedy for flatulence and helps to soothe the digestive tract and reduce spasms.
Ginger for indigestion
Ginger relaxes and soothes the intestinal tract to help prevent indigestion, gas and bloating.
Chamomile tea for heartburn
reduces ‘nervous’ reactions in the gut making it less sensitive to food and other triggers. It can also improve peristalsis (the muscular movement of the intestines) which pushes content through and helps to reduce acid reflux.
Flax seed and omega-3 fish oils for heartburn
Cranberries for indigestion
Cranberries contain substances known as ‘anti-adhesins’ which reduce bacteria sticking to cell membranes. Although cranberry extracts are best known for reducing urinary tract infections, preliminary research suggests cranberry juice may prevent Helicobacter pylori – a bacterium linked with stomach ulcers – from sticking to cells in the stomach lining, too – at least in women.
Manuka honey for indigestion
Manuka honey contains natural antibiotics that can help to eradicate Helicobacter pylori. It is usually taken on an empty stomach at a dose of four teaspoons, four times per day, for eight weeks (avoid if you have diabetes).
Mastic gum for indigestion
Mastic gum is a resin derived from a Greek pistachio-like tree. Mastic gum has a powerful antibiotic action against Helicobacter pylori – including antibiotic-resistant strains – and can improve indigestion.
Use a vitamin B12 spray or lozenges if you have indigestion
Reduced absorption of B vitamins becomes increasingly common after the age of 50 due to reduced production of stomach acid. The same parietal cells that secrete hydrochloric acid also secrete a substance called intrinsic factor, which is needed for the absorption of vitamin B12 in the small intestines.
Vitamin B12 deficiency affects 10% to 15% of over 60s due to a lack of intrinsic factor secreted in stomach. By the age of 75 years, as many as 60% of people are deficient in vitamin B12 – mostly due to atrophic gastritis. If not diagnosed this can lead to pernicious anaemia.
Unfortunately, taking oral vitamin B12 tablets will not correct the deficiency due to lack of intrinsic factor. One way round this is to use sublingual lozenges or spray so the vitamin B12 is absorbed through the lining of the mouth. Otherwise, pernicious anaemia is treatment with vitamin B12 injections.
Take a multivitamin if you have indigestion
The absorption of many minerals depends on the presence of good levels of stomach acidity (pH) which dissolves mineral salts and releases electrolytes such as calcium, iron, magnesium, zinc and phosphate for absorption within the small intestines.
If you are taking antacids and acid suppressing drugs for indigestion, heartburn and acid reflux, these also lower the level of acidity in your stomach and affect the solubility of minerals and reduce their bioavailability.
Multivitamins aimed at people aged 50+ or 70+ have increased levels of certain micronutrients to help make up for reduced absorption.
See your doctor if heartburn or indigestion persist
A Gallup poll of over 1000 people found that although 48% suffered regular heartburn, only a quarter had sought help. As many as 75% of people put up with their symptoms or used simple remedies such as drinking milk, taking a sodium bicarbonate solution (not recommended due to the sodium content, especially if you have high blood pressure) or simple antacids.
If symptoms continue for more than a week or two, or if they become more frequent or severe during that time, see your doctor to diagnose the underlying cause. You may need further investigation of your symptoms to exclude a peptic ulcer, for example, or tests to look for a stomach infection with a type of bacteria (Helicobacter pylori) that increases secretion of gastric acid.
Don’t ignore recurrent heartburn or continue to treat it with antacids alone as this will lead to inflammation of the oesophagus which can cause scarring and permanent damage. In fact, taking antacids long-term does not protect against the damage due to acid attack on delicate tissues. In some people, excess acid can cause cell changes that might increase the risk of eventually developing oesophageal or stomach cancer.
If symptoms do not respond to prescribed drug treatment, severe reflux may need to be surgically corrected.
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