February is the month where we express our heartfelt love to our valentines.

Unfortunately for some those boxes of chocolates and sweet indulgences may deliver a different type of warm feeling…heartburn.  Most sufferers describe heartburn as a sharp burning pain over the chest.

If you suffer from heartburn, you’re not alone. Some 60 million Americans experience it once a month, and about 25 million have daily heartburn according to a 2007 report issued by the Mount Sinai School of Medicine.

While the pain of heartburn feels as if its coming from your heart, the pain is actually the result of the acidic contents of the stomach refluxing (or flowing backward) up the esophagus. There are several different causes of reflux. Reflux can occur when the valve between the stomach and esophagus does not close properly. A hiatal hernia, or a slow emptying stomach can also create reflux.

Reflux is actually a normal activity for the body, and it occurs throughout the day. It may surprise you to hear that reflux occurs just as frequently in normal people as it does in people who have heartburn.

If reflux is a normal event, why do some people experience heartburn and others don’t? The difference between normal reflux and heartburn has to do with changes in the lining of the stomach.  People who get heartburn have a compromised mucous lining in their stomach and lower esophagus, which allows the acid to burn. A healthy stomach is lined with a network of cells that secrete a thick layer of mucous, which coats and protects the stomach from acid. When the mucus lining of the stomach or esophagus becomes damaged, it no longer protects us from acid, and we feel its burning effects.

Contrary to what you hear on television commercials, excess stomach acid is not usually the cause of heartburn, and rarely occurs. The real problem with heartburn is damage to the mucous lining of the stomach.

What damages our stomach lining?

Our stomach’s lining can become damaged by three factors---drugs, stress, and food intolerances.  Seemingly harmless non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen block the production of mucous in the stomach and cause microscopic bleeding in the stomach. Frequently the bleeding can become severe. Medical journal studies estimate that 10,000 to 16,000 people bleed to death annually from repeated use of NSAIDs.

Stress also plays a role in damaging the mucosal lining of the stomach. Whenever we are under repeated stress, digestion takes a back seat to the body’s attempt to handle the stress. High levels of the stress hormone cortisol suppress mucous production by the stomach, similar to the way anti-inflammatory drugs do.

Your heartburn may also be caused by foods that irritate your digestion system.

Common culprits are chocolate, coffee, alcoholic beverages, spices and rich foods. You may also have food intolerances or sensitivities that you may have found difficult to identify which may also contribute to heartburn.

Extra pounds can cause heartburn. Studies show the larger your body mass index is the greater the chance is that you will experience heartburn. 

The Problem with Antacids

While reaching for an antacid may offer you short-term relief from the pain of heartburn, it does not treat the cause, and can result in some harmful side effects.

Stomach acid is essential to the digestion and absorption of your food. When we alter stomach acid levels with over the counter antacids or prescription drugs we alter our digestion and absorption.

One of the most damaging side effects of antacids and acid blocking drugs is poor calcium absorption. The body can only absorb calcium and other vital minerals when there are adequate amounts of stomach acid. Our ability to absorb minerals depends on stomach acid. A December 2006 study in the Journal of the American Medical Association showed that the risk of hip fractures increased by 244%  after taking high doses of proton pump inhibitor drugs such as Prilosec, Prevacid, Aciphex, Protonix and Nexium.

Other recent studies raise a concern that people on acid blocking drugs are now refluxing bile and other alkaline substances. Basic or alkaline substances damage the body’s tissues even more than acid.

Treating the Cause

Clearly, traditional medical approaches to heartburn may relieve symptoms but are creating other serious side effects. Rather than interrupting your body’s own natural processes with antacids, you may want to consider a more holistic approach.

First, find out what is stressing your body. Is it emotional stress? Is it a problem digesting foods? Is it a problem caused by a medication? To truly heal heartburn, you must reduce the impact that these three stresses have in your life.

If you are overweight, drop those extra pounds by reducing calories and exercising.

Next, see if you can determine which foods trigger your heartburn, and reduce your intake of them.

If over the counter medications are causing the problem, can you find less harmful alternatives? Frequently, a holistic approach that employs dietary changes, exercise and manual therapies can free you from the pain that drives you to take aspirin and ibuprofen. Providing appropriate nutrients and herbs to nourish the stomach’s mucous cells can restore your stomach lining and prevent heartburn.

2009, © Dr. Patrick Giammarise, DC