The GORD, the bloat and the burning

Have you been put on a low FODMAP diet and medication to treat Gastro-oesophageal Reflux Disease (GORD) and heartburn? Have you reached the point of reintroducing foods and you’re freaking out about your symptoms coming back?

Low FODMAP Pros and Cons

Pros:

  • Good evidence for reducing symptoms such as bloating, gas and irritable bowel (IBS)
  • Works within a few days
  • It’s a non-medical intervention
  • Puts the power back into your hands by taking control of your diet
Cons:
  • Excludes a LOT of nutritious fruits, vegetables, and grains
  • Can’t be followed for life (far too nutrient deficient and complicated to be on forever)
  • Not individualised to you
  • Doesn’t improve or restore the function of your stomach and oesophagus
  • Not proven to work for reflux/GORD specifically

Proton Pump Inhibitors (PPIs) and Reflux

Proton Pump Inhibitors such as Nexium are what is generally prescribed by GP’s, specialists and pharmacists for reflux and heartburn symptoms. PPIs are an Antacid.

These medications work very well for preventing heartburn pain and damage to the oesophagus.

However, these medications are indicated for short-term use, just like the low FODMAP diet – it’s a solution that can only be used safely for 4-8 weeks!

If you take this medication for months or years (I know you’re out there!), these are some of the issues that may arise:

  • Vitamin B12 deficiency
  • Increased risk for neurological diseases like Alzheimer’s
  • Increased risk of bone fracture
  • Headaches
  • Diarrhoea
  • Nausea
  • Stomach pain
  • Dry mouth
  • Constipation
  • Gas/bloating

A lot of these symptoms are due to the fact that PPIs change the way our digestion works – they act as an antacid; reducing the amount of stomach acid we produce. This means that when the stomach acid moves back up into the oesophagus (this is called refluxate), there is reduced damage because our stomach acid is weaker.

While the reduced oesophageal damage is what we want (Click here to find out why), reduced strength of our stomach acid can have negative effects, too. If our stomach acid is not acidic enough, we can’t break down and absorb our nutrients. This is why you’ll be at risk of B12 deficiency and bone fracture: we can’t absorb proteins, vitamins, and minerals (e.g. calcium) properly if our stomach acid can’t break them down!

The reason that you’ll be at higher risk of neurological disease is that a main active ingredient in most PPIs is aluminium. This is a heavy metal which has been shown to cause neurological damage. Aluminium has been shown to be cleared from the body effectively when taken orally, but considering that constipation is a side effect of this medication, I wouldn’t want it sitting in your bowel and reabsorbing back into your bloodstream!

So What Do You Do?

I’m a big believer in everybody’s body having different needs. What triggers reflux for one person may not be the trigger for someone else.

There might be underlying nutritional deficiencies that are resulting in reflux as a symptom, or there might be certain lifestyle measures and stressors that are aggravating things for you. Perhaps you might even have a bacterial imbalance in your digestive system somewhere or a food intolerance.

Diet and lifestyle changes are an essential part of healing from GORD – short-term measures will get you the relief you need to get on with life, but it isn’t going to be a complete solution to be low FODMAP for life, and PPI use long-term is going to do more harm than good.

The Naturopathic Approach

My approach with GORD is to get to the root of the problem. What is the driver for you, specifically? What is in your diet that could be triggering this? Have you been under a lot of stress lately? Do you have dysbiosis? Do you have a food intolerance?

My therapeutic protocol involves specific testing to find out what foods you’re reacting to with food intolerance testing. No hectic elimination diets that are complicated and nutrient deficient!

My approach also involves figuring out what we can do to improve the structural integrity of your digestive system. This means you can keep your stomach acid the way it’s meant to be (acidic) and prevent it from causing damage where it doesn’t belong (e.g. the oesophagus!).

There will be nutritional changes, there will be supplements and there will be some amazing herbs that will do wonders for your digestive pain (some of them work in minutes!).

In all honesty, helping people manage their GORD naturally is my passion project – I love to do it and I will get you results.

  Lauren Booth

Lauren Booth

Naturopath