Esophagus and Stomach Care

For many people, the stomach is where health problems begin. When things get backed up, acidic liquid sloshes up into the lower esophagus causing burning and irritation. If the process is severe and chronic, erosions and scarring occur at the lower esophagus.

Grain-based foods are very erosive to the stomach lining. When emptying the stomach is inhibited by certain drugs, alcohol consumption, and especially emotional stress, erosions to the stomach lining can occur.

What is digestive dysfunction?

If you have burning in your esophagus, you probably have assumed that it is caused by too much acid.

But that assumption would be incorrect.

Reflux of acid into the esophagus is actually caused by delayed or inadequate emptying of the stomach. In fact, people with reflux often have inadequate acid production.

Poor eating habits, regularly eating processed food, certain drugs, alcohol and chronic stress all inhibit normal stomach function. These factors slow gastric emptying and compromise acid production.

When eating habits are good and everything is working normally, eating food stimulates intense acid production. This is followed by emptying of the stomach fairly rapidly after the acid has done it’s job. During the intense acidic reaction, the lower part of the esophagus, called the lower esophageal sphincter (LES), stays tightly constricted to protect the esophagus from acid. Once the stomach empties, acidity in the stomach declines and the LES relaxes.

When stomach function is compromised by eating processed food, chronic stress, or the other factors mentioned, instead of the normal response, a moderately acidic stew of partially digested food sloshes around in the stomach for much longer than it should. With reduced acidity and slowed emptying, the LES does not constrict properly, and acidic material slashes back into the esophagus, causing burning and irritation. If this occurs chronically, scarring of the lower esophagus can occur.

Irritation and erosion of the stomach lining are caused by many of the same factors as acid reflux. This presents as the classic “heartburn” symptoms along the left side of the upper abdomen. Erosion can also occur at the duodenum, where the stomach empties into the small bowel. This presents as pain in the middle of the abdomen in an area called the “epigastric region” and can radiate to the back.

Erosions in the stomach are intimately associated with stress. Stress redirects resources of the body toward dealing with whatever threat is at hand. Everyday functions such as digesting food become less of a priority and are placed on hold. The normal churning that mixes food and ultimately pushes it through the stomach comes to a halt. The stomach becomes a flaccid bag holding a fermenting acidic stew that weakens the lining of the stomach. If the process is chronic, erosions occur.

Erosions are often associated with a bacteria called H. pylori. While H. pylori is often present in ulcers, the bacterium is simply an opportunist; 40% of people harbor H. pylori as a normal flora. When ulcerations start to occur, the bacteria, which is already present, starts infecting the wound and aggravating the process. Antibiotics are sometimes indicated, but the processes causing stomach irritation and erosion must be reversed for complete healing.

Healthy Tips from Dr. Rawls

  • Avoid all processed food and limit your diet to fresh whole foods.
  • Avoid fatty foods, which slow gastric emptying.
  • Cook all food well and chew food well (smoothies are also an option to break food down and make it easier on your stomach).
  • Ginger tea is a good beverage choice(either cold or hot). Ginger reduces nausea and enhances healing of the stomach esophageal lining (though it may cause burning when you first start using it).
  • Eat smaller and more frequent meals.
  • Avoid large meals, especially at the end of the day.
  • Do not eat after 6pm.
  • Sleep with several pillows supporting the head and back to assist in sleeping in a slightly upright position.
  • Make a habit of allowing yourself only one thing to worry about at a time and take a break from worrying about anything as often as you can…the world will still turn.
  • Slow down. (See our protocol for dealing with stress).

Eat Fresh, Whole Foods

The first step in maintaining a healthy digestive system is following a diet made up of a wide diversity of fresh and natural whole foods with sufficient fiber. Vegetables and fruit are especially important. Fruits and raw or lightly steamed vegetables contain enzymes that aid the digestive process. Avoid processed carbohydrates (sugar and starchy foods). Red meat consumption should be low. Avoid acidic foods such as citrus and tomatoes. Spicy foods such as hot peppers can irritate an established problem, but are not causative. Coffee is a gastric irritant and alcohol consumption can aggravate the disease process. Soft drinks are acidic and should be avoided. Even tea is a gastric irritant. Plain water is your best beverage option until healing is complete.

Foods to avoid:

  • all processed food products
  • sugar and starchy foods (wheat, flour products, potatoes)
  • acidic foods (citrus, tomatoes)
  • coffee and tea (until healing is complete)
  • spicy foods
  • dairy
  • pork and beef
  • soft drinks
  • alcohol

Modify Your Eating Habits

Remember that digestion starts in your mouth. Eat more slowly. Chew your food thoroughly. Chewing is the only part of the digestive process over which we have voluntary control. Overeating is less common in individuals who eat slowly and chew their food thoroughly. Eating slowly also makes for a relaxed meal, and is better for digestion all the way around. Smaller and more frequent meals allow the stomach to return to normal size.

The American habit of sitting down to a large meal at the end of a stress-filled day encourages gastrointestinal dysfunction. We would all do well to mimic our European neighbors with a midday main meal and a light supper, but most Americans find it hard to make the change. At the very least, a regular practice of distributing food throughout the day instead of a large end-of-day meal is better for digestion. Avoid eating after 6pm. Relaxing and stretching before a meal is another good practice. Never eat on the run.

Large amounts of liquids consumed with food may slow enzymatic function and impede digestion. Small sips of liquid during a meal are better. Again the Europeans are one up on us with a habit of drinking water, wine or beer at room temperature (though alcohol should be avoided until healing is complete). Large iced drinks should be reserved for quenching thirst after exercise. This advice sounds harsh for most Americans, but it reduces gastrointestinal dysfunction.

Enhance the digestive process

  • Drink 2 tbsp. of apple cider vinegar in 6 oz. of water with each meal. This improves digestion and stimulates stomach emptying.
  • Use standard OTC antacids for burning until the burning no longer occurs.
  • Use acid reducing medications only as necessary. This should not be your primary therapy. Start with moderate acid reducers like Zantac or Pepcid first and only use stronger acid reducers like Prilosec and Nexium if absolutely necessary.
  • Pepto Bismol is effective for reducing burning and encouraging healing (but it will turn stools very dark).

Considerations for Medications

Short term use of medications to reduce acid can allow healing of the lower esophagus, but acid reducing drugs should never be your only strategy. Treatment with acid-reducing medications neutralizes acid and reduces symptoms of esophageal burning, but does not eliminate the actual reflux. These drugs actually compromise digestion even further. Chronic use of these drugs also carries the problem of accelerated bone loss and increased allergies and food sensitivities. These drugs should not be used long term.

*Statements on this page have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease. For medical concerns, please consult a qualified healthcare provider.