Acid reflux and bloating can increase as our stress levels increase. Good health starts with digestion – here are 3 ways to start healing digestive issues.
During periods of elevated stress in your life, you may have noticed a corresponding increase in uncomfortable digestive symptoms such as acid reflux and bloating. That’s certainly not a coincidence. As a naturopathic doctor hearing from many patients each week, I can attest that during this stressful time of the COVID-19 pandemic, many are experiencing these symptoms with their digestion.
Common Digestive Issues Associated with Stress
For many people I know, heartburn has recently begun causing problems again. Same with acid reflux. The burning sensation caused by gastro-esophageal reflux disease (GERD) isn’t the only digestive complaint associated with stress, however. You may instead or additionally be experiencing the following tummy trouble:
- Cramping and pain
- Histamine reactions, such as itchy throat and runny nose
- Sore throat, hoarseness, cough, and/or congestion, often also caused by acid reflux (with or without “heartburn”)
And all of these digestive issues can be tied back to something referred to as “leaky gut” or intestinal permeability, which is when the intestinal cells are not as healthy as they could be.
To understand leaky gut and how to solve these stress-related gut issues, it is first important to understand healthy digestion.
Our digestion begins in our mouth, where we chew our food, signaling to our digestion to make stomach acid and enzymes for the food that is making its way through our digestion. As food travels down the esophagus and enters the stomach, it goes through the lower esophageal sphincter (LES) which is a muscle that helps keep food and stomach acid in the stomach. Protein in our food signals to the LES to close.
The esophagus goes through a hole in our diaphragm and the stomach is located just under the diaphragm. In the case of a hiatal hernia, the stomach is bunched up through the hole in the diaphragm, making it harder for food to get through and more likely that stomach contents to come back up.
Protein digestion occurs mainly in the stomach, thanks to stomach acid, before the partially digested food continues on to the small intestines where enzymes from the pancreas and bile from the liver via the gall bladder enter to further assist with protein, carbohydrate and fat digestion.6
In order for the nutrients – protein, carbs, fat, and vitamins – from our food to be absorbed into our bodies, the food must be fully digestion down to the smallest possible parts. The cells lining the small intestine ensure that this digestion is complete and only allow the digested molecules, water, minerals, and nutrients to get through or between the cells. Our intestinal cells are created and turned over on a frequent basis.
Once through the intestinal lining, water and nutrients pass through tissue on the way to our bloodstream, and this is where our immune system is on guard for foreign substances, viruses, and bacteria, ready to protect us before those substances can enter our bloodstream.
Any food that is not digested, and is not able to get across the intestinal lining, will either be fermented by the bacteria living in our intestines or continue down through the large intestine as fiber, which is formed into stool. Those bacteria are known as our “microbiome” and, as we’ve become acutely aware, they play a huge role in our health in general.2 We’ve learned that we need plenty of the right bacteria, in the right location, and in an optimal balance, in order to get the most benefit from them.
The bacteria living in our intestines are determined by what we eat, how much we eat at any given meal, how well we digest our food, and the amount of stress we are exposed to at any given time.3
The Stress-Digestion Connection
When our bodies are stressed (which is a lot of the time), cortisol and adrenaline signals tell our bodies to focus first on blood flow to our heart and muscles, raising our blood sugar level, and keeping our brain working (or mind racing).
In turn, less essential functions are diminished, including our digestive functions. When under stress, we don’t digest food as well because stomach acid and enzyme production is decreased. The stomach is less protected from stomach acid because the mucus barrier is decreased. We don’t absorb our nutrients as well because intestinal cells are not getting the nutrients (glutamine) they need to be healthy.
Undigested food can “leak” through between the intestinal cells where it triggers an immune response, creating inflammation and further damage to the intestinal lining. The good bacteria living in our intestines decrease in number, allowing fewer health bacteria and yeast to thrive on the undigested food, which leads to bloating and yet still more damage to the intestinal lining and immune reactivity, attempting to protect us.
This perfect storm of undigested food, imbalanced gut bacteria, and inflammation from food reactions, leads to nutrient deficiencies and a stress signal from the gut to the brain – the gut-brain axis – causing a vicious cycle of stress that can cause symptoms throughout the body, including anxiety, insomnia, insulin resistance, weight gain, skin rashes, hormone imbalances, autoimmunity, cervical dysplasia, bone loss, and dementia.4,5
For many people, they don’t have digestive symptoms, but they do still have leaky gut due to stress, which is then predisposing them to other health issues. If we don’t address and improve digestion, and recover from stress, we won’t really be getting at the underlying cause.
Essentially, digestive issues, like heartburn and bloating, are beacons. They are a stress signal – telling us that bigger trouble is coming if we don’t start healing the gut. Covering it up with proton pump inhibitors is a temporary fix with long term ramifications (such as the increased risk for dementia).1 And, especially in the case of heartburn or GERD, I find, we have to address it first, before being able to address other issues in the body.
How to Know if You Have Acid Reflux, GERD, or Gastritis
“Acid Reflux,” as it is often referred to, is when stomach acid goes back up through the esophagus, causing irritation and inflammation of the surrounding tissue. Some people can feel this as a burning sensation in the chest and/or throat. Others experience it as coughing, hoarseness, a sore throat or even sinus congestion.
The official way to identify GERD or gastritis (inflammation of the stomach) for that matter is with an endoscopy. The report will indicate “erythema” which means redness due to inflammation. And your doctor will likely prescribe a medication (often a proton pump inhibitor) to turn off the stomach acid for a period of time while the tissue heals. But, turning off your stomach acid decreases digestion of your food, which can further aggravate bloating and leaky gut.
The reality is that if you don’t address the underlying cause, as soon as you stop the medication, the acid reflux will return.
To truly solve GERD, we need to understand what is causing it and make changes from there.
While acid reflux is commonly blamed on the overproduction of acid, that is not actually the case (most of the time). It is more often caused by stress, which decreases protection from stomach acid, prevents the LES from working well, and makes a hiatal hernia more likely, due to smaller breaths and less diaphragmatic pressure on the stomach.
Certain foods and beverages can also weaken the LES, such as alcohol, coffee, chocolate, peppermint (even mint toothpaste), making acid reflux more likely. Spicy foods, tomatoes, and citrus fruits can also aggravate acid reflux by triggering a histamine response.
And another factor, I find not often discussed, is that when we consume less protein and more carbohydrates, such as when eating comfort foods like popcorn, pasta and cookies, there is less of a signal for the LES to close, thus allowing “reflux” of acid.
Acid reflux can be more apparent at night once you lie down to go to sleep because you no longer have gravity helping you to keep food down.
It is important to know that GERD and gastritis are also often associated with gluten sensitivity and/or Celiac disease.
I find quite often that when patients are experiencing heartburn or nausea (from gastritis), and we check for food sensitivities, they are positive for gluten IgA and IgG antibodies to gluten and gluten-containing grains such as barley, rye, spelt and wheat.
I believe this is because gluten causes leaky gut – it literally signals zonulin to open up the space between the intestinal cells – leading to inflammatory responses to gluten and other foods. The inflammation occurs in the small intestine as well as the stomach, making the tissue especially sensitive to stomach acid.
If you are experiencing heartburn, bloating or nausea, take a step back and ask yourself, “have I been consuming more gluten recently as a coping mechanism for stress?”
Identifying Gluten and Other Food Sensitivities
While it is possible to test for Celiac disease with a biopsy during an endoscopy, you’ll need to specifically ask for this test because it is not done automatically. Plus, the biopsy result will not be able to identify gluten sensitivity which is much more common than Celiac disease.
Celiac disease is an autoimmune condition and is much rarer than gluten sensitivity (1 out of 133 people versus 1 out of 4 people). The treatment for both Celiac disease and gluten sensitivity is to avoid gluten.
If you are wondering whether gluten is an issue for you – whether it is an underlying cause of heartburn, bloating, and other digestive symptoms – then you can find out in one of two ways:
- Go on an elimination diet: Avoid gluten (and potentially other foods) for 3 weeks, then add gluten and the other foods back in one by one and note any symptoms that increase as you do so.
- Do a food sensitivity panel that checks for IgA and IgG antibodies to gluten, gluten-containing grains, and other common food allergens, such as dairy products (made from cow milk), and eggs.
It is important to know that your standard doctor or allergist will not run an IgA and IgG panel. They only check of IgE reactions, which are immediate responses to foods. While it is important to know whether you have a classic food allergy, that won’t tell you whether you also have a delayed food sensitivity.
There are many food sensitivity panels available, however, I want to make sure you know about the best IgA and IgG panels based on my 20 years of experience.
- 48 most common foods, IgA and IgG, finger poke panel (can be done at home)
- 96 most common foods, IgA and IgG, finger poke panel (can be done at home)
With these results, you can understand which foods are causing an inflammatory response— leading to pain, discomfort, bloating, etc — and to what extent you have leaky gut.
You’ll also then know what you need to do to get ahead of this whole tummy trouble once and for all.
Healing Your Digestive Issues
It is absolutely possible to address your stress-related digestive issues without medications, and get all of this pain and discomfort behind you. Here are my 3 steps to healing your digestive issues.
1. Address your stress:
Create a positive ripple effect throughout the body by getting cortisol and adrenaline working for you instead of against you. To reset the stress signal in our bodies we should look for ways to sprinkle in stress recovery selfCARE activities such as:
- Going for a walk
- Getting out in nature
- Having a conversation with a friend
- Sitting in the sunlight
- Letting our bodies be STILL.
Please note that these are ALL activities that can be done safely during our current “social distancing” requirements.
2. Change the way you eat:
Feed your body in a way that support healthy digestion. This includes:
- Eat smaller portions. It’s important to eat only as much as we can digest. Overfeeding even good bacteria causes gases and bloating.
- Eat at consistent intervals. Setting a routine helps to decrease stress caused by blood sugar fluctuations and unpredictability.
- Slow down to eat. Take time to sit, chew, set aside other tasks, and enjoy a relaxed meal—all of which send the right signals to our bodies to digest.
- Breath. Deep breaths between bites of food and throughout the day can help mitigate acid reflux associated with a hiatal hernia.
- Incorporate protein into each meal. The protein trick is something I learned for my own body many years ago. Include 5 to 10 grams of protein in each meal (or “snack”) to ensure that you have enough protein signal to the esophageal sphincter to close.
- Eliminate trouble foods from your diet. Either follow an elimination diet, or do a food panel and eliminate the foods that come back high. For bloating, you may need to pay special attention to FODMAP foods. And for histamine issues, eliminate foods that trigger histamine.
3. Take supplements* to heal digestion:
The supplements I count on and have grown to trust to help heal heartburn, leaky gut and other digestive issues are:
- Plant-Based Enzyme Support: When we’re stressed and have leaky gut, our digestive enzymes are turned down, and when we take a PPI, our stomach acid is turned off. I find it is essential to take pancreatic enzymes in this situation to help digest your food and ensure that you get the nutrients from your food, not a food reaction. I would not include HCL (stomach acid) at this time because it can be irritating when your tissue is already inflamed.
- DGL Powder: Which is herbal licorice and much different than candied licorice which contains gluten and sugar. It has anti-inflammatory properties and promotes healing of the esophagus, stomach and intestinal lining with incredibly small dosages.
- Heartburn Powder: Contains DGL, zinc, and aloe, which help to heal the esophagus and stomach.
- Leaky Gut Healing Powder: Contains Glutamine – an amino acid which is essential for small intestinal cells – plus DGL, arabinogalactan (food for your good bacteria and immune system), and aloe.
- Magnesium citrate or oxide: if you tend to constipation, magnesium is a great tool to encourage regular bowel movements without creating a dependency or worsening bloating.
- Peptide Therapy For Stomach and Intestines: Peptides are uniquely capable of resetting specific tissue functions after stress exposure. They support our bodies to go back to digesting food appropriately and without pain despite periods of stress.
Guided Support to Implement these 3 Steps
My Stress Remedy Program is designed to bring all of this healing into one program for you.
As an elimination diet protocol, it guides you to remove gluten, eggs, dairy, and sugar from your diet for 3 weeks while incorporating protein (with my Pea Protein Powder), digestive enzymes, Leaky Gut Healing Powder, and probiotics. During this 3 week period, you’ll learn how to recover from stress and heal leaky gut.
Another option is to work directly with me in my Leaky Gut and Digestive Solutions Program. This program includes the 96 food panel, consultations with me, and the Stress Remedy Program guide and materials, plus a 10% discount on products for 6 months.
I’ve also decided to offer another way to work with me to help you solve leaky gut and your digestive issues. It is an online GROUP course, which includes 2 group sessions, one 30-minute solo session with me, the 48 food panel, as well as the Stress Remedy Program materials and 10% discount for 1 month. It’s called Healing Leaky Gut with Dr. Doni (Live Group Course).
Starting May 7th, 2020 at 3 pm ET
REGISTER NOW TO GET EXCLUSIVE ACCESS
The thing to remember here is that this is simply how the human digestive system works and as humans, sometimes it will get off track – especially in times of stress.
That said, this doesn’t have to be a question of how to find a temporary fix… we can get to the root cause and heal it for good.
And when we do, your entire health landscape will change, too. A healthy digestive system helps to prevent dementia, diabetes, heart disease, cancer, infections, autoimmunity issues, fertility complications, and more.
That’s the power of your digestion.
Wishing you well as always, but particularly in times like these where stress levels are elevated,
9th April 2020
*Please keep in mind that any and all supplements – nutrients, herbs, enzymes, or other – should be used with caution. My recommendation is that you seek the care of a naturopathic doctor (with a doctorate degree from a federally-accredited program) and that you have a primary care physician or practitioner whom you can contact to help you with individual dosing and protocols. If you ever experience negative symptoms after taking a product, stop taking it immediately and contact your doctor right away.
- Novotny M, Klimova B, Valis M. PPI Long Term Use: Risk of Neurological Adverse Events?. Front Neurol. 2018;9:1142. https://www.frontiersin.org/articles/10.3389/fneur.2018.01142/full
- Hills RD, Pontefract BA, Mishcon HR, Black CA, Sutton SC, Theberge CR. Gut Microbiome: Profound Implications for Diet and Disease. Nutrients. 2019;11(7). https://www.ncbi.nlm.nih.gov/pubmed/31315227
- Zmora N, Suez J, Elinav E. You are what you eat: diet, health and the gut microbiota. Nat Rev Gastroenterol Hepatol. 2019;16(1):35-56. https://www.nature.com/articles/s41575-018-0061-2
- Househam AM, Peterson CT, Mills PJ, Chopra D. The Effects of Stress and Meditation on the Immune System, Human Microbiota, and Epigenetics. Adv Mind Body Med. 2017;31(4):10-25. https://www.ncbi.nlm.nih.gov/pubmed/29306937
- Karl JP, Hatch AM, Arcidiacono SM, et al. Effects of Psychological, Environmental and Physical Stressors on the Gut Microbiota. Front Microbiol. 2018;9:2013. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6143810/
- Ianiro G, Pecere S, Giorgio V, Gasbarrini A, Cammarota G. Digestive Enzyme Supplementation in Gastrointestinal Diseases. Curr Drug Metab. 2016;17(2):187-93. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923703/