Mechanical Causes of Heartburn

by | Nov 13, 2015 | Digestive Health | 0 comments

causes of heartburn acid reflux

Acid reflux is the backward flow of acid into the esophagus. Gastroesophageal Reflux Disease (GERD) is a more severe form of acid reflux. Both of which can cause the burning sensation known as heartburn.

In this article, I cover the lesser-known mechanical causes of heartburn. But first, it’s important to note that low stomach acid (hypochlorhydria) is the main culprit of heartburn (which can be related to mechanical issues). By the way, low stomach acid can also be related to mechanical issues, more on that later.

achlorhydria: the condition in which the stomach produces no stomach acid

hypochlorhydria: insufficient stomach acid
 

Too Little, or Too Much Acid?

 
There are various schools of thought on the causes and treatments of heartburn. The mainstream medical model sees the problem as too much acid, which makes sense at first glance. “If I had less damn acid, I wouldn’t have this problem!” But, if you look a bit deeper, you may conclude that you have too little gastric acid. In fact, that’s usually the case. High stomach acid is rare. Insufficient gastric acid production is called hypochlorhydria. When we don’t have enough acid, food sits in the stomach longer and ferments. As pressure builds, the stomach swells and pushes the lower esophageal sphincter (LES) up into the diaphragm. Chronic crowding can cause damage to the sphincter, leading to gastric acid splashing into the esophagus, creating heartburn. Similar to making kombucha or sauerkraut. Pressure builds in the bottle as the contents ferment. This fermentation process creates pressure on the lid. In my amateur fermenting days, I once had kombucha blow the top right off the bottle, and the contents ended up on the ceiling. Imagine the lid of the bottle is your LES, and the kombucha is your gastric acid.
 
As we age, acid production slows down, sometimes as early as 30 years old; yet, the standard prescription is antacids, which further lower stomach acid. If we don’t have stomach acid, we don’t feed ourselves!
 

Why do we need stomach acid?

  • It’s part of our immune response, as it kills bacteria in our food.
  • Acid activates pepsin, which breaks down proteins.
  • Acid helps us absorb vitamins and minerals. If you have insufficient acid, you won’t absorb adequate nutrients, no matter how good your diet is.
  • Acid signals the rest of the digestive tract that food is coming. Each step in digestion relies on the step before for proper functioning.

Causes of Heartburn Acid Reflux

As always, it’s best to find the source of your acid reflux before taking a drug to fix it. This is not an exhaustive list, but rather a few lesser-known mechanical issues that can cause excess pressure and tissue strain, which may lead to acid reflux. By mechanical, I mean relating to, produced by, or dominated by physical forces.

1. Bloating. When the belly is bloated, it can prevent the diaphragm from moving comfortably. When the bloated intestines push the diaphragm upward, the diaphragm pulls the junction between the esophagus and stomach upward. The negative pressure in the chest cavity attracts acid from the stomach toward the esophagus, causing heartburn. This type of reflux can be remedied by #1 addressing the cause of the bloating (SIBO, parasites, eating too quickly, overeating, food sensitivities, sitting too much, pelvic and thoracic alignment, low stomach acid) and #2 receiving Visceral Manipulation™. One or both of these approaches may be needed depending on the root cause of the bloating. Visceral Manipulation™ has been known to help decrease bloating via improving organ motility. Visceral Manipulation™ also helps to restore proper function to the LES.

2. Hiatal Hernia. A hiatal hernia occurs when the stomach bulges up into the chest cavity through the hiatus opening in the diaphragm. The Mayo Clinic states that the causes aren’t always known, but possibly could be related to “persistent and intense pressure on the surrounding muscles, such as when coughing, vomiting, or straining during a bowel movement, or while lifting heavy objects.” (source)

Perhaps poor alignment is the very reason the coughing, vomiting, straining during bowel movements, and heavy lifting can trigger hernias. We should be able to cough, vomit, and strain once in a while without pushing our organs up and out, or down and out (prolapse), but due to years of poor movement habits, we have become less efficient at our natural expelling capabilities. One of those habits is sucking in the belly. Where do you think your organs go when you suck your belly in? See my video demonstration HERE.
There’s also the mechanical displacement of internal organs by corsets. Yes, some people still wear corsets.

3. Posture and Heartburn: Hyperkyphosis of the thoracic spine contributes to mechanical problems in the hiatal zone. A popular belief is that hyperkyphosis stems from slouching and that simply “sitting up straight” is the solution. However, it’s a bit more complicated than that, and it may in fact start with an internally rotated arm habit.

4. Working consistently with arms overhead when you lack shoulder range of motion. This may be related to #3 because hyperkyphosis and limited shoulder range of motion are often associated. If you lack shoulder range of motion, you will displace your entire ribcage to raise your arms over your head. The constant lengthening of the longitudinal fibers of the esophagus decreases the tone of the LES.

5. Retroverted Uterus  When the uterus is tilted back, the small intestines can descend and occupy the space where the uterus should be. This puts a downward drag on the stomach, decreasing mobility of the gastroesophageal area. This can eventually degrade the tone of the gastroesophageal zone. I can teach you how to correct your tipped uterus in the Womb Care course. 

6. Obesity from the exact upward force mechanism, which causes bloating.

7. Not chewing your food well can cause acid reflux in several ways. Mechanically, each phase of digestion only works as well as the phase that came before. Guess what? There are no teeth in the stomach! Chewing lubricates your food, mechanically breaks it down, and increases its surface area, allowing enzymes to work effectively. Chemically, Chewing increases digestive enzymes, allowing food to be broken down more smoothly and efficiently, thereby enhancing digestion and assimilation. Chewing more may be your key to alleviating symptoms such as reflux, bloating, gas, and abdominal pain.

These final two are not technically mechanical, but are essential not to overlook. Consider it bonus information.

8. Emotions– Stress can slow down the digestion and lead to reflux. Anger, worry, fear, you name it. Be present with your food, don’t talk politics or watch the news during meals. Read more HERE.

9. Pharmaceutical drugs. Read the possible drug side effects! Certain medications slow down digestion, irritate the stomach, weaken the cardiac sphincter, and cause stomach inflammation.

You may also be interested in my articles Digestive Health Part 1 and Digestive Health Part 2.

Update: Consider the risks before treating your heartburn with Proton Pump Inhibitors (acid blockers). Not only because the cause is most likely low stomach acid, but also because acid blockers are linked to many physical ailments.

“It’s not the first time that PPIs have led to health concerns. Their use has been linked to increased rates of fractures, pneumonia, the gut infection C. difficile, and low vitamin B12 and magnesium levels.” Popular heartburn drugs could lead to kidney damage without warning: study

Author: Barbara Horsley has more than 26 years of experience as a licensed massage therapist. She specializes in abdominal massage and Visceral Manipulation™ and is an NCBTMB-approved educator. In addition to being certified in abdominal massage, she also studied biomechanics and restorative exercise. She is also a Certified Women’s Herbal Educator and a graduate of the IWHI Perimenopause & Menopause Certificate Program.