Ayurvedic point of view on Acid Reflux

Today, we will discuss the causes and symptoms of Acid reflux from an Ayurvedic point of view. But, first, let’s look at how diet and lifestyle changes help treat Amlapitta.

Supplements Recommended - Coriander tea, Celery juice, Licorice, Cardamom, CCCFT Tea, Triphala.

Portia - Namaste to all of our listeners. Thank you for tuning in to another Athreya family podcast episode. Today, we will talk about one of doctors and hospitals’ most commonly seen conditions, acid reflux. We will always look at this condition from an Ayurvedic point of view and explain how our diet and lifestyle may contribute to acid reflux. To help us develop a deeper understanding of this topic and tell us what we can do to prevent or manage the onset of this condition, we have Vaidya Jay Parla. Namaste, Vaidya Jay.

Vaidya - Namaste, Portia, and all our listeners, this is a much-needed topic that we have taken. We at Athreya Herbs support our listeners, their families, and loved ones with the knowledge of Ayurveda and help them to thrive in life.

Portia - There's so much we can unpack about this topic, but let's start by explaining to our listeners what acid reflux is and the mechanics of what's happening in the digestive system when one experiences the symptoms of acid reflux.

Vaidya - Sure. Most people who have experienced some kind of acid reflux would have read about acid reflux from the web. I would like to walk all our listeners through how Ayurveda looks at this condition. From the numbers point of view, 25% of the US population suffers from health disparity. People have variable symptomatology or signs and experiences when they go through acid reflux, and one may experience it as just discomfort. Another one may have significant acid coming up through the throat and into the esophagus. There are various manifestations, but it all boils down to the excess of secretions in the stomach, which is the basic understanding. Let's go into how Ayurveda classically, from the ancient knowledge of these great sages, would look at acid reflux. We need to introduce the Ayurvedic name of acid reflux for our audience; it's called Amlapitta. All of our listeners would have heard about Pitta, and it is the biosystem that governs the body with heat, transformation, digestion, metabolism, hormones, etc. Pitta is meant for transforming things in the body. The Pitta is Amla; Amla in Ayurveda stands for sour, or Pitta that is raw. That’s the translation Amlapitta stands for. In this situation, the body generates the secretions meant for combining with the food, causing the metabolic fire (Agni) stationed in the digestive tract, stomach, and small intestines fueled or brought together by the Pitta. The word raw is what we want to emphasize, what it raw is all about. This condition is specific to the stomach thinking, smelling, tasting food will trigger the brain and the cranial nerve responsible for stimulating the stomach. The cranial nerve is called the vagus nerve. Ironically, it's called the vagus nerve, where people overeat most of the time in buffets. The Vagus nerve starts stimulating the stomach and the gut to secrete. The nerve component is responsible for activating the secretions in the stomach and the intestines, especially the stomach. The nerve receives the stimulus through various sense organs. It may be the crunch of a chip that you hear; you may not see or smell it, but the crunch itself will trigger the nerve to prepare. The food comes as a signal that travels down the gut through the vagus nerve to stimulate the stomach. The stomach starts preparing. What does it prepare? In terms of Ayurveda, it prepares with motility, the movement of peristalsis, the sounds that we hear when we are hungry. I'm referring to those gurgling sounds that we have when the stomach is squeezing in and asking for food, making a fist inside, and saying, give me that. It happens with the stomach being stimulated by the nerve that is the motility. The second thing is, it has stored secretions inside. The secretions include mucus secretions. It includes one significant thing that everybody knows: the stomach has stomach acid, also known as hydrochloric acid. It is mind-boggling that acid in the stomach is at a pH that could burn the skin; it is 1.5 to 2.1. There are chief cells in the stomach lining, and they will start getting released into these gastric pits. Our listeners have to imagine that the stomach is somewhat like an accordion in all the digital expands and contracts, and pits of this accordion contain acid, mucus, and enzymes. The enzymes that break down fat and protein existing in the stomach. When the food comes in, it starts expanding, and the accordion folds get expanded or stretched, the acid and secretions come out and get combined with the food, then the food begins breaking down. Another interesting thing is acids; these regulation mechanisms and enzymes help sterilize the food because it contains various harmful organisms. The moment they contact the strong secretions in the stomach, they all get destroyed, and this is the normal process. There is also natural stomach protection, the mucous layer or mucous membrane, essential for containing the acid and keeping it from contact with anything other than food. When the food comes in, it has to contact only with the food and nicely insulate the acid, not go anywhere and focus on the food. These are the three things that get prepared when we are thinking about food or smelling food. This mechanism disturbs either the movement of the stomach, the secretions in the stomach, or the containing mechanism done by the mucous membrane. If any of these are disturbed, it can cause an abnormal digestive process, which tends to give the Amlapitta or acid reflux. I know that you have some more guiding questions towards the amla, etc., and we'll talk about it. We want to make sure of three things for all of our listeners: the movement is the Vata aspect of digestion, the secretions are the Pitta aspect of digestion, and the lining or the protection is the Kapha aspect of digestion. All three are essential for keeping the digestion and the gut free of disharmony in digesting the food.

Portia - I love this explanation that you offered, because I think too often, especially in our society, that people eat so fast in this country. It's such a fast-paced lifestyle that we take the whole process of eating mindfully and slowly for granted. It is essential because we're supporting the natural digestion process, but it's not something that comes to the forefront of most people as they're just going about their day and stuffing food down their mouths. So I loved that explanation, and I hope our listeners can appreciate what the process looks like. I want to ask you about the burning sensation that is often associated with acid reflux or Amlapitta. Can you also talk a little bit more about the common signs and symptoms that our listeners should tune in to so that, if they see these signs and symptoms in themselves or their loved ones, they can start to key in on what might be happening and when there might be a cause for concern?

Vaidya - The common symptom that anyone experiences are a sense of discomfort. The discomfort may be a spectrum of experiences that an individual can experience. Initially, it may be just a pressure at the base of where the two rib margins meet. The breastbone or the sternum has this sharp end where the bone ends, and then the soft abdominal muscles begin, and this is where the condition is seen. Most people think that something is happening in their hearts, and that's why this condition is also called heartburn. That relation between the stomach and the heart is what I want to distinguish for our listeners. Anatomically when we look at the separation between the stomach and the base of the heart is the diaphragm. They're very closely related. Above the fundus, the stomach is like a bag, and on the top of this bag where the esophagus comes and attaches to the stomach, the heart is very closely related to it. When people have a sensation of discomfort, sometimes it can be painful, sharp-pointed pain. Sometimes, it can be like they want to burp or feel like something is lifting their ribcage or pushing up into the ribcage sensation of oppression, pressure there. With all of that, people think that they're having a heart issue. Most people go to the emergency room thinking they have heart problems, but after being examined, they will run all the tests and say it's just that your stomach is sore, has acid, and is causing the symptoms. It can be simple as pressure to as complex as a mind-doubting thing of having something in the heart. All are symptoms of acid reflux. Sometimes some people also have silent reflux. I want to talk about it a little bit for our listeners to know the silent reflex. Silent reflux is where the person does not have any burning sensation, discomfort in the area I was earlier explaining that is where the two cages meet, the xiphoid process. They have to go to the dentist, and the dentist says their teeth look like they're eroding or gums are inflamed. Or they go to a doctor thinking that their voice is so harsh and they have to clear their throat all the time because they feel this sensation of discomfort and soreness in their throat. Their ENT puts a scoop inside him and says, you have a lot of inflammation in your vocal cords, and you could be having these silent reflections. Some people can even have chronic sinus congestion, thinking they have sinus infections or seasonal allergies. If they do an actual close study, they may be having silent reflux. Every night when they lie down, the acid flows without control into the esophagus, mouth, throat, fairings, nasal area and starts irritating and inflating everything. This is a wide range of symptoms. Lastly, one of the things that I want to tell people who have headaches may be suffering from Amlapitta. In a broader sense, symptoms of acid reflux cannot be pigeon held to one set of symptoms, and they are variable. They have to approach a good practitioner or their primary care physician to determine if they have a sign of acid reflux causing various other symptoms that they are experiencing?

Portia - As you said, it is a wide-ranging symptom that anyone could experience. It would be great if you could talk to us a little about how to differentiate more of an acute attack that would want immediate medical care versus someone who periodically experiences heartburn and can take an antacid to find relief. I think that will be a good takeaway for someone listening to us. Not to be dismissive of what the body's telling you, but how do you differentiate what immediate concern is versus something that could be managed by another practitioner, other than Western medicine, for instance?

Vaidya - Classical relate to the food and the pain. What did I eat last night? What did I drink last night? If the pain is associated with a specific type of food. Everybody knows what acidic foods are, and somebody who has eaten oil-fried food, a lot of mustard on a hot dog, or even greasy, oily food, sriracha, or something like that will immediately know what is causing this. If they have experienced it a couple of times, they will recollect what causes acid. The second thing is what you're going through mentally in terms of stress, your day-to-day activity going on mentally. If it is causing you a lot of pressure or stress, it is another thing that can be traced out, "I haven't been sleeping well, which could be one of the reasons why I'm having this problem." I said earlier, Portia, the mind through the vagus nerve, can stimulate the stomach if it is stressed. There are stress-induced Amlapitta cases as well. Those are the two things you want to check-in; the first question is, is it the first time you're experiencing these symptoms? If it is and you're in the age group of 35 to 50 and feel that you eat something like that, do some minor home remedies, like drinking coriander tea or something that's very alkalizing like celery juice. If the pain subsides and you feel some relief, you suffer from Amlapitta, also known as acid reflux. If the pain does not go away in 4 to 6 hours, go to the nearest emergency because we don't want our listeners to ignore a real heart pain that isn't going away despite doing some simple home remedies that could lower the acid. They should go and get it checked out; if not, check what you've eaten, drank, check your stress level, and if there is any relief by taking these simple remedies.

Portia - Good point, Vaidya Jay. Thank you so much. You've started to talk about this a little bit, and I’m wondering if we could spend the next few minutes talking about the role of diet and lifestyle and getting more specific about common trigger foods. A couple of years before I discovered Ayurveda, kombucha was a big thing, how great it was for the gut, and so are all of these fermented foods. I just doubled down on those things; if I hadn't tuned in to my body and stopped at the point that I did, I feel like I would have gotten into something more serious. I didn't see any new food trends that sound healthy, but if we don't consume them in moderation or are not mindful of our body type and how we're responding to those foods, there could be some issues related to that. If you could summarise some of the things that people should be mindful of consuming, that could bring about the onset of Amlapitta.

Vaidya - Let's start with taste. I think that would be the easiest tool for all our listeners. The pungent tastes, like chili peppers, vinegar, wasabi, anything that is very spicy, mostly chilies, our food is so dominant of these types of exciting food. People want to eat these because they feel excited; otherwise, life is too boring. The extra spicy chips like jalapeno, people get hooked down to these types of food because they're exciting. Of course, the body is excited, but the stomach is even more excited; it’s on fire. I would say pungent or spicy is the first taste. The second taste is salty. Suppose you look at foods that we eat as snacks. In that case, American snacks are so salty, and it may be chips, pretzels, or anything with salt, it is one of the strongest triggering agents for the Pitta or the acid bound energy in Ayurveda that is suddenly provoked by the salty taste and also pungent taste and sour taste. The sour is another interesting thing, and you’re giving an example of fermented food. Fermented food is extremely pungent and sour. Both of these qualities exist in fermented food. Kombucha may even be like balsamic vinegar, rice vinegar. When you go to a restaurant to make it exciting to your tongue, the chefs will use all these strong flavors and tastes. You may even think of pickles; for example, all those pickles that are added may be pepperoncini or jalapenos or olives that are pickled. These all have a lot of salty and sour taste in them. Those are the three keys that first we should check on. Then, added to this is the oil. Remember that the acid reflux is somewhat compared to a fire that is not under control. It's now burning the house, and you don't want to add fuel to it. The pungent, salty, and sour flavor spreads the fire, and the oily food adds the fuel. The oily food can be falafel, french fries, chips, or nuggets; anything deep-fried in the oil is another source of increasing the Pitta. All our listeners are like, we know this and have heard about this, we know about these days, about this acidic food, but what we miss is the stomach rest. I want to emphasize that if you don't allow your stomach to rest and rest, I mean if you don't stimulate the stomach. For example, you eat your lunch and, 15 minutes later, you think nuts are good, I should have some protein, and you take a handful of cashews and start eating them. After you finish eating a handful of nuts, you go around, watch something on your computer, listen to good music, and then you look around; there is candy. You open the candy and put it in your mouth, and you're enjoying it, then there is a friend who has come by and is drinking green tea, and you think green tea is delicious, it has antioxidants, let's let me drink some. We don't think about how continuously we are stimulating the stomach. In the past, people had a meal and completely stopped having anything until they finished working in their fields or the farms wherever they worked, and when they came back after complete stomach rest, they started the next meal. That opportunity never comes modern in our fast-paced life. We keep on stimulating our stomach, and that's one of the causes for Amlapitta or acid reflux to go out of control. Taste, oil-food, and the stomach rest. Apart from that, the list of things that we want to look at is nightshades, tomatoes, bell peppers, chilies, eggplant, potatoes. These all tend to trigger both the Vata, the motility in the stomach, and the Pitta, the acid aspect of the stomach. Both get involved or tweaked by consuming these.When I say tweaked, it means abnormally or to miss their normal track. The movement increases, the stomach will start moving faster or slower, acid increases, and it doesn't know how to combine with the food. That's another thing that we need to inspect. Another layer is the abnormal combination. Think about our food, how it has changed from ethnic food. I don't think America has an ethnic food like Japanese or Koreans or Indians, Europeans or Greek people. America is a mishmash of all the things that you can imagine. There is no logic in combining what we are combining and when we are combining. Let's think you go to a Mexican restaurant, think about salsa and take the salsa with some chips, in the bowl you had guacamole and some sour cream, you also ask for a little bit of mozzarella cheese on it. We combine things in excess, like, sour cream and salsa are not a proper combination. Ayurveda says milk products like sour cream or milk or yogurt should not be combined with salty or sour. Salsa is usually made from tomatoes. If your stomach is strong, you may bulldoze through it and be okay by the next meal, but this abnormal combination will start triggering the stomach if your stomach is sensitive. The stomach secretes specific hormones to regulate other organs, like the stomach regulates the liver secretions by secreting its hormones. The stomach controls the pancreatic secretions by secreting these hormones. If an abnormal food combination occurs, these regulation mechanisms fail, and your stomach can hold the food for an extended period without releasing it, causing excessive Pitta and acid buildup inside. That's one example. Think about abnormal combining of Fish and milk; Ayurveda says no on that. Many sauces and varieties of fish sauces, etc., combine with milk products. I'm just giving some examples of abnormal food combinations. Combining is a crucial part of keeping the stomach proper to ensure that you're not doing any unethical act. When I say abnormal combining, if it is not done in the history of any food culture, don't do it, that's the bottom line. Abnormal food combining is another aspect that people have to see if it is causing acid reflux. What do you drink with your food? If you're drinking sugary solutions or liquids, carbonated water, all of this can have a trigger factor towards acid reflux.

Portia - You've given us so much to think about. We can do a whole different podcast episode on food combining and how that impacts our bodies. We will maybe file that for a later time to talk about. I appreciate the guidelines you've given, and perhaps we could do a follow-up episode to get more into this topic. Mindfulness and discipline are essential when talking about eating because it's so easy to consume everything in front of us. As you said, you see somebody, a colleague, perhaps at work with a cup of tea, and then you think you want it, or there's a bowl of snacks, and the convenience factor makes it easier for you to grab it. Before I studied Ayurveda, I was that kind of an eater, and to be mindful has helped me realize that I've had enough, and now it's time for my body to rest. I can wait, and I don't need to pick up anything else.

Vaidya - Our listeners should know that in Ayurveda, a healthy diet or meal is not what you calculate and bring on your plate. A healthy meal is what you completely digest and assimilate. The mindfulness key that you pressed on in the Ayurveda diet is nothing but mindful eating. What is suitable for you? What season are you eating in? What are you combining it with? What taste do you prefer? These are all the things that make you think of what you're putting in your mouth. If you do that correctly, not only the Amlapitta or acid reflux, none of the digestive issues will bother you.

Portia - I agree with you. We've touched earlier about stress-induced eating without mindfulness. I think people don't even realize that they're picking up food to eat because they're just trying to process a stressful event or an unsettling conversation with a loved one or a co-worker, without realizing it will eventually have an impact on their bodies.

Vaidya - The tongue is such a vital organ when the food is coming in. The tongue is a dual organ, and it works as a tasting organ, that is a sense, and also it helps to speak. As you said, if you had a hard conversation with your subordinate or your boss, then the tongue wants relief from that and pacifies itself with the food. If you ignore that, you will end up eating something that is not appropriate for you.

Portia - Vaidya Jay, do you have a few minutes to talk about some simple home remedies for our listeners to see some of these symptoms come up. For example, you mentioned coriander tea or an alkalizing drink like celery juice earlier. Is there a couple of other things you want our listeners to take away from?

Vaidya - Yes. People always look into a quick fix. I don't want our listener to think that he has given us these quick home remedies, now my symptoms are gone, and now they should resort to the same food habits. My humble request to all our listeners is that they have to change their diet and lifestyle and these home remedies. Licorice is another wonderful herb. This sweet, mild coating, calming tea herb has been used for the stomach for millions of years. Licorice is pacifying and calms down the nerves, and it helps to neutralize the Pitta and acid inside the stomach. Studies have shown that it can help calm down the damage done to the inner walls of the stomach, like the erosions or stomach lining agitated by Pitta. It's a calming herb that can be made into a tea mixed with honey and then consumed. That is one herb I want to stress to all of our listeners. Additionally, chewing on things like Cardamom or keeping Cardamom in the mouth. Studies show that Cardamom is an anticancer agent in the stomach. Studies also show if one has abnormal cell changes, the cardamom can soothe it and help to heal it. Cardamom pods can be used as a mouth refresher for people who have acid reflux. Apart from these two spices in Ayurveda, we have certain combinations which we can use. A very famous one is CCCFT. Whoever knows Ayurveda will know CCCFT is coriander, cumin, cardamom, fennel, and turmeric as tea. CCCFT tea is a powerful gut balancer, especially for the stomach, the ratio of which is unique. Coriander is the most cooling, calming, and soothing spice added to other things that calm down the Pitta and Vata, which also causes the stomach to inflame when Pitta and Vata come together. These spices will calm down the stomach and reduce food allergies. If the food reacts to the gut, it causes more acid in the stomach, which will calm down the acid. They can make tea and drink it with the food. Take one teaspoon and pour hot water in it, then let it sit. As they are finishing the meal, they will sip this tea. It will combine the food properly with the digestive juices and leave no room for any irritation. Lastly, if you have any issues with bowel movements, try to clear that. Going to the bathroom regularly will also help remove the stagnation of acid or the Pitta inside the stomach. It can be cleared by taking Triphala, a very famous Ayurveda combination that everybody knows about. Triphala has become so renowned that one can find it in all healthy gut and colon formulas. It includes three fruits: Haritaki, Vibhitaki, and Amalaki. These three will help to balance out the gut in terms of its motility and elimination. These home remedies are more than enough for our listeners to try, and if they don't get relief, I would highly recommend that they visit a practitioner and then get a consultation to see what best can be done in terms of other herbal choices.

Portia - It's an excellent point to know when it's time to seek medical attention. Why not try Ayurveda? This holistic system prioritizes the importance of a balanced diet and lifestyle to achieve good health and longevity. That's a good point you made. I wanted to get into Pranayama and Yoga. I feel like there is so much we can cover with those two things in terms of kinds of symptoms, conditions, poses, and breathing techniques. That would be something for another conversation.

Vaidya - We should continue this conversation because it's such an important topic. Imagine 25% of the entire US population is going through some of this. The more Ayurvedic support they can get, the better. In the following conversation that we will initiate, I want to talk about Liver health. The liver and its importance in keeping the stomach healthy are things we can discuss and bring light to these aspects of digestion for all our listeners.

Portia - I agree. We will put something down on the calendar soon because this is an important topic. When we meet again, we will talk about Liver health. Until next time, encourage everyone to stay well and be safe. Thank you for your time, Vaidya Jay.
Namaste.

Vaidya - Thank you, Portia, and all our listeners. Namaste to all of you.