The number of patients complaining of chronic upper abdominal pain has mushroomed over the past years. The majority of the complaints relate to the stomach and lower esophagus.

The upper abdomen consists of the liver and gallbladder on the right side under the bottom of the right rib cage. On the left side, below the rib cage, is the stomach. The pancreas is located behind the stomach toward the back. The spleen, the size of a fist, sits in the upper far left part of the abdomen, to the left of the stomach.

In this post, we will focus exclusively on the esophagus and stomach.

Esophagus

 The esophagus is the muscular tube that connects the back of the throat with the stomach. Any irritation or inflammation of the esophagus is called esophagitis. The most common cause of esophagitis is acid reflux also known at GERD—Gastro-Esophageal Reflux Disease, or heartburn in common parlance. Reflux occurs when stomach acid backs up into the esophagus.

The far end of the esophagus joins the stomach at a circle of muscles called the esophageal sphincter—not that different from an anal sphincter. The sphincter ensures a one-way flow from the esophagus to the stomach. The sphincter is located in the diaphragm, which offers reinforcement in keeping the sphincter closed.

When you eat, the sphincter opens to let food pass into the stomach. When not eating, the sphincter remains tightly shut so that the contents of the stomach don’t flow back up into the esophagus.

A widely held misconception, even among medical doctors, is that acid reflux is caused by too much acid. The problem is acid in the wrong place. 

When the digestive juices from the stomach reflux up into the esophagus, the acid causes burning of the esophageal tissue. Unlike the stomach, the esophagus has no protective mucous barrier and is vulnerable to the powerful digestive acids from the stomach.

Symptoms of esophagitis from reflux include the following:

1. Pain or tightness in the chest—in some cases mimicking cardiac pain.

2. A burning sensation—although some people have heartburn without any obvious symptoms

3. Difficulty swallowing

4. Unpleasant taste in the mouth

5. Chronic cough from the hydrochloric acid fumes

6. Hoarse voice

7. Loss of enamel in the back of the teeth from acid fumes

8. A sensation of lump in the throat.

9. Nausea

10. Frequent hiccups from irritation of the vagus nerve

11. Bad breath

When I worked many years ago in the Española emergency room, I had patients come in with chest pain, thinking they were having a heart attack. If the pain did not respond to a tablet of nitroglycerin that dilates the vessels of the heart, then I would give them Mylanta for acid reflux. If they got immediate relief, it helped confirm the diagnosis of “heartburn.”

At home, if you get chest pain, you can put a teaspoon of baking soda in six ounces of water and drink it to see if you get relief.

Causes of Esophageal Reflux 

1. weight gain and obesity
2. pregnancy
3. smoking
4. physical inactivity
5. drinking too much alcohol and caffeine
6. eating large meals before bed
7. some medications
8. fried food and greasy foods.
9. bending over or stooping forwards
10. Undigested food in the stomach from lack of sufficient digestive enzymes

When one has acid reflux, lying flat in bed can make the symptoms worse.

Until you can identify the underlying cause of your reflux, you can buy a wedge to put under your sheet, which will elevate your upper body. Elevating the head of the bed with blocks is another option.

For temporary relief, you can use baking soda in water.

Some of my patients report that adding apple cider vinegar with their main meal helps lessen acid reflux, which is counterintuitive. This phenomenon might be due to the improved digestion with the ACV, especially in people older than 50.

If the acid reflux occurs frequently, it is critical to search for the underlying causes. Over the years, the acid that bathes the lower esophagus will lead to cellular changes, including chronic redness and thickening of the lining. This condition is called Barrett’s esophagus, a risk factor for developing esophageal cancer.

The most persistent cause of chronic, recurrent acid reflux is the sliding hiatal hernia. 

Sliding Hiatal Hernia 

A hernia occurs when part of an organ protrudes through a weak spot in surrounding connective tissue. A hiatal hernia occurs when the upper part of the stomach squeezes through the tiny opening in the diaphragm where the esophageal sphincter normally lies. The upper part of the stomach ends up above the diaphragm, resulting in unrelenting distress,discomfort, and severe acid reflux.

A “sliding” hiatal hernia means that the stomach can be coaxed back into place, back under the diaphragm, using specific techniques people can perform on themselves to fix the hernia.

Common symptoms of a hiatal hernia include the following:

• Feeling full after only a few bites of food and/or a few sips of water
• Feeling short of breath
• Feelings of intense anxiety
• Chronic, unremitting acid reflux
• Nausea
• Bloating
• Tenderness to touch in the upper abdomen, about an inch below where the breastbone ends. Sometimes one can notice a slight bulge in that area.

Why do people get hiatal hernias? 

Some people have a genetic weakness in the area of the diaphragm where the esophagus joins the stomach. Such people need to do the procedure periodically to get the top of the stomach back under the diaphragm with the rest of the stomach.

A protuberant belly can push the stomach upwards where it doesn’t belong. Eating a very large meal, like at Thanksgiving, can also push the stomach upwards.

Severe stress can cause an inward contraction of the chest, resulting in a caved-in posture. The contraction can cause the esophagus to shorten, which then pulls up on the sphincter that resides in the diaphragm. The sphincter is attached to the stomach, which gets pulled upward, causing the top part of the stomach to herniate up through the diaphragm and become entrapped.

After my accident, I was so weak and contracted, I experienced a constantly recurring sliding hiatal hernia with reflux and tenderness in my mid upper abdomen. The stomach was only slightly herniated, so I was able to fix the hernia easily with a simple technique.

Techniques for Fixing a Sliding Hiatal Hernia

1. Stand with your back ramrod straight.
2. With the ball of your thumb placed right on the tender spot below your breastbone, take a deep breath and exhale slowly.
3. On exhalation, press your thumb straight back toward your spine as far as you cam and, while still pressing, forcefully drag your thumb down and diagonally to the left where the stomach lies below the diaphragm.
4. If the maneuver is successful, then the tenderness will subside and the reflux disappear. Sometimes you will hear gurgling sounds as the trapped fluids move out of confinement.

Because my posture was so poor in those days of unrelenting insomnia, I had to repeat the maneuver several times throughout the day, even while seeing patients.

For many of my patients with hiatal hernias, a larger area of the upper stomach is entrapped, in which case my technique is not effective.

Here is a short video with a health coach demonstrating a very effective technique for fixing sliding hiatal hernias that don’t respond to my simple maneuver. I think you will find the 12 minutes very valuable.

https://www.youtube.com/watch?v=6iJOrRcZpJk 

One of Santa Fe’s highly skilled body workers contacted me just now to let me know that the health coach in the above video showed signs of having a misaligned spine in the area of the diaphragm. As you scan down the front of the coach’s body, note the area above the waistline with slight tilting to the right. 

The Stomach—Gastritis and Gastric Ulcers 

People often use the term “stomach” to mean abdomen. “I have a stomach ache,” usually translates to “I have pain in my gut.” Technically, the word “stomach” refers to the actual stomach. The stomach is located in the upper abdomen. 

Stomach fluids contain hydrochloric acid, which breaks up the proteins and extracts minerals from our food. The powerful acid also helps to kill bacteria and other pathological organisms that enter the mouth.

The stomach is lined with a mucous barrier that prevents the hydrochloric acid that digests our food from burning the layer of tissue under the barrier. Gastritis occurs when that barrier is breached and the stomach becomes chronically irritated.

Some common causes of gastritis include:

1. Excess use of pain medication in the category called, NSAIDs (non-steroidal anti-inflammatory drugs), including aspirin, ibuprofen (Advil), and naproxen (Aleve). These medications disrupt the mucous barrier and allow the hydrochloric acid to burn the stomach.
2. Excess caffeine and alcohol can disrupt the mucous barrier.
3. Food allergies and sensitivities can cause inflammation of the stomach.
4. Unrelenting stress can cause swelling and inflammation of the entire GI tract.
5. Chronic exposures to toxic chemicals and mold can cause inflammation of the entire GI tract.
6. A bacteria called H. pylori can cause persistent pain, inflammation, and ulceration. If you have have persistent pain, ask you doctor to do a blood test for H.pylori antibodies and/or a stool test for the H.pylori antigen (the actual bacteria). If you test positive, mainstream doctors will treat you with three different medications. However, there are natural remedies that can be effective if taken for at least a month.

If inflammation persists, an ulcer can develop in the stomach. Ulcers usually cause a burning, gnawing pain in the upper abdomen. Sometimes stomach ulcers can be “silent.”

Many years ago, one of my Swiss relatives bled to death from a silent ulcer while she was hospitalized for treatment of a severe flare up of her rheumatoid arthritis. Long-term use of NSAID medication prescribed by her doctors caused the ulcer.

Mainstream doctors treat gastritis and gastric ulcers with acid-blocking medications, often without addressing underlying causes. Long-term use of these medications can cause serious health problems. The body is unable to extract minerals and other nutrients from food we eat, due to the lack of stomach acid.

Mineral deficiencies can cause heart arrhythmias, hypertension, accelerated osteoporosis, muscles cramps, worsening asthma, delayed wound healing, fatigue, and headaches—to name just a few of the consequences of having low levels of minerals.

If you are in pain, it would be acceptable to use acid-blocking medication for a limited period of time while you make an effort to address the underlying causes of your gastric distress.

Self-care for gastritis and gastric ulcers 

1. Stop the known irritants, like alcohol, caffeine, acidic foods, and NSAIDs. 

2. Make dedicated efforts to mitigate and manage the stressors of life. 

3. Mastic gum accelerates healing of ulcers. Take two capsules on an empty stomach first thing in the morning for two or three months. 

4. Drink chamomile tea, known to be soothing for ulcers and stomach inflammation. 

5. Suck on two DGL tabs (unflavored), derived from licorice root, each time you feel pain in your stomach. The DGL coats the stomach lining. In DGL tabs, the glycyrrhizin has been removed because it can cause an increase in blood pressure.

6. Try slippery elm tablets and see which works best for you, that or the DGL.

7. Baking soda can offer temporary relief from the acid. Take one level teaspoon in 6 oz. of water up to four times a day, away from food.

A patient of mine had a 12-year history of chronic gastritis and a non-healing gastric ulcer. Her gastroenterologist had treated her for many years with powerful acid blocking medications and repeated endoscopies. While the pain from her gastritis diminished on the medication, her gastric ulcer did not respond to any mainstream measures.

After I became involved in her care, she agreed to slowly wean herself off her acid blocking medication. She carefully followed the healing protocol, which helped with the gastritis, but the ulcer did not respond. Her gastroenterologist referred her to a major medical center to get extensive testing for cancer.

I suggested that the patient temporarily postpone the testing for cancer and consider the possibility that food allergies might be keeping the ulcer from healing. She had some symptoms that suggested she might have dairy allergies. I had discussed with her this possibility in the past, but she was reluctant to give up one of her favorite foods—yogurt. She said that yogurt made her stomach feel better.

I urged her to give a six-week trial of 100% avoidance of all dairy products. Reluctantly, she gave up her favorite food. When she had her follow up endoscopy two months later, there was no sign of the ulcer—at long last! She remains dairy-free and, after suffering from 12 years of gastric distress, she has no abdominal complaints.

Conclusion 

It’s time to get the inflammatory fires out of your body. With a few dietary and lifestyle changes, a few specific supplements, and a few maneuvers, you will be able to extinguish the burning fires caused by hydrochloric acid in the wrong place. When the gastrointestinal tract gets what it needs and is in peace, it can create a tremendous sense of wellbeing.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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