Reflux and heartburn

Reflux is stomach contents moving back up into the oesophagus. Heartburn is what that usually feels like — burning behind the breastbone, often worse lying down or after a large meal.

The part that surprises people is that it’s frequently not a question of too much acid. It’s acid in the wrong place. The muscular valve at the top of the stomach opens when it should stay shut, and what’s normal in the stomach is corrosive to the oesophagus above it.

What your naturopath looks at

Meal size and timing. A full stomach and a horizontal body are the two conditions reflux likes most. Where the last meal of the day sits often matters more than what was in it.

The specific triggers in your pattern, rather than a generic avoid list. Fat, alcohol, coffee, chocolate, peppermint and very large meals are common, but the set is individual.

Pressure from below. Abdominal weight, constipation and bloating all push upward on a valve that’s already struggling.

How you eat. Speed, chewing and eating standing up or at a desk all change how much air and how much volume arrive at once.

Digestive capacity. Slow gastric emptying keeps the stomach full longer, and some people do better with support for digestion rather than further suppression of it.

Stress, which changes both motility and how sensitive the oesophagus is to what reaches it.

⚠ Reflux that needs medical assessment

Chest pain can be a heart problem, and it is not worth assuming otherwise. Crushing or pressing chest pain, pain spreading to the arm, jaw or back, breathlessness, sweating or nausea need emergency assessment now, not a booking.

Also get assessed rather than treated for: difficulty or pain swallowing, food sticking, vomiting blood or black stools, unexplained weight loss, or reflux that started newly after the age of 50. Long-standing reflux is followed medically because of what persistent irritation can do to the oesophageal lining.

If you contact us with any of these you’ll be told the same thing and helped to get seen.

Working alongside medication

Plenty of people arrive already on a proton pump inhibitor. Don’t stop it on your own — stopping abruptly can cause a rebound surge in acid, and some people are on them for reasons that still apply. Your naturopath works alongside the prescriber, on the mechanical and dietary side, and tells you what interacts with what.

Related: bloating, how digestion works, IBS, weight and healthy living.