Chronic Reflux & Barrett’s Esophagus

Transcript:

Brandy: Welcome to Dishing Up Nutrition brought to you by Nutritional Weight & Wellness. If you're somebody who's been suffering from ongoing acid reflux, this is the episode for you. Because I think a lot of people think that heartburn and reflux is just kind of annoying and uncomfortable. Maybe you carry a bottle of Tums around and that's that. But really this is something to take seriously because long-term chronic heartburn is significant and the consequences can be severe.

Kara: They really can. And I think this is such an important topic because people can kind of normalize the symptoms that are occurring week after week. They might think, I just have a sensitive stomach, or I must have eaten something spicy. Meanwhile, their body is giving them signals that their digestive system really needs some help. But many people live with reflux for years and don't realize that it can progress into something more serious.

Brandy: That's right, so we're going to talk about that today. We're going to discuss kind of the biochemistry of what is acid reflux and what is GERD, and we're also going to touch on another condition called Barrett's esophagus, and we're going to think about how reflux and Barrett's are related and how they're different. And most importantly, we're going to talk about what you can do through diet and nutrition to heal and prevent GERD and acid reflux from progressing into something more serious.

But before we go any further, let's introduce ourselves. My name is Brandy Buro. I'm a Licensed and Registered Dietitian. And today I'm here with Kara Carper. Hi Kara.

Kara: Hi, Brandy. Great to be here with you again. I'm Kara Carper. Like she said, I'm a Licensed Nutritionist and Nationally Board Certified Nutrition Specialist. And I work with clients mostly on Zoom, but occasionally in person at one of our local Minnesota offices.

The basics: what is Barrett’s esophagus?

So we're going to start with the basics. First of all, Barrett's esophagus, it's a condition where the lining of the esophagus changes due to repeated exposure to stomach acid. You know, normally your esophagus is lined with delicate cells that are thin and flat, but with chronic acid exposure, the body tries to adapt by replacing those with tougher cells, more like what are found in the intestinal tract.

And while that might sound like it's helping, this cellular change actually increases the risk for esophageal cancer over time. And even a small amount of acid that can get up into the esophagus can cause serious damage when it's happening regularly. And that's because unlike the stomach, the delicate lining of the esophagus has no protection against this harsh acid. So with reflux, acid keeps pouring into the esophagus and it's not supposed to be there. And over time there can be scar tissue, and even a more serious pre-cancerous, potentially cancerous condition, and that's Barrett's esophagus.

What’s the difference between acid reflux, GERD & Barrett’s esophagus?

Brandy: Right. Yeah. So now you could be wondering what is the difference between all these things? What's the difference between just having acid reflux occasionally, GERD, and this more serious condition, Barrett's esophagus? How would you know which one you have?

Well, acid reflux is when that stomach acid is flowing backward into the esophagus, but it's not chronic. It's happening here and there, maybe once a month, a few times a year. And that's pretty common, you know, especially if you do consume a common trigger food.

Or it could even just happen after overeating, kind of overindulging having a large meal. GERD on the other hand, or gastroesophageal reflux disease, is when that reflux is chronic. It's happening multiple times a week or maybe even every day. And you're experiencing symptoms like that classic heartburn, a burning in the chest. You may even have a little regurgitation. I've had some clients, they've thought they're having a heart attack. The pain is so significant in their chest.

Kara: I’ve heard that as well. How scary.

Brandy: Right. Then we have Barrett's esophagus. Barrett's esophagus is not just symptoms. This is again a structural change in the tissue of your esophagus. And this has to be diagnosed through an endoscopy and a biopsy of that tissue. So if I were to summarize these three conditions, it's kind of on a spectrum. We have reflux on one end of the spectrum where we have those symptoms occasionally here and there.

GERD is more chronic where those symptoms are occurring multiple times a week or daily. And then Barrett's is an actual physical change in the tissue as a result of chronic reflux.

Kara: That's a really great summary. I think that's going to clear up the definitions for a lot of people. I also want to point out that reflux doesn't always show up the exact same way for every person. It's not always that burning that Brandy just mentioned or that kind of feeling of regurgitating food or like the food is kind of sitting in your esophagus.

It doesn't always show up like that. It could show up as a chronic cough feeling like you always have to clear your throat. You have mucus production in that throat.

Brandy: That post nasal drip sometimes.

Kara: Difficulty swallowing, and even issues with teeth enamel. These are all clues that reflux could be going on. And like Brandy mentioned, a Barrett's diagnosis does require an upper endoscopy to be diagnosed. And that's when a doctor looks at the esophagus and takes a biopsy. It's basically like having a camera put down in there.

And then they also take a tissue sample. So if you've had reflux for years, it's really, really important that you discuss this with your doctor and highly consider getting a screening because this can really prevent future damage, future potential risk of cancer, and they can really look closely at any changes within your cells.

Brandy: Yeah, especially if you know you've had reflux, you've had kind of the telltale signs of like that burning sensation, the things you think of when you think of heartburn. But you may even want to consider this if you have some of those like silent reflux symptoms where you have like mucus production, you're constantly clearing your throat, that post-nasal drip.

I mean, that could be a sign that you have chronic reflux without knowing it, you know, quietly increasing your risk for developing this Barrett's esophagus, which as we know has some serious long-term effects.

Kara: Absolutely. I just want to mention one quick thing Brandy before you go more into that, but I heard about a client who was diagnosed with Barrett's and the reason that she went in to get tested is because her sister had it. Her sister ended up dying. I think there were complications with pulmonary fibrosis, which can sometimes go hand in hand with Barrett's.

So this woman got tested. She had it. She was a low risk of cancer. But then she knew how to manage it going forward. And this same woman, her mother had Barrett’s and ended up dying from a respiratory complication. So there has to be a genetic component too. It'd be something to consider if you have a couple of family members, it would be worth definitely getting tested.

Brandy: Absolutely. Yeah, because we know if you catch it early, we can prevent these downstream effects. And it's interesting that some people with Barrett’s don't even know that they have reflux like you just described. That's a great example of how that can happen. But only 5% to 15% of people with chronic reflux end up developing Barrett's esophagus.

So it doesn't necessarily mean that you will develop Barrett's if you have reflux. But I do think the risks are significant enough that chronic reflux shouldn't be ignored. So even if you have a low risk, it's not something that you want to develop. And the longer GERD goes untreated, the higher the risk. So the longer you have chronic reflux, the more risk you have of developing Barrett’s, you know, plus if it's an ongoing issue, you're also just putting yourself at risk for nutrient absorption. There's a lot of other risks that go along with chronic reflux, which we'll talk more about in a moment.

What causes reflux?

So let's go over what causes reflux in the first place. How can we prevent reflux from escalating to this point? Well, reflux happens when the esophageal sphincter, or the valve, between your esophagus and your stomach is open, when it shouldn't be. That can allow stomach acid and the contents of your stomach to kind of splash back up into your esophagus where it shouldn't be.

And this can be triggered by a few different things. Of course, there are dietary triggers. I know a lot of folks might say spicy foods will trigger it. I've known several clients where stress can be a huge trigger of reflux. Higher fat foods, really rich meals, like I mentioned earlier, overeating, overindulging, and midsection weight gain or obesity, central obesity, even gut dysbiosis or an imbalance of the good bacteria in your gut can result in reflux.

Just aging can increase your risk of developing reflux. Another interesting thing is if you've been using acid-reducing medications, that can paradoxically increase your risk for chronic GERD.

Kara: So interesting.

Brandy: Yeah, you'd think it'd be the opposite, but that is one of the triggers.

Kara: Well, that's a really important point because those antacids temporarily give relief, but they're really not getting to the root cause. They're not fixing the underlying issue. Sure, they do neutralize or reduce or block stomach acid, but they can't fix a weak valve that connects the esophagus to the stomach. And they can actually worsen digestion because we need stomach acid. We need a certain amount to digest and break down our food and absorb our nutrients.

If acid is too low, food will naturally just sit longer in the stomach. It could start fermenting. That can lead to gas and bloating and increased pressure in the stomach. That can push acid up into the esophagus. It’s like a catch-22. We'll talk more about this.

Brandy: So when you think about it, it's easy to think that with reflux you must have too much acid. You know, that's what the assumption often is. But like you're saying, Kara, most often that's not the case. Most of the time when somebody is experiencing heartburn or reflux, the root cause is usually due to having too low of stomach acid.

So if you think about it, reflux is more common as we age and our production of stomach acid decreases with age. So in that way it does make sense. It correlates that inadequate stomach acid is related to higher risk of reflux.

Kara: Another thing that can happen is low stomach acid can reduce the function of the esophageal sphincter. Stomach acid plays a really important role in digestive signaling. So that sphincter that keeps acid down, it gets kind of lazy without the proper signaling from stomach acid. And the problem people get into is that once you try to stop your acid blocking medications, it's very common to get what's called rebound. And that's when your symptoms feel even worse than they did to start with.

And so of course, people are super uncomfortable. They may not be able to even be eating many foods. And then they go back on their acid blockers just to kind of get through their day.

Brandy: Right, understandable. But if getting off acid blocking medications is something that you want to do, strong recommend to not go cold turkey. You really want to slowly wean yourself off for this exact reason. And these acid blocking medications are extremely common. They're actually in the top five medications used, and that's accounting for both prescription and over-the-counter medications.

So a lot of people are dealing with this. And these medications are effective short term. They do help manage symptoms, but they're really not designed to be taken long term every day.

Kara: Don’t they even say that on the package?

Brandy: Yes.

Kara: I think, is it two weeks?

Brandy: Yeah, up to two weeks is the recommendation.

Kara: Yeah. People are on these years. I hate to say it, like their whole life; decades.

Brandy: And unfortunately, the longer you suppress your stomach acid with these medications, that can cause some serious health consequences and put you at risk for nutrient deficiencies down the road. Because as we've talked about, we need stomach acid to digest our food and help us absorb nutrients.

In fact, long-term use of proton pump inhibitors are associated with an increased risk of osteoporosis. If that doesn't kind of paint the picture of how these impact your ability to digest and absorb nutrients. I think that's significant.

Kara: Maybe the person on an acid blocker, you said PPI like a Prilosec, probably not breaking down their protein, which we need for bone health. Not absorbing minerals from food like magnesium and calcium, potassium.

Brandy: Vitamin B12, I know, is another common nutrient deficiency.

Kara: And you know, if somebody is very low in B12, they can start to have numbing, neuropathy, issues with memory, brain function. So the trickle down effect could be really have a lot of negative consequences. Stomach acid is also necessary to kill off unwanted bacteria. We all have a certain amount of bacteria in our gut. I think it's like three to five pounds. But we want most of that to be beneficial bacteria.

So when we have the unwanted bacteria, you know, not having enough stomach acid can make that more likely to proliferate and grow. And sometimes not having enough stomach acid can lead to a bacterial overgrowth called SIBO, small intestinal bacterial overgrowth, just like it sounds. The biggest symptom of SIBO is bloating and gas. And of course that can lead to more reflux. So again, it's kind of a vicious cycle.

So while the antacids, whether it's Tums or Rolaids or Prevacid, Prilosec, Omeprazole, or some names, you know, there are different kinds of antacids and proton pump inhibitors. Sometimes those are temporarily necessary and they can be effective to relieve discomfort.

But remember that they are meant to be short-term temporary aids while you investigate, work with a provider preferably to get to the root cause, and naturally figure out a way to wean off of these acid blockers for long-term health and longevity.

And as nutritionists and dietitians, we're always trying to find and treat the underlying root cause of reflux or GERD or Barrett's so that these medications are not needed on a daily basis.

Brandy: And unfortunately, like you said, the medications are not treating the root cause. So if we continue to take the medications, we could actually just be making the situation worse. And by reducing our stomach acid long-term, we have more serious health consequences to deal with.

So really too much stomach acid is not usually the cause of reflux. Usually it's the opposite, too little stomach acid that's relaxing the sphincter, allowing that stomach acid to flow back into the esophagus. And it's so easy to get reliant on the use of those medications because we get quick relief.

But as soon as you stop taking them, those symptoms come back with a vengeance, usually a lot worse than they were before you started the medication. There's a term for that: rebound acid hyper secretion. It is a, it's a real thing.

How to stop GERD or reflux from progressing

So now we have to ask, how do we stop GERD or reflux from progressing to this point where we are reliant on these medications and just kind of progressing towards a more serious issue?

Well, this is where dietitians and nutritionists can really help out. There's a lot that you can do with diet and some key supplements to heal your gut and reduce those symptoms. Well, it's already time for our next break. You are listening to Dishing Up Nutrition. Our topic today is chronic reflux and Barrett's esophagus.

When we come back, we will be filling you in on dietary strategies and key supplements to heal that reflux, gradually get off PPIs, and feel a lot better. We'll be right back.

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Kara: Welcome back. You're listening to Dishing Up Nutrition. I'm Kara Carper here with Brandy Buro. We are licensed nutritionists and licensed dietitians. And our topic today is discussing chronic acid reflux, GERD, and Barrett's esophagus. And for the second half of our podcast today, we are going to be looking at a dietary perspective of ways to improve reflux so we can identify trigger foods and beverages.

Ways to improve reflux through a dietary approach/identifying trigger foods & beverages

So we'll start with some common ones that include any alcohol or caffeinated beverages. Chocolate can be a trigger, fried foods, sometimes citrus or tomatoes, and mint. It really just depends on the person. It's great to keep a food diary though, whether you're using an app or you like to just write it in a journal, because then you can kind of look back and figure out what your individual trigger foods or beverages were.

Kara: But it may be a new thought to some that foods containing gluten can be underlying triggers or even just grains. Even gluten-free grains can be a trigger for some. If you have a gluten sensitivity, that in itself creates inflammation in the gut. Digestion can become impaired. Food might sit longer without being digested. We know that increased gas or bloating or abdominal pressure can lead to more acid reflux as well. So you have to consider what types of foods contain gluten and grains mostly tend to be heavily processed foods high in sugar, high in refined carbohydrates.

Those will cause inflammation regardless of the reflux piece, but they can certainly trigger reflux. Gluten is a common irritant to the gut lining, and can lead to something called leaky gut, which is intestinal permeability. And so if I'm working with a client and they have reflux, I will often have them remove gluten from their diet for at least four weeks. So it's kind of an elimination for a month with some food journaling and it can heal the gut, but also give a lot of information at the same time.

Brandy: Right.

Kara: Because many of them notice improvements and other areas as well. Less inflammation, maybe their knees don't hurt as much, their asthma starts clearing up so there can be...

Brandy: Skin improves.

Kara: For sure, there can be a lot of benefits.

Brandy: I don't think I've had anybody remove gluten and react poorly to it. It really can't hurt.

Kara: Great point.

Brandy: Well, and Kara, you mentioned earlier that SIBO or small intestinal bacterial overgrowth can create excess gas in the abdomen, which can also push the stomach contents upward, push that esophageal sphincter open. It can make it a lot easier for acid to reflux back into the esophagus.

More on what can cause bacterial overgrowth & excess pressure in the abdomen 

Well, I just want to talk a little bit more about what can cause that bacterial overgrowth and this excess pressure. One reason could be carbohydrate malabsorption.

Kara: So what might be causing carbohydrate malabsorption in the first place? Low stomach acid. We're back to that. If we don't have enough stomach acid, we're not able to digest our foods properly.

Brandy: Yeah, so if we're not digesting food, the bacteria in our gut are just going to ferment and feed off of those carbohydrates.

Kara: So low stomach acid means the food's not getting digested properly. Undigested food can travel into the intestinal tract. It's just trying to move through its cycle. But if it's not digested properly, it can get basically eaten, consumed by bacteria. And that produces gas.

Brandy: That's right.

Kara: So again, this could just lead to more acid reflux or GERD. So that low stomach acid, it's more likely that someone will have bacterial overgrowth. And that's when the bacteria feed on the undigested carbohydrates kind of downstream in the wrong area.

Dairy: a possible food trigger for reflux

Brandy: I may also have somebody remove dairy while we do a bit of an elimination diet trying to figure out some of those triggers for reflux. Dairy foods, especially those that are a little higher in fat like cheese or ice cream, they can slow digestion, which just, you know, food is sitting in the gut longer, the potential for that food to kind of push that sphincter back up increases.

Also keep in mind that it's very common to have a lactose intolerance and lactose is the sugar found in dairy foods. So if you're not able to digest lactose, it can easily ferment in your gut which can again cause bloating and gas and more pressure on the stomach that leads to that reflux again.

Kara: And some people may be under the impression that drinking a glass of milk or having a bowl of ice cream can get rid of their uncomfortable reflux symptoms. You know, it might temporarily soothe symptoms because it does coat the esophagus, but in the end, it's just stimulating more acid production. So the relief, if there's any, is going to be temporary and it can cause more inflammation and more harm than good.

Brandy: That's right. Also for many people dairy can be mucus producing. I've known many people who have kind of an underlying dairy sensitivity that can cause like that phlegm production or even like sinus issues. And that's not something we want. We don't want excess mucus buildup in this case, especially since you know that post-nasal drip and phlegm can be a sign of silent reflux.

Kara: It all can kind of exacerbate the symptoms. That's something that dairy does. It increases mucus production. I know I'm sensitive to it. I've never ever drank milk in my entire life. I don't eat ice cream. I can tolerate a little cheese, but even if I put heavy cream in my coffee, I start clearing my throat.

Is there a cure for Barrett’s esophagus?

So now let's ask the big question. Is there a cure for Barrett's esophagus? Well, it's not yes or no. It's a little bit of a gray area, but Barrett's can sometimes be treated and sometimes reversed, especially if it's caught early. But the primary goal with the condition, Barrett's esophagus, is to stop the progression and prevent esophageal cancer.

There are some medications or procedures that can be done. There is a surgical procedure that can remove abnormal cells and some of that tissue overgrowth and scar tissue, but nutrition and lifestyle still need to be foundational.

Best eating plan if you have reflux, GERD or Barrett’s esophagus

So Brandy and I are going to talk about the best eating plan if you have reflux or GERD or Barrett's. We like to start with reducing inflammation and supporting digestion.

Brandy: These strategies will apply even if you're just dealing with occasional heartburn, I would say. Anything to aid digestion and reduce inflammation is going to be helpful here.

Kara: As always, we're going to prioritize whole unprocessed foods. So what does that look like? Well, carbohydrates, mostly coming from vegetables, proteins coming from quality animal sources, and then real fats coming from nature. Things like olive oil, olives, avocados, avocado oil, coconut, grass-fed butter, and nuts and seeds.

And people often do better if they're on a lower carbohydrate plan, especially if they eliminate gluten and sometimes grains because as we talked about, the bacteria that gas feed on are carbohydrates.

Brandy: Yeah, and those grains especially can be common triggers or food sensitivities. And since we're focusing on digestion, how do we aid digestion here? We're looking at soft cooked foods, things that mechanically are already kind of broken down for us so that our gut doesn't have to work as hard.

So I really like to think about soups and stews, slow roasted vegetables and meat; eggs and fish are usually pretty easy to digest. Some people will do a protein shake maybe as a snack or if you bulk it up enough it can be a nice meal. Just an easy way to get a lot of nutrients in that are very easy to digest because again, mechanically they're already kind of broken down for you so your gut doesn't have to work as hard to digest that food.

Eat in a relaxed state

Kara: And speaking of breaking down foods, this is a simple step that often gets overlooked. And that is eating in a relaxed state, preferably sitting down, you know, not eating at the kitchen counter, preferably not eating in your car. I know this can be challenging. Everybody's busy and running around, but slowing down, taking time to chew each bite thoroughly. And I don't have an exact number. I feel like I've heard 30 chews.

Brandy: Sounds good to me.

Kara: I mean, think most people are, you know, wolfing things down, spending like 10 seconds on each bite and food is really not getting chewed up, which that's where the digestion starts.

Brandy: Yeah, digestion starts in your mouth. And chewing is like the mechanical process that gives your stomach a leg up. I've also heard, you know, chew until it's like baby food. If you want like a textural cue.

Kara: Yeah, that's another great tip. And think about if you have low stomach acid, you really want to do whatever you can to help the pre digestion for the food before it reaches the stomach. Because it's already a compromised gut, making it more difficult to break things down. So let's have our mouth do a lot of the work.

Consider smaller meals & eating more frequently

Brandy: Exactly. You have to give it all the help that it can get. And for that same reason, digestion is somewhat compromised. You may need to eat smaller portions because of that. Large meals may be too much work and they increase pressure on that sphincter and can lead to reflux. So smaller meals might work better for you. You may find that four or five small eating events throughout the day works better than three large meals.

Allow enough time between last meal & bedtime

And another tip is to give yourself plenty of time between that last meal and laying down for bed. At least two, if not three hours. I've had some clients where four hours is like the magic cutoff from finishing dinner and laying down for bed. Cause when you think about it, you lay down, all that food is going to get pushed up against that esophageal sphincter. And that can be extremely uncomfortable when you're, you're trying to sleep.

Kara: And I've also heard of people propping up pillows. So they're kind of sleeping at an angle. There's probably things you can get on Amazon that are better than just putting a bunch of pillows on top of each other.

Brandy: Yeah, I think there's probably specific like wedges, foam wedges for this purpose.

Kara: And that might be needed. All these little tips, eating smaller portions, chewing your food, relaxing while you eat, finishing eating several hours before you go to bed, possibly sleeping or resting at an incline.

Carbonated beverages can be a trigger for acid reflux

Brandy: Exactly. Yeah. It can all help. One other little tip I want to mention is carbonated beverages. You know, that's a trigger that not a lot of people think of, but as we've been talking about like gas production in the stomach from fermented food can push that sphincter open, I think carbonated beverages are doing the same thing. So that could be a common trigger that's overlooked. Do you know of any other diet tips that we haven't covered yet?

Supplement support for acid reflux

Kara: Well, we're going to talk about enzymes now and I have a couple tips as we switch over more to talking about supplements. So supplements can be a key player. You know, we always start with the foundation of food, drink, and then some of the other tips that Brandy and I gave surrounding the eating process.

But one of my go-tos for reflux conditions that specifically are caused by low stomach acid, it's something called Key Digestive Enzymes. So the Key Digestive Enzymes contain enzymes that are going to help break down proteins, carbohydrates and fats. There's also some ox bile, which I know is supportive for liver, gallbladder and intestinal health. And then there's a little bit of HCl, hydrochloric acid.

Brandy: The same thing that’s in your stomach.

Kara: One thing to note is that this betaine hydrochloric acid, again, the same acid that's in your stomach if you have enough, same thing that's in your stomach, that as a supplement could make symptoms worse in some cases. If the valve between the esophagus and the stomach is weak, it could increase that stomach acid and allow it to leak back into the esophagus. So you may notice a burning sensation and more actual reflux symptoms. So this would be, I would say if someone has a diagnosis of Barrett's esophagus or really chronic diagnosed GERD, I don't know that I would recommend taking hydrochloric acid or even digestive enzymes that contain hydrochloric acid, or at least proceed with caution and start really slow.

Maybe just one here and there with a bigger meal. Now that's not to mean that it's not important to have hydrochloric acid. It's just that there may need to be some healing done first and really heal the esophagus and the whole gut and the gut lining before starting to add something like that in. It's kind of a case-by-case basis.

Brandy: Right. And there are digestive enzymes available that do not contain hydrochloric acid, so that could be a bit of a compromise if you want the benefits of getting a little support, a little digestion support without going down the hydrochloric acid route if you're worried that it's going to flare symptoms.

Kara: Absolutely, and we do carry a product by the company Ortho Molecular, and it's called Digestzyme V, and then there's a V like Victor. So that is the digestive enzyme we carry that doesn't have the ox bile or the hydrochloric acid. I guess it's a little bit more of gentle approach, but still has those important enzymes to break down carbohydrates, protein, and fats.

Brandy: That's right. Still very helpful. I think another more gentle approach is digestive bitters. Sometimes that's an alternative that I'll try with clients. Digestive bitters can sort of turn on digestion in the stomach. It can increase your body's own production of stomach acid. So it could be just a gentler approach than just taking some hydrochloric acid.

Other clients I've had have tried a little bit of apple cider vinegar mixed in a little bit of water before a meal. That can also be a little bit of a boost to improve the acidity of your stomach. Both of these options, digestive bitters and apple cider vinegar, they may not be everybody's favorite taste, but they can be an accessible tool to aid digestion.

Kara: Yeah and it's not too bad to get that down. You know, like I like to put a tablespoon of apple cider vinegar in a few ounces of water, just kind of drink it down real quickly. I mean, you can sip on it too, but if you...

Brandy: Some people like the taste.

Kara: Some people do, yeah. But if you don't, you can just kind of take it quickly.

Brandy: Or could even put it in a salad, use it in a salad dressing. It can be part of your meal maybe.

Kara: Actually, that is very tasty. I've done that. If I have clients struggling with reflux, there's another supplement that I really like and people have great success with this. It's called Glutashield and it's a powder. I believe is it chocolate flavored?

Brandy: Chocolate or vanilla.

Kara: Perfect. Okay. And it contains L-glutamine, which is a really important amino acid that we need for healing the gut.

Brandy: Yes.

Kara: It contains aloe, not the form of aloe that can create diarrhea or loose stool. It's different than that. So you don't have to be concerned about that. And it contains a type of licorice. It's called DGL. And I believe it's deglycyrrhized licorice, which I think that means the glycyrrhizin, a component that's naturally occurring in the herb licorice is removed because the glycyrrhizin portion could lead to high blood pressure or it could, it's contraindicated with somebody that has high blood pressure.

Brandy: Ok.

Kara: So just a couple of things to ease people's minds.

Brandy: Yeah. So it's very focused on gut health specifically.

Kara: Yes. It's a formula that is just made to soothe irritated inflamed tissue in the esophagus and the intestinal tract lining. So it kind of adds a protective layer between acid and your delicate tissues. So that's just something I'm a real fan of. Clients really benefit from that.

Brandy: Yeah, I have to agree. I've had really great success with Glutashield. The L-glutamine is helpful on its own, but adding that DGL in there, the aloe can be so soothing for the gut. A lot of reflux protocols often focus on only reducing stomach acid, like we've talked about with the use of antacids or those proton pump inhibitors.

But Glutashield is actually focusing on repairing damage and building resilience in the gut. So it's not going to stop acid production, but it does create I guess a stronger gut barrier.

Another supplement that I'll sometimes recommend for reflux, especially if it's just kind of early phases, it's like more of an occasional issue and hasn't progressed to Barret’s, is a probiotic, acidophilus. That's one of my favorite go-to probiotics for reflux.

Kara: Yeah, acidophilus is great. And I know some people prefer capsules, others prefer powder. I know it comes in both forms. So probiotics are great, replacing beneficial bacteria in the intestinal tract that may have been lost from a round of antibiotics. Or, you know, even the PPIs and the acid blockers, I think can disrupt that microbiome and lead to less beneficial bacteria. So that's a great one.

I also wanted to mention something called DGL chews and DGL again is an ingredient that we talked about that was in the Glutashield, which is a powder form, but you can buy separate DGL or basically it's a form of licorice in chewables. I mean, they're usually kind of like a gummy and they actually have a little bit of natural licorice flavor.

Not the Twizzlers. The actual real herb. But those can be really helpful for just occasional reflux throughout the day and it's a natural remedy. You know, it's not doing what the PPIs and acid blockers are doing. It's really just helping the tissues naturally.

Brandy: That could almost be as needed for a flare up instead of kind of taking a Tums or a Rolaids.

Recap

Kara: Yeah, yeah, it would be a great solution. So as we're wrapping up our podcast today, I would like to just recap the definitions of reflux, GERD, and Barrett's. So again, reflux is when you have just the occasional symptoms, not chronic. Chronic means that you likely have GERD, gastroesophageal reflux disease. And if you have chronic GERD, it could potentially lead to something called Barrett's esophagus, which is an actual physical structural change in the esophagus.

And that makes your risk of esophageal cancer higher. So it's really important to get tested if you suspect that you have GERD or Barrett's or family history, any of the symptoms we talked about today.

Brandy: Yeah, and that can sound kind of scary, but I think the big takeaway from our show today is that we can prevent this. We can turn this around with the right diet, early intervention, maybe even some key supplements to get your gut health back on track.

Kara: Yes, exactly Brandy and removing the processed foods, removing gluten and probably dairy, chewing thoroughly and eating in a calm state and consider using some of the key supplements that we discussed today to support digestion.

Brandy: And if you are battling with reflux, whether you have Barrett’s already, or maybe it's chronic GERD, or maybe it's just a few times a year, but you want to be proactive, working with a dietitian or a nutritionist like Kara or myself is going to help a lot.

We can help you figure out a meal plan that works for you that seems realistic and sustainable. We can determine which supplements are right for you based on where you are. You are not helpless when it comes to reflux, especially if you start early and proactively.

Kara: Our goal at Nutritional Weight & Wellness is to teach people the power of real food and how life-changing it can be. It's a simple but very powerful message. Thank you so much for listening today and please take a moment to share this with anyone that can benefit. Have a great day.

Brandy: Thank you.