More than 2,000 years ago, the Greek physician Hippocrates declared that “all disease begins in the gut.” The cycle of eating, digesting, and elimination goes on day after day, year after year, without us paying much attention until something goes awry. And something often does. More than 30 million Americans have persistent symptoms of gas, bloating, and/or constipation. Another 60 million Americans experience heartburn at least weekly, with 15 million experiencing heartburn daily. Those are big numbers.
Numerous integrative approaches can optimize digestive health, including a glycemic load diet, avoidance of triggers, proper sleep position, as well as optimizing digestion of macronutrients and supporting healthy gut motility, lower esophageal function, and gastric and intestinal barriers.
The following protocol should be offered for eight weeks, and then re-evaluate the patient’s symptoms.
*Occasional heartburn or indigestion.
Pure Encapsulations Melatonin 3 mg
Take 1 to 2 capsules 90 minutes before bed
Pure Encapsulations Digestive Enzymes Ultra
Take 1 to 2 capsules with the main meal of the day
Metagenics Ultraflora Spectrum
Take 1 capsule per day
Rightful Daily Digestive Relief and Repair
Take 1 ounce after main meals and at bedtime if needed
- Recommend that the patient follow a low glycemic load diet to reduce heartburn symptoms. Dietary sugar and high glycemic load diets are more strongly linked to acid reflux than fats.
- Have your patient keep a diet journal to determine what foods/beverages may be triggering their heartburn. These often include alcohol, peppermint, chocolate, deep-fried foods, and spicy foods.
- Instruct the patient not to eat any food or drink carbonated beverages within three hours of bedtime. Instruct patients to sleep on their left side to reduce nocturnal heartburn. Using a body pillow and/or putting blocks under the head of the bed can be helpful.
- Melatonin promotes restorative sleep and supports normal lower esophageal sphincter tone and gastric barrier function.
- Botanicals have long been used for promoting healthy digestion, many of which are supported by modern science. Aloe vera gel, marshmallow root, chamomile flower, deglycyrrhizinated licorice (DGL), and mastic gum are effective botanical demulcents, soothing the esophagus and stomach. Artichoke leaf and amla (Indian gooseberry) are prokinetics, supporting healthy gastric motility while aiding digestion and elimination. Amla supports normal lower esophageal sphincter tone and gastric barrier function. Aloe vera gel, artichoke leaf, and marshmallow root have prebiotic effects, supporting a healthy gut microbiome.
- Digestive enzymes promote the healthy digestion of macronutrients.
- Healing Heartburn Naturally: A Guide to Managing Acid Reflux and Restoring Gut Health by Tieraona Low Dog, MD, is a great resource for practitioners and patients. This eBook is completely referenced with evidence-based recommendations for managing heartburn, tapering protocols for weaning off PPIs, and strategies for supporting patients who must take long-term PPI therapy.
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