Acid reflux is the backward flow of acid into the esophagus. Gastroesophageal Reflux Disease (GERD) is a more severe form of acid reflux. Both of which can cause the burning sensation known as heartburn.

In this article, I cover the lesser known mechanical causes of heartburn. But first, it’s important to note that low stomach acid (hypochlorhydria) is the main culprit of heartburn (which can be related to mechanical issues). Say what?!!! Yep, read on to find out how that could be. By the way, low stomach acid can also be related to mechanical issues, more on that later.

achlorhydria: the condition of which the stomach is producing no stomach acid

hypochlorhydria: insufficient stomach acid
Too Little, or Too Much Acid?
There are different schools of thought on the cause and treatment for heartburn. The mainstream medical model sees the problem as too much acid, which makes sense at first glance. “If I had less damn acid I wouldn’t have this problem!” But, if you look a bit deeper, you may come to the conclusion that you have too little gastric acid. In fact, that’s usually the case. High stomach acid is rare. Insufficient gastric acid production is called hypochlorhydria. When we don’t have enough acid, food sits in the stomach longer and gasses off. As pressure builds the stomach swells and pushes the lower esophageal sphincter (LES) up into the diaphragm. Chronic crowding can cause damage to the sphincter leading to gastric acid splashing into the esophagus creating heartburn. Kind of like when you make kombucha or sauerkraut. Pressure builds in the bottle as the contents ferment. This fermentation process creates pressure on the lid. In my amateur fermenting days, I once had kombucha blow the top right off the bottle and the contents ended up on the ceiling. Imagine the lid of the bottle is your LES and the kombucha is your gastric acid.
As we get older acid production slows down, sometimes as early as 30 years old, yet the common prescription is antacids which lower stomach acid even further! If we don’t have stomach acid we don’t feed ourselves!
Why we need stomach acid:
  • it’s part of our immune response, as it kills bacteria in our food.
  • acid activates pepsin to break down proteins
  • acid helps us absorb vitamins and minerals. If you have insufficient acid you won’t absorb adequate nutrients no matter how good your diet is.
  • acid signals the rest of the digestive tract that food is coming. Each step in digestion relies on the step before for proper functioning.

As always, it’s best to find the source of your acid reflux before taking a drug to fix it. This is not a complete list, but a few less known mechanical issues that can cause excess pressure and tissue strain which may lead to acid reflux. By mechanical I mean relating to, produced by, or dominated by physical forces.

1. Bloating. When the belly is bloated it can prevent the diaphragm from moving comfortably. When the bloated intestines pushes the diaphragm upward, the diaphragm pulls the junction between the esophagus and stomach upward. The negative pressure in the chest cavity attracts acid from the stomach toward the esophagus and causes heartburn. This type of reflux can be remedied by #1 addressing the cause of the bloating (SIBO, parasites, eating too quickly, eating too much, food sensitivities, sitting too much, pelvic and thoracic alignment, low stomach acid) and #2 receiving Visceral Manipulation™. One or both of these approaches may be needed depending on the root cause of the bloating. Visceral Manipulation™ has been known to help decrease bloating via improving organ motility. Visceral Manipulation™ also helps to return proper function to the LES.

2. Hiatal Hernia. A hiatal hernia is when the stomach bulges up into the chest cavity through the hiatus opening in the diaphragm. The Mayo Clinic states that the causes aren’t always known, but possibly could be related to “persistent and intense pressure on the surrounding muscles, such as when coughing, vomiting or straining during a bowel movement, or while lifting heavy objects.” (source)
Perhaps poor alignment is the very reason the coughing, vomiting, straining during bowel movements, and heavy lifting can trigger hernias. We should be able to cough, vomit, and strain once in a while without pushing our organs up and out, or down and out (prolapse), but due to years of poor movement habits we have become less efficient at our natural expelling capabilities. One of those habits is sucking the belly in. Where do you think your organs go when you suck your belly in? See my video demonstration HERE.
There’s also the mechanical displacement of internal organs by corsets. I don’t know how anyone wears corsets. Tight garments make me want to smash things!

3. Hyperkyphosis of the thoracic spine contributes to mechanical problems in the hiatal zone. These are a couple of Alignment Snacks I may recommend as homework to my alignment clients who are working on minimizing or preventing hyperkyphosis. Rhomboid Madness, Can’t Get Enough Shoulders, Everyone Needs a Little Shoulder Bolster, and The Back Bones Are Connected To The Other Back Bones

4. Working consistently with arms overhead when you lack shoulder range of motion. This may be related to #3 because hyperkyphosis and lack of shoulder range of motion are often related. If you lack shoulder range of motion you will displace your entire ribcage to raise your arms over your head. The constant lengthening of the longitudinal fibers of the esophagus decreases the tone of the LES.

5. Retroverted Uterus Say What???? Yeah, when the uterus is tipped back the small intestines can descend and take up space where the uterus should be. This puts a downward drag on the stomach decreasing mobility of the gastroesophageal area. This can eventually degrade the tone of the of the gastroesophageal zone.

6. Obesity from the same upward force mechanism bloating causes

7. Not chewing your food well can cause acid reflux in several ways. Mechanically: Each phase of digestion only works as well as the phase that came before. Guess what? There are no teeth in the stomach! Chewing lubricates your food, mechanically breaks it down and increases the surface area, so the enzymes can do their job effectively. Chemically: Chewing increases digestive enzymes, so that food is broken down making digestion and assimilation smoother and more efficient. Chewing more may be your ticket to eliminating reflux, bloating, gas and abdominal pain! Read more on chewing HERE.

These final two are not technically mechanical, but important not to overlook. Consider it bonus information.

8. Emotions– Stress can slow down the digestion and lead to reflux. Anger, worry, fear, you name it. Be present with your food, don’t talk politics or watch the news during meals. Read more HERE.

9. Pharmaceuticals drugs. Read the possible drug side-effects! Certain medications slow down digestion, irritate the stomach, weaken the cardiac sphincter, cause stomach inflammation.

You may also be interested in my Digestive Health Part 1 article and Digestive Health Part 2.

By the way, trying to find a stock photo for this post has been a challenge. The heartburn stock photos of men have fire shooting from their chests and the women act out pain while trying to remain sexy in their push-up bras and pouty lips. Ain’t no way I’m gonna pay $3 for that crap! So I hired my husband to be my stock photo model. FYI, If you need him for stock photos, he only charges $1 a photo. His specialty is acting out smirks, looks of disgust, overly dramatic martial scenes (sword thrusts, etc.) and constipation.

Russ with heartburn

Russ pretending to have heartburn.

Update: Think twice before treating your heartburn with Proton Pump Inhibitors (acid blockers). Not only because the cause is most likely low stomach acid, but also because acid blockers are linked to many physical ailments.

“It’s not the first time that PPIs have led to health concerns. Their use has been linked to increased rates of fractures, pneumonia, the gut infection C. difficile, and low vitamin B12 and magnesium levels.” Popular heartburn drugs could lead to kidney damage without warning: study

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