Category: Digestion

Heartburn and Discontinuing Acid Blocking Medication

Why Do We Need Strong Stomach Acid? 

  • Essential in absorbing certain nutrients, such as protein, vitamin B-12, and minerals 
  • Kills bacteria and other pathogens in the stomach to prevent infection 
  • Acid blocking medication increases risk of osteoporosis and fractures, pneumonia, Clostridium difficile and other gastrointestinal infections, vitamin B12 deficiency anemia, chronic kidney disease, and dementia.   

Five steps to fixing your heartburn:   

  1. Manage symptoms 
  2. Identify causes of heartburn 
  3. Change diet and lifestyle factors 
  4. Repair stomach lining, look for infection, and support a healthy microbiome 
  5. Wean medication slowly 

Step 1 – Manage symptoms 

At first, if you are on an acid blocking medicine stay on the lowest dose you can tolerate.  To treat occasional breakthrough heartburn symptoms, choose one at time from this list:  

  • Chew 2 DGL wafers (this black licorice wafer also helps heal stomach so its good to chew 2 three times a day regardless of symptoms) 
  • Chew two Tums 
  • Drink 2 dissolved Alka-Seltzer 
  • Drink baking soda in water (1 teaspoon baking soda in 4 ounces of room temperature water) or plain seltzer water 

Step 2 – Identify causes of heartburn 

  1. Hiatal hernia (diaphragm dysfunction, belly fat) 
  2. Infection – H. Pylori 
  3. Gastric acid over-secretion and under-secretion both can create heartburn 
  4. Hypersensitivity to a normal amount of acid (lack of mucus in stomach) 
  5. Pancreatic insufficiency (digestive enzymes) 
  6. SIBO – Small Intestinal Bacterial Overgrowth 
  7. Stress, improper breathing, posture, spinal alignment 
  8. Diet and Lifestyle – see step 3 

Step 3 – Change diet and lifestyle 

Start with “low hanging fruit” – things that are relatively easy. Eliminate as many of these as you can.   

  • Acid foods such as citrus and tomatoes 
  • Alcohol  
  • Caffeinated products 
  • Chocolate 
  • Dehydration 
  • Eating quickly and unconsciously, not chewing 
  • Eating too close to bedtime  
  • Fatty foods 
  • Food sensitivities – Consider testing (wheat & dairy?) 
  • Overeating 
  • Raw vegetables in excessive amounts 
  • Smoking 
  • Spicy foods 
  • Sugar are refined carbohydrates 
  • Tannins in black tea 
  • Wearing restrictive clothing 

Step 4 – Repair the stomach lining, look for infection, support a healthy microbiome 

Your doctor will create an individualized protocol based on your symptoms, history, and lab testing.   

Step 5 – Weaning medication slowly 

Go slow – this process will take weeks or months and depends a lot on steps 1 – 4.  Stopping your medication abruptly can cause rebound acid hypersecretion.   

If you are on a PPI, in collaboration with your doctor, you will wean the dose and frequency of the PPI first, then you’ll switch to an H2 blocker then wean it slowly.   

H2 Blockers – partially stop stomach acid secretion 
– nizatidine (Axid) 
– famotidine (Pepcid, Pepcid AC) 
– cimetidine (Tagamet, Tagamet HB) 
– ranitidine (Zantac)   
PPI – almost completely stop stomach acid secretion 
– omeprazole (Prilosec, Prilosec OTC, Zegerid) 
– lansoprazole (Prevacid) 
– pantoprazole (Protonix) 
– rabeprazole (Aciphex) 
– esomeprazole (Nexium) 
– dexlansoprazole (Dexilant) 

When your digestive enzymes and/or hydrochloric acid are low 

Heartburn symptoms can happen from having low digestive juices – both hydrochloric acid from your stomach, digestive enzymes from your small intestines and pancreas, and bile from the gallbladder.  People low in digestive juices can have not only heartburn but often bloating, feeling overly full, abdominal pain, and other digestive symptoms.   

Your doctor can test for and explore the use of digestive enzymes, bile, hydrochloric acid capsules, and the proper use of apple cider vinegar and digestive bitters.   

Relaxation Therapy with Deep Breathing Reduces Heartburn Symptoms 

Do not underestimate the impact of stress on your digestive tract! 

Your Lower Esophageal Sphincter (LES), the muscle at the top of the stomach that closes when the stomach is digesting is affected by stress.  When it doesn’t close at the right time (during digestion), it allows acid to reflux up into the esophagus.  In a study, deep breathing exercises decreased severity and frequency of reflux episodes.  

The LES, and the rest of your digestion, is controlled by the vagus nerve, an important part of the gut-brain connection.  The vagus nerve controls the rest-and-digest side of your nervous system which in turn balances the flight-and-flight part of our nervous system.   

Take many moments each day to check in with your breathing.  Work on only breathing through your nose.  Practice a slightly slower exhale to calm your vagus nerve.  Check in with your posture’s effect on your breathing and diaphragm.  Get up, stretch your ribs and back.  Do a few twists or even better take a yoga class!   

Read more about heartburn from Dr. Haynes: 

PPIs and Dementia Risk

Proton pump inhibitors, or PPIs, are a common heartburn relief medicine.  Some examples are Omeprazole (Prilosec), Famotidine (Pepcid) and Pantoprazole (Protonix). While they can be helpful in the short-term, long-term use can throw a wrench in the digestive process. PPIs don’t correct the original problem but mask it while the underlying destructive processes continues.

New Link with Dementia

And now, a new study[1] found that people who used proton pump inhibitors (PPIs) for more than 4.4 cumulative years were at a 33% higher risk of developing dementia than those reporting no use.

Previous studies showed mixed results in regards to PPIs and dementia but didn’t study cumulative use. This study used 5,712 dementia-free participants (58% were women) and the median follow up was 5.5 years and studied cumulative use. There were no significant associations for shorter times of PPI use.

While we need more studies to understand what the relationship is between dementia and cumulative PPI use, it is important to heal your gut now and help prevent this occurring to you or a loved one that may be on chronic PPI use.

What are Some Causes of Heartburn?

Naturopathic medicine shines at correcting underlying issues and can help you address the cause of your symptoms.

Eating an improper diet, having a hiatal hernia which allows acid to be where it’s not meant to be, stress, lack of optimal GI health (lack of enzymes, acid, chewing food, etc.), etc.

Read More

Here is another article on our web page from with helpful information:

Heartburn -Get relief with naturopathic medicine on our web page.

Feel free to contact Boise Natural Health for a free 15 min consult or to set up your appointment with Dr. Nicole Maxwell.   

[1] Northuis C, Bell E, Lutsey P, George KM, Gottesman RF, Mosley TH, Whitsel EA, Lakshminarayan K. Cumulative Use of Proton Pump Inhibitors and Risk of Dementia: The Atherosclerosis Risk in Communities Study. Neurology. 2023 Aug 9:10.1212/WNL.0000000000207747. doi: 10.1212/WNL.0000000000207747. Epub ahead of print. PMID: 37558503.

Is it IBS or SIBO?  A New Look at Old Symptoms

It has been estimated that 60-70% of people diagnosed with IBS instead have SIBO (Small Intestine Bacterial Overgrowth). Common symptoms of SIBO are bloating, gas, constipation, diarrhea, restless leg syndrome, interstitial cystitis, brain fog, increasing food sensitivities, hair loss, and anemia.  Sometimes we think of SIBO when patients report that the more fiber and healthy foods they eat, the worse their bloating and gas is or if they try to eat onions or garlic, its like a bomb went off.

What is SIBO?

Simply put, Small Intestine Bacterial Overgrowth is a chronic bacterial infection of the small intestine. The bacteria that normally reside in the large intestine have abnormally grown in the small intestine.

Why is Overgrowth Bad?

The small intestine is made to absorb our nutrients and food but is not made to tolerate bacteria. As bacteria grow in the small intestine, they cause inflammation to the small intestine lining as well as they get first dibs on all our nutrients before we can absorb them. The bacteria also emit gas as they feed on our nutrients. This leads to increasing food sensitivities, deficiencies of iron and B12, increased gas and bloating, and changes in your bowel movements.

What causes SIBO?

We aren’t completely sure of the cause of SIBO; however, we do know that certain conditions are likely to result in SIBO. Any condition that slows the movement of the GI system (constipation, hypothyroid, surgeries, antibiotics, etc) can make the conditions ripe for SIBO to occur. Another common cause is food poisoning.

How do we Test?

In the past, testing was not as reliable or complete as it is now. There are 3 types of SIBO: hydrogen, methane, or hydrogen sulfide. You can have only one type, or up to all three! There is now a test that can look for all 3 types of SIBO, called TrioSmart. You drink a lactulose solution and then blow into small bags every 15-20 minutes for 2 hours. TrioSmart then measures the amount of the 3 gasses in your breath and gives us results.

How do we Treat?

SIBO is treated by in a stepwise fashion: kill the bacteria in the small intestine, ensure motility of the GI system and do our best to prevent relapse, and then repopulate if needed.

Oftentimes a combination of a unique antibiotic (Rifaximin) plus herbs has the best outcomes. Some herbs often used are oil of oregano, garlic extract, berberines, and multiple others. Treatment protocols usually last 1-3 months, depending on severity and how long these symptoms have been present. Then we shift to relapse prevention and motility via herbs and diet.

Info from,, 2020 Advanced Application in Medical Practice conference

Did you know you are a Super Organism?

Every day we carry around 10 times more microbial cells than our own.  As Dr. George Weinstock, professor of microbial genomics says, “You’re not just a human, you’re a kind of super organism because you’re a community of all these things that are with you your whole life”.

Our microbial partners carry out a number of metabolic reactions that are necessary for human health like:

  • harvest energy from foods
  • improve gut motility and function
  • reinforce our gut barrier
  • protect against pathogens
  • synthesize vitamins, hormones, and amino acids
  • influence our brain, liver, kidney, skin and vaginal tract function
  • and much more!

Due to innovations in testing, we can now identify the microbial communities, their genes, and use that information in helping people return to health.  At Boise Natural Health we can test for over 50 different microbes that inhabit your GI tract and review them with you.

Here are two easy ways you can start feeding your good gut bugs now and keep that super organism that is you functioning optimally!

1. Feed your bugs resistant starches.  Resistant starches increase our beneficial population and increases short chain fatty acids – food for the good gut bugs.

  • Oats. Oats are one of the most convenient ways to add resistant starch to your diet.
  • Cooked and cooled rice. Resistant starch amount increases over time.
  • Beans and legumes. Soaked and heated.
  • Raw potato starch. 1 tbsp a day in smoothie or overnight oats. Don’t heat.
  • Cooked and cooled potatoes. Don’t reheat – think salad.
  • Green bananas. Replaced with simple sugars as they ripen.

2. Eat a phytonutrient rich diet!  In other words, like mom said, eat your vegetables.  Go for a rainbow of colors at two of your meals. If you’re an omnivore, consider going vegan for two nights of the week or more.  Check out the recipe section on our website or these other websites: and

For more help keeping your super organism healthy, feel free to schedule a free 15-minute consult at Boise Natural Health Clinic.

Test Your Gut Microbiome with a Simple Stool Sample

By Joan Haynes, NMD

Your unique make up of the bacteria, viruses, protozoa, and fungus that compromise your microbiome have a profound effect on how you digest food, fight disease, and even your mood and behavior.  The GI MAP test offered by Diagnostic Solutions provides an easy and affordable way to understand what may be growing inside you.  

Some of the conditions and symptoms associated with a disturbed microbiome:

  • Abdominal pain
  • Asthma
  • Autism Spectrum Disorder
  • Autoimmune conditions
  • Bloating
  • Cancer
  • Chrohn’s disease
  • Constipation
  • Depression/Anxiety
  • Diabetes
  • Diarrhea
  • Eczema
  • Food sensitivities and allergies
  • Frequent illness
  • Gastritis
  • Gastroesophageal reflux
  • Hormonal imbalance
  • Inflammatory bowel disease (IBD)
  • Irritable bowel syndrome (IBS)
  • Obesity
  • Small intestinal bacterial overgrowth
  • Ulcer
  • Ulcerative colitis

If you think you may have an imbalance in your microbiome, consider testing.  Learn more about the GI MAP test see a sample test here.

Just as important as running the test is knowing what to do with the results:

Our naturopathic medical doctors at Boise Natural Health Clinic have been extensively trained in interpretation and treatment of altered gut microbiomes.   If you would like to be tested, just call and we’ll set you up for an appointment.

The Carroll Food Intolerance Test

By Nicole Maxwell, NMD

The Carroll Food Intolerance test, also known as FIT, helps us to understand the digestive and metabolic capacity of a patient’s body by identifying foods that are not compatible with their system.  

The History: Dr. Carroll practiced from 1917 to 1962 in Spokane, WA.  He was a busy and successful naturopath, however he couldn’t help his chronically ill son Bill.  In his search for better treatment methods, he learned about the work of Stanford physician, Dr. Albert Abrams who had been experimenting with new diagnostic techniques.  Dr. Carroll modified Dr. Abrams’ work to devise the FIT. Dr. Carroll discovered that his son was intolerant to fruit, removed fruit from his son’s diet, and for the first time his son recovered.  The FIT as devised by Dr. Carroll is similar, in some respects, to the bioelectronics testing of Voll, from which many biofeedback mechanisms have evolved.

What is it testing? This new method evaluates foods that are not well digested or metabolized by the body.  Those foods become a source of dysbiosis and can lead to inadequate breakdown of food, intestinal toxemia, and chronic irritation of the body tissues.  Dysbiosis means an imbalance between the types of organisms present in a person’s natural microflora, especially that of the gut, thought to contribute to a range of conditions of ill health.

Diagnosis? The Carroll test does not diagnose a disease, nor does it diagnose an allergy.  It is a determination of a patient’s incompatibility with food groups or combinations of those food groups.

The nitty gritty: A sample of blood is collected and evaluation is done using a specific electric circuit exposed to various foods in contact with a reagent. Fluctuations in the current are detected. Most people evaluated intolerant to one of the following foods or food categories: milk, egg, meat, sugar, fruit, grain and potato. In addition, he discovered that most people had a problem with one or more combinations of food, similarly not well tolerated.*

It works! I have used the Carroll food intolerance test for the last 17 years and have had great success.  I estimate 95% of my patients experience significant improvement when following their results. Do you experience a variety of health complaints and are unable to figure out why?  Do you seem to have multiple food intolerances from other food sensitivity testing or from observation? The Carroll Food Intolerance Test is often the game changer for people to help resolve a variety of complaints, heal their gut to be able to eat more foods, or lessen the load on the body so that the body can move toward health more easily.

We over this modality at Boise Natural Health Clinic to help you have optimal digestion and health.


Heartburn – Get Relief with Naturopathic Medicine

by Joan Haynes, NMD

Up at night with heartburn?  Worried about the side effects of acid blocking prescriptions?  Learn what other options you can explore to tame the discomfort and optimize your digestion and thereby your overall health.

Conventional medicine offers patients little insight into the cause of heartburn and instead puts a band aid on the problem by prescribing stomach acid-blocking medications such as Pepcid and Nexium.  Often patients take these medications for many years, leading to nutritional deficiencies and diseases such as osteoporosis and dementia. There are other options. 

Here are factors your naturopathic physician considers in patients with heartburn:

  • Evaluate food and lifestyle factors
  • Improve digestion
    • Consider enzymes, bitters, bile acids
    • Asses stress reduction needs
  • Correct nutritional deficiencies
  • Screen for gallbladder and pancreatic problems
  • Soothe and repair inflamed tissue with natural remedies
  • Screen for H. pylori and dysbiosis – imbalance in the gut flora
  • Evaluate for hiatal hernia
  • Promote smoking cessation if needed
  • Evaluate if weight loss is needed
  • Screen for more serious diseases such as ulcers or inflammation in esophagus

Reducing or eliminating acid blocking medications can be uncomfortable and even impossible without laying the proper foundation for healing.   It often helps to get professional help through the many variables – the naturopathic physicians at Boise Natural Health Clinic can all help navigate your way to pain-free digestion. 

Follow Your Gut: The Enormous Impact of Tiny Microbes by Rob Knight

What I’m Reading

by Joan Haynes, NMD

This little TED book, written for a non-medical audience, is an engaging explanation of the ground-breaking science in the last few years about the microscopic life within our bodies.  It’s a quick read to help us understand how these tiny creatures play a role in nearly all aspects of our health.

Rob Knight is the Director of the Microbiome Initiative at the University of California, San Diego and the co-founder of the American Gut Project and the Earth Microbiome Project.  He wrote the book with science journalist Brendan Buhler to explain why these new findings matter to everyone.  You can also watch Knight’s TED talk at

As you may have heard before, there are 10 times more microbe cells in our body than human cells.  The average adult is carrying about three pounds of microbes – roughly the weight of your brain.  Knight explains how different sets of species inhabit different parts of the body, where they play specialized roles.

Knight also explains how new technology makes identifying the microbes easier.  Here is a sample copy of the stool test we’ve been running in the clinic with great results:  GI-MAP DNA Stool Analysis.  For just a few hundred dollars, we get a report looking for pathogenic microorganisms (bacterial, viral, and fungal/yeast) as well as the healthy population of bacteria.  Also included are useful gut function measures that look for inflammation, immunity, leaky gut and more.

Harboring Bad Bacteria, Parasites or other Pathogens?

By Joan Haynes, NMD

I’ve been trying out a new test on patients for that last year with great results. I’ve helped diagnose Giardia in a 2-year case of diarrhea after cancer treatment, a little boy with failure to thrive with C. diff, and a Lyme patient with Microsporidia. These results are exciting
because when I first began my practice almost 20 years ago, the only way we could test for pathogens in the gastrointestinal tract was a culture which left up to 50% of the bacterial species undetectable. I hardly ever ran tests looking for a microbe because it was so expensive and inconclusive. Now we have access to new and affordable testing using DNA, which has transformed the field of microbiology, making diagnosis much easier.

Paraphrased from the lab’s web page: The Gastrointestinal Microbial Assay Plus (GI-MAP) was designed to assess a patient’s microbiome from a single stool sample, with particular attention to microbes that may be disturbing normal microbial balance and that may contribute to illness. The panel is a comprehensive collection of microbial targets as well as immune and digestive markers. It screens for pathogenic bacteria, commensal (friendly) bacteria, opportunistic pathogens, fungi, viruses, and parasites.

If you are harboring pathogens, you might have some of the following symptoms:

Gastrointestinal symptoms:

Abdominal pain

Crohn’s disease
Food poisoning
Gastric cancer
Gastroesophageal reflux
Irritable bowel syndrome
Small intestinal bacterial overgrowth (SIBO)
Ulcerative colitis

Autoimmune conditions:

Ankylosing spondylitis
Reactive and Rheumatoid arthritis
Thyroiditis (Hashimoto’s, Grave’s)

Allergic Disease:


If you think you might have an imbalance in your microbiome, consider testing.  Look at a sample test here.   The Diagnostic Solutions Lab will bill your insurance with a deposit.

What is a “Leaky Gut”?

By Dr. Joan Haynes, NMD

“Leaky gut” is also known as “increased intestinal permeability”.  Our intestinal tract is a semipermeable membrane, allowing very small molecules through in order to absorb nutrients.  Inflammation causes more permeability in the lining of the gastrointestinal tract and incompletely digested food particles, toxins, and waste get through into the blood stream.  The immune system then has the task of dealing with those invaders and can result in a variety of symptoms.

leaky gut

Causes of Leaky Gut:

  1. Stress and age
  2. Infection or imbalance of the microorganisms in the gastrointestinal tract
  3. Irritation from chronic constipation
  4. Overuse of non-steroidal anti-inflammatory drugs (NSAIDs) like asprin and ibuprophen (Advil)
  5. Food intolerances, particularly gluten
  6. Pro-inflammatory foods such as alcohol, sugar, and highly processed foods

Symptoms of Leaky Gut:

  1. Digestive issues that might be labeled as irritable bowel syndrome (IBS) such as gas, bloating, discomfort, diarrhea.
  2. Seasonal allergies, chronic sinus congestion, asthma
  3. Autoimmune diseases such as rheumatoid arthritis, Hashimoto’s thyroiditis, lupus, etc
  4. Chronic fatigue syndrome
  5. Chronic achiness, arthritis, fibromyalgia
  6. Chronic headaches
  7. Mood issues such as depression, anxiety, ADD, ADHD, mental fogginess
  8. Skin issues such as acne, rosacea, eczema, psoriasis
  9. Food sensitivities and intolerances
  10. Difficulty losing weight

Possible Testing for Leaky Gut:

There is no definitive testing, so often we are using clinic symptoms and history to help diagnosis. Sometimes though we need more information and one or more of these labs can be useful:

  1. Food sensitivity testing can be useful – if more than a couple of foods show up positive on an IgG blood test, leaky gut is strongly suspected.
  2. Stool testing for gastrointestinal infections.
  3. Lactulose and mannitol test. The patient drinks a premeasured amount of these non-metabolized sugars and the degree of permeability is reflected in the levels of the sugars recovered in a urine sample collected over the next 6 hours.

How to Heal a Leaky Gut:

  1. Diet – sometimes a general anti-inflammatory diet is enough, but other times people need to identify and remove specific food intolerances using a formal elimination-rechallenge program or food sensitivity testing through a blood test. See Are Foods Causing Your Symptoms.
  2. Sometimes using digestive enzymes or hydrochloric acid (to be used cautiously) can help breakdown foods into smaller particles.
  3. The amino acid L-glutamine is useful to heal the gut which is often given with other herbs and nutrients. At BNH we often use a Metagenics product called is UltraInflammX, a medical food shake high in glutamine, easy to assimilate protein, carbs and healthy fat, along with nutrients and anti-inflammatory herbs such as turmeric, ginger and rosemary.
  4. Bone broths and green vegetable drinks are useful for easy nutrient assimilation.
  5. Probiotics and fermented foods.
  6. Stress reduction if needed. See What is Adrenal Fatigue.