Episode 15 - Uncovering the causes of Infantile Reflux, GERD and the problems with PPI's - Brigitte Factor Episode 15 - Uncovering the causes of Infantile Reflux, GERD and the problems with PPI's - Brigitte Factor

Welcome back to the Season 2 of the Hungry for Truth Podcast. This season is all about gut health. Episode 15 specifically focuses on a common digestive issue called GERD, also know as reflux. Listen to my personal experience of having a child with infantile reflux, and how I successfully help clients improve digestion and thrive again. I also discuss the potential dangers of using PPI's or proton pump inhibitors and why stomach acid is necessary for optimal gut health.

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References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3576942/
https://www.bmj.com/content/365/bmj.l1580
https://www.ifm.org/news-insights/gut-alternatives-ppis-h2-blockers/
https://pubmed.ncbi.nlm.nih.gov/28899441/

 

Episode 15 Transcript

Brigitte Factor 0:13 Hello, and welcome to the hungry for truth podcast. I'm your host, Brigitte Factor, truth seeker, researcher, scientist, nutritionist, teacher and truth teller. An awakening is coming. Get ready for it. Hello, and welcome back to another season of hungry for truth podcast. I'm really excited to get back to recording some more episodes, I have a lot that I want to share with you this season. And this is going to be a really great series for you. First, I want to give you an update about what's going on with me, when in my world. Well, the legislation that those of us at the Missouri nutrition Alliance have been working on for three years finally passed and is has gone into effect this month, which is really exciting. This is effectively opened the doors for health coaches and nutritionists to practice to their full ability in the state of Missouri. So we have paved a way for this industry to blossom, and I'm so excited for this, God has definitely gone before us and made this happen. I have this note on my whiteboard here, as I'm recording that says he has given us victory. And I wrote that on the whiteboard at the beginning of this journey, believing that he was going to give us victory that he had already given us victory, it was just us too. For us to claim. And so I just want to share that with you. It's really exciting. So I'm really excited about what the future holds. And really excited about what the future holds for this podcast as well. So this season, I'm really going to dive into what my expertise is in which is in gut health. I'm going to be sharing with you why gut health is so central to our overall health and the way that gut health of felt affects other conditions of the body and what that connection is and in ways that you can support your gut health and dig a little deeper into that if you want.

Brigitte Factor 2:43 Today's episode is specifically going to focus on reflux, also known as GERD. And GERD or G-E-R-D stands for gastroesophageal reflux disease. But I want to talk about digestive wellness in general, and really going on with reflux in ways that we can naturally support this. But I want to take you back to a story when my youngest was an infant. This was several years ago back in the time where it took a lot of effort to get everybody in the car to go to the store. And one day we were going to go to the mall. So remember packing the car with a stroller and the diaper bag and trying to get everybody in the car in their car seats buckled in and ready to go. Because we were going to go shopping at the mall. And we were walking through Macy's. And all of a sudden my youngest, who was probably around nine months old at the time, I want to say in that infant range, and just, you know, reflexes or vomits or spews everywhere, all over the floor and not just a little bit but a lot where we have to get somebody to help us clean up the mess because just a few paper towels aren't going to cut it right. And this happened quite frequently. So my youngest really struggled with this infantile reflux for many, many, many months where we took him to get a barium scan of his intestines to see if he had pyloric stenosis because nothing that we were doing was working. And what the doctors were using to try and treat this was a PPI or a proton pump inhibitor. Now this was at a time before I had started studying nutrition formally, and studying how the digestive system works. And I really wasn't sure what was going on. And I was just in this place where I was just trusting the doctor's guidance because I didn't know how to help my son and I could tell he was uncomfortable and knew it wasn't normal because my first son didn't deal with this issue, but what I've learned since then I'm going to share with you because I think it's very powerful. But infantile reflux is typical. It's common among infants. And this is where splitting up peaks around three to four months. Normally, it goes away around six to 12 months. And you're told to just give smaller feedings and burp more frequently. And commonly, the pediatricians will prescribe a PPI. To treat this issue in the way a PPI works, it's a proton pump inhibitor, it turns off the pumps that produce stomach acid in the stomach in a way to lower the amount of stomach acids that is there in hopes that that doesn't cause them to basically bubble over and spit it back up problem with this is that there's very little evidence for using PPIs and infants. And there is evidence of the potential harm that this could cause downstream. And I want to go through that today's so I want to share a little bit of the research that we have now just to give you a glimpse into this.

Brigitte Factor 6:17 These are some quotes from this journal called the Canadian family physician. And this journal is looking at some of the review articles that have been done on PPI use and infants and how it has affected GERD symptoms and crying and irritability and reduction of gastric acidity. So reducing the acids in the stomach. And here it's looking at a systematic review, including five placebo-controlled studies and infants looking at PPI's and concluded that they were not effective in reducing GERD symptoms of feeding-related crying or infant irritability. And the conclusion that the authors have is the use of PPIs. In the management of infants with excessive crying, based on a presumptive diagnosis of GERD remains a common practice among pediatric caregivers, despite the lack of any evidence-based treatment, efficacy or utility in these patients. So we have evidence in the literature, showing that there's not a significant reduction in symptoms from the use of these PPIs in infants.

Brigitte Factor 7:31 So the question remains, why are they using this as a treatment? And I honestly think that they're just trying to do what they can to see what works. And for some people there they notice a difference. I'm not saying that some people haven't experienced results from using PPIs in this case, but when you look at the data as a whole, there is a significant benefit from this approach. And it completely misses the question of why is this happening. So I want to give a quick overview of how our digestive system is supposed to work. And the understanding of why stomach acid is important not just to be able to digest your food, but for many other reasons as well. And so when you take a bite of food and you begin chewing it, your stomach is preparing to take in that food you start that I always say the digestive process starts in the brain because your brain is what is signaling the stomach juices to start being produced. So chewing your food slowly giving your body time to respond to produce those juices. You have some enzymes in your saliva that help start break down carbohydrates, you swallow that food, it goes into your stomach, and then your stomach is producing these digestive juices that contain hydrochloric acid which is very acidic, as well as pepsin, which is an enzyme that breaks down protein and some other things as well. If there isn't enough stomach acid present, the pepsin does not get activated because the pepsin has to be activated at a very low pH our stomach is designed to be at a very low pH. And if you're not producing enough stomach acid and you're not activating the pepsin, then you're not properly breaking down the proteins in the stomach. Also, the acidity of your digestive juices are what we call chyme, once it mixes with the food in the stomach is what triggers the release of the contents of the stomach to move into the small intestine which then triggers another cascade of digestive juices to be released from the pancreas including your digestive enzymes and some bicarbonate. So yes, when someone takes some proton pump inhibitor to reduce the production of stomach acid that can temporarily reduce the amount of reflux someone may be experiencing. But then that begs the question, if stomach acid is so important for the process of digestion, what happens when we shut that down. And that's what I want to dig into.

Brigitte Factor 10:29 So the British Medical Journal published an article called the estimates of all cause mortality and cause-specific mortality associated with proton pump inhibitors among us veterans. And so this particular study is analyzing the outcomes, the health outcomes of people that are using PPIs for a long period of time. And what they found was that taking PPIs is associated with an increase of specific mortality, including death due to cardiovascular disease, chronic kidney disease and upper gastrointestinal cancer. This is a result of long-term use of shutting down your digestive system is there's downstream effects that can occur. And I have personally witnessed in clients other things that have resulted in the use of ppis, especially in children, ranging from nutrient deficiencies, being diagnosed with failure to thrive, I've seen that happen a few times where the child is put on a proton pump inhibitor to help deal with the reflux and the colic and the crying, and then all of a sudden, they stop growing. And it's because they're not able to properly absorb the nutrients that their body needs. So there's these downstream effects. And one of the downstream effects is systemic inflammation or inflammation that is circulating throughout the body because of the deterioration of gut health as a result of shutting down the digestive system. So if you are a parent, like I was, where your child is suffering, and you're looking for ways to help them, and you're desperate for answers, because you want to ease the suffering, and stop the constant reflux and spit up, that was happening, which, by the way, absolutely destroyed our carpets, and we had to replace them after that. But, you know, what do you do? How do you get to the bottom of this, and it wasn't, until after my son started to grow out of this and recover from this issue that I really dug into learning how the digestive system works. And, you know, realize that there were a lot of things I could have done differently. And so that's just the that's just life, you know, you live and you learn and you move on. But I want to share some of the things in hopes that it's helpful to you. And what actually contributes to reflux. Well, one thing is just immature digestion, baby's digestive systems are still developing, still forming, still learning to function. And so there is that piece of it as well.

Brigitte Factor 13:27 Now, commonly, we're told that there is LES dysfunction or lower esophageal sphincter dysfunction, and that's the little muscle that sits at the bottom of the esophagus, on top of the stomach that closes once food passes through to keep it in the stomach and keep it from coming up into the esophagus. So when that sphincter is not working properly, and it opens back up, then the contents of the stomach can leak through up into the esophagus and then out. And so this is commonly why people experience heartburn too, because the contents of the stomach are very acidic, which our stomach is designed to be acidic, it has this mucosal layer that protects it from the acid. But our esophagus is not designed to be acidic. So we actually feel that burning when that material that chyme comes back up into the esophagus. And so if that sphincter isn't working, then that can happen. Well, then, that still leaves us with the question of why isn't that sphincter working. And again, some of it could be just the immature digestive system learning to develop or waiting to develop because a child's gastrointestinal tract isn't fully developed and fully sealed until about 2, 18 months to two years of age. So this is why you don't give children certain foods until a certain age as well.

Brigitte Factor 15:03 So, but other contributors, and this is what's true, in my case, our food sensitivities, both for mom and baby. And I'll go into that in just a little bit, as well as dysbiosis. And dysbiosis refers to an imbalance of the gut bacteria in the digestive tract, we are more bacteria than we are human, we have more bacteria in and on our bodies. And we do humans, I've talked about that before. So we have a lot of bacteria in our digestive system that plays many, many roles, which I will spend future episodes discussing those roles and why it's so important. But when we have an imbalance of those bacteria, that leads to problems that can lead to leaky gut inflammation, which can also eventually lead to food sensitivities. Well, a baby gets their first dose of good bacteria or beneficial bacteria from their mother as they move through the birth canal. And that inoculates their gut to start that process. So a baby, you know, if you remember, or have had have children or around children, they like to put lots of things in their mouths, that's a way of them sensing the world, but it's also a way to inoculate their system to help establish that gut flora. And so babies get their gut flora, their start with our gut flora from mom. So if mom has dysbiosis, that imbalance can potentially be transferred to the baby as well. Also, in my case, if the baby is born via c-section, then the baby is missing out on that first inoculation and is actually being inoculated from the medical staff that are handling the child in the beginning because the baby's not passing through that birth canal to get that, so dysbiosis can set in place starting at birth. And that's why one of the questions I ask all of my clients is about their birth, you know, how are they born? What happened around their birth. The other thing that can contribute to this dysbiosis is the use of antibiotics, which is becoming more and more frequent. And so the child has an ear infection, or sinus infection or some kind of other issue. Antibiotics are frequently prescribed, antibiotics will wipe out all of the bacteria. But just like when you weed your garden, that creates open space for more weeds to come in unless you plant something in its place. So that creates again, this open space for dysbiosis to set in. So you know anti-biotics are a frequent contributor to this. And antibiotics can also contribute to pyloric stenosis, and pyloric stenosis is where there's this twist in the intestines that causes projectile vomiting in children. So this is rare and only happens with one 500 children, mainly boys. But there are studies showing a link to a rethrow myosin use, which is an antibiotic used for ear infections to the prevalence of pyloric stenosis. So there's a link there. Again, going back to that dysbiosis formula feeding can also further exacerbate dysbiosis because the baby's not breastfeeding. And then maternal stress. So when mom is stressed, that stress can be translated to the gut and create dysbiosis and then that dysbiosis can be then translated to the baby as well. So those are different things that can contribute to this dysbiosis and as well as food sensitivities. So food sensitivities again result in a child from part of that's from the immature digestive tract, part of that is from this dysbiosis that can occur that allows the body or the gut to be more reactive to certain foods. And that can all lead to this reflux that is occurring this inflammation and reflux in the digestive system.

Brigitte Factor 19:41 So the way that I help my clients address these issues is to bring balance back to the gut bacteria to support natural digestive function with the right nutrients, things like vitamin B 12 and zinc. Zinc is very key to being able to grow and use enough stomach acid, as well as different things that you can bring in to help support the motility of the digestive tract as well. And also to remove those foods that baby is sensitive to or that mom is sensitive to, especially if she's breastfeeding. Because those inflammatory compounds that are produced in response to mom being sensitive to the food can be passed on to the baby through the breast milk. This is all stuff that I didn't know at the time that my youngest was dealing with these issues. And that that I learned about after the fact, you know, and you have that moment of frustration of why didn't I know this? Why didn't my doctor know this. So that is why I'm sharing this information with you in hopes that it helps you along your journey, or you can share it with someone that is experiencing the same challenges and looking for references or ways to support them. So I just kind of want to summarize that stomach acid is important, you're supposed to have it in the right places. And if it starts refluxing out of the stomach, asking the question, why is this happening instead of just trying to shut it down. PPI's are not approved for long-term use. So really digging into why is this happening and getting to the root cause is going to help with long-term resolution of this issue as well as overall improvement of your digestive and gut health. And also, you are not taking on the additional risk of what can happen or what's been linked with long-term PPI use. Again, some of those risks include nutrient deficiencies in children and adults failure to thrive in children, increased risk of bone fractures, kidney disease, cardiovascular disease, depression, and other mental health conditions and there's even an increased risk of catching pneumonia. I will put references to these research articles in the show notes so you can link to them and look at them.

Brigitte Factor 22:18 And if reflux is something that you are struggling with, or that your child is struggling with really digging deep and asking the right questions as to why this is happening, what could be contributing to it, working with a functionally minded or trained practitioner. And in the functional nutrition world, and the protocol that I use to approach this issue is called the five R protocol. And it starts with removing anything that can be irritating to the digestive tract, you know, removing those foods that you're sensitive to, or the child is sensitive to. And then replacing the nutrients necessary for good digestive function. Zinc is a common one that is needed that I see. And you also want to rebalance or repopulate the gut with good gut bacteria. So bringing in those fermented foods and sources of probiotics, as well as bringing in food and nutrients that help support the lining of the gut and reduce the inflammation. And then the fifth R of this protocol, which is often overlooked is the lifestyle factors which we call rebalance. Rebalancing those lifestyle factors like sleep, and stress and exercise. Because poor sleep, lots of stress and improper exercise can all contribute to dysbiosis and gut inflammation. I have seen great success with my clients taking this approach, I have helped children that were dealing with reflux or stomach pain or being diagnosed with failure to thrive, to get back on track and start thriving, again without pain, so that they can be the happy, healthy children that they're designed to be.

Brigitte Factor 24:10 I hope you have found this information helpful. Again, I will post links to resources in the show notes so you can research this, I also invite you to join my free online community at the authentic table. And that's at authentictable.mn.co. It's a mighty network community. And it's free to join where I share tips and tricks and recipes and ways for families to get on board with adopting a real food lifestyle. And I do workshops every now and then as well. So it's a great free resource for you to connect with other people and to connect with myself as well. So check that out. I'll put a link to this in the show notes as well. And then look forward to other episodes. Subscribe to this podcast because I have more episodes on gut health and the gut immune connection and ways to support gut health in immune health coming up, so you'll want to be notified of those episodes. And thank you so much for listening. Until next time, Grace and peace to you.

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