What Causes Heartburn?
Heartburn is the burning sensation felt in the chest, usually occurring after a meal. There are many reasons that people experience heartburn, but the overwhelming majority of heartburn felt by Americans is the result of acid reflux caused by failure of the lower esophageal sphincter. But what the heck does that even mean?
Acid reflux occurs when the lower esophageal sphincter (LES), a ring of muscle that separates the stomach from the esophagus, relaxes or weakens and allows stomach acid to flow back up into the esophagus. This can cause a burning sensation in the chest, known as heartburn, as well as other symptoms like sour taste, coughing, wheezing, or difficulty swallowing. Acid reflux is not a life-threatening condition, but it can affect your quality of life and cause discomfort and pain. By understanding what causes acid reflux and how to manage it, you can enjoy your food and your life without worrying about heartburn.
The stomach is an extremely acidic environment. Stomach acid works to break down foods for proper digestion. One component of your stomach acid is something called bile salts, responsible for processing the fat that you eat. When you consume a fatty meal, sometimes our stomach needs a little help to process all of the fat. Traditionally, fatty meals are accompanied by some sort of acid. This acid triggers the production of bile salts, aiding in digestion.
Some common examples of this can be seen in our favorite Mexican cuisine where citrus such as lemon and lime are almost always added to fatty foods. In Southern Europe, wine vinegar and olives are usually consumed with fatty meats. In France, rillettes (a type of cold meat served in its own congealed fat) is always served with cornichons (cucumber pickles). In Argentina, the famous parrillada argentina is accompanied by chimichurri, an acidic sauce usually made with wine vinegar or lemon juice, herbs and olive oil. American barbecue varies greatly by region, but always incorporates an acidic component in the form of bbq sauce, pickles, and mustard/ketchup. Korean barbecue is never served without fermented pickles, most commonly kim chi.
There seems to be an evolutionary reasoning behind what we think tastes good. Most people would agree that the best beverage to accompany a pizza is soda, beer, or wine. All of these beverages have a pH under 4, meaning they are acidic. Too much alcohol can have the opposite effect, but a reasonable amount with a fatty meal can actually aid in digestion by stimulating the production of bile salts and in turn reducing acid reflux. Most traditional and modern remedies for upset stomach include some type of acid as well, including buttermilk and coca cola.
Next time you find yourself with heartburn, think about the meal you previously ate. If it was fatty and didn’t include any acidic component, avoid antacids. They tend to exacerbate the problem. Antacids will calm the burning sensation felt in the esophagus, but hinder the closing of the lower esophageal sphincter, causing the symptoms to persist, usually worsening the condition. Instead of taking an antacid, try a little bit of lemonade or eat an orange. It may sound counterintuitive, but this will stimulate your digestive system into producing the necessary bile salts which will trigger the lower esophageal sphincter to close.
Edibles & the Gut
We all know by now that cannabis can increase appetite. This is, by far, the most common side effect of cannabis on the digestive system. For many, this may lead to the munchies or overeating, but for a medical patient who needs proper nutrition to heal, this is akin to a miracle. Many cancer patients have praised cannabis for helping them to eat and regain their strength during the intense treatments they had to endure. Without the digestive stimulus provided by cannabis, many cancer patients struggle to eat and succumb to malnutrition, making their chance for survival decrease drastically. Food is our best medicine and without it, our body cannot heal itself, no matter how much medical intervention is given.
THC edibles are a popular way of consuming cannabis, but few studies have been done on the effect of them on the digestive system. THC edibles are absorbed through the stomach and intestines, where they interact with cannabinoid receptors. You can read more about the difference between smoking and eating cannabis in our article Incredible Edibles, that’s not the focus of this article.
Cannabis edibles can act like a topical, affecting the membranes it comes in contact with. The same light numbness you feel in your mouth when eating a strong edible can affect each muscle on its way into your bloodstream, including the esophagus and stomach lining. Some of the possible negative effects of THC edibles on digestion, the stomach, esophagus and gut microbiome are:
Delayed gastric emptying: THC edibles can slow down the movement of food from the stomach to the small intestine, which may cause bloating, nausea, or vomiting. This effect may be more pronounced in people with gastroparesis, a condition where the stomach muscles are weakened or damaged.
Reduced esophageal motility: THC edibles can also reduce the contractions of the esophagus, which may impair swallowing and increase the risk of reflux or aspiration. This effect may be more noticeable in people with esophageal disorders such as achalasia or scleroderma.
Weakening of the lower esophageal sphincter: THC edibles can have a numbing effect on the muscles responsible for closing the passage connecting the stomach to the esophagus. This can result in the sphincter remaining open, allowing stomach acid to travel up the esophagus, causing heartburn.
THC edibles may have different effects on different individuals depending on their genetics, metabolism, tolerance, dosage, and type of edible. Generally, light use of edibles poses little risk of adverse effects. However, heavy, long term edible consumption can potentially lead to these issues. Therefore, it is important to consume THC edibles responsibly, especially if you have any pre-existing GI conditions or take any medications that may interact with cannabinoids.
If you are currently experiencing one of the above issues and are consuming edibles daily, we recommend taking a break from the edibles for a couple weeks or even up to a month to allow the digestive system to go back to baseline. After this period, reintroduce the edibles and pay attention to your body. If symptoms go away and then come back once you reintroduce the edibles, you may need to make some adjustments to the way you consume your cannabis.
If symptoms persist during the break and reintroduction, you may have another underlying issue that is completely unrelated to edibles. In this case, we would recommend some of the following:
Avoid excessive alcohol consumption, especially before/during eating.
Avoid lying down or heavy exercise immediately after eating.
When eating a fatty meal, incorporate some kind of natural acid into the meal such as citrus or vinegar. Acid stimulates the production of bile salts (responsible for proper digestion of fat) and helps to trigger the closing of the lower esophageal sphincter. Also, it tastes amazing with fatty foods.
Avoid antacids, as they tend to exacerbate the problem. Antacids will calm the burning sensation felt in the esophagus, but hinder the closing of the lower esophageal sphincter, causing the symptoms to persist, usually worsening the condition.
Cannabis can affect the digestive system in multiple ways, both positive and negative. The effects depend on many factors, such as the dose, strain, route of administration and individual characteristics of the user. Cannabis edibles may be helpful for some digestive disorders or symptoms, but it may also cause or aggravate others. Therefore, it is important to think clearly and do your own thorough research, including consulting with a doctor before using cannabis for any medical purpose.