Episode 18: Reflux: Understanding Causes & Finding Solutions with Paula Werrett

1 Jul

Healthily | 07/01/21

In this episode, I talk to Paula Werrett, who brings to the conversation her expert knowledge on the many reasons why we might develop reflux, what we should know about it, and how to tackle it. As with so many health issues, the underlying causes for reflux can be multifaceted, which is why I was so keen to share this information with you all. Paula also covers the lesser-known silent reflux, which is incredibly helpful to know about.

We cover stomach acid, but also chat about other, often overlooked, influences on upper digestive health, including pepsin and bile. We discuss the impact of small intestine bacterial overgrowth (or SIBO), and Paula also shares useful information on how the gallbladder, the vagus nerve, hormones, and stress influence symptoms. This episode is honestly packed with so much information!

Paula provides really useful, practical details on the role that diet can play in the management of reflux, touching on dietary regimes such as the low FODMAP diet (including benefits and drawbacks), and foods to support good digestive health.

This is a must-listen for anyone interested in supporting optimal digestive health or looking for more information on how they can manage their symptoms of reflux better.

Please do share with anyone who you think would benefit from listening, and if you find it helpful, please do give it a 5-star rating, as this is so, so helpful for getting the podcast to a wider audience and helping more people. Thank you!

TAKEAWAYs

✔️ Silent Reflux (Laryngopharyngeal Reflux – LPR)

Silent reflux doesn’t always present as heartburn. Common symptoms include:

Chronic cough (especially at night)
Throat irritation or soreness
Constant clearing of mucus
Feeling of a lump in the throat
Swallowing difficulties

Diagnosis is often missed or misattributed; doctors may prescribe acid-blocking medications like omeprazole without deeper investigation.

✔️ Causes of Reflux

Bacterial imbalances:

H. pylori infection (testable via stool or breath test)
Small Intestinal Bacterial Overgrowth (SIBO) can cause fermentation, gas, and upward pressure leading to reflux.

Structural issues:

Weakening of the lower esophageal sphincter with age
Hiatal hernias
Gastroparesis (delayed gastric emptying)

Lifestyle & diet:

High-fat meals, chocolate, coffee, and spicy foods can relax the sphincter
Obesity increases abdominal pressure

Nervous system factors:

Vagus nerve dysfunction affects digestion and reflux

Hormonal influence:

Low estrogen in perimenopause/menopause affects sphincter function
Thyroid imbalances can slow digestion

✔️ The Gallbladder’s Role

Concentrated bile is essential for fat digestion.
Without a gallbladder, bile flows continuously, leading to:

Difficulty digesting fatty foods
Diarrhea
Increased risk of bile reflux and gastritis

Supporting gallbladder function:

Digestive bitters stimulate digestive juices
Bile acid supplements (e.g., ox bile) for those without a gallbladder
Lipotrophic factors (e.g., choline, phosphatidylcholine) help bile flow
Include bitter foods in diet: leafy greens, bitter vegetables

✔️ Supporting the Vagus Nerve & Digestion

Damage or poor function can impair digestive processes.
Healing and support strategies:

Gargling, singing, meditation, relaxation
Mindful eating with proper posture
Meal spacing: 4–5 hours between meals, 12+ hours overnight
Avoid eating before truly hungry

✔️ Dietary Strategies for Reflux & Small Intestine Health

Short-term interventions:

Low-FODMAP diet to reduce bacteria-feeding foods
Avoid over-restricting long-term to protect gut microbiome diversity

Volume control:

Pay attention to cumulative food intake over the day

Trigger foods to manage:

Spicy foods, coffee, citrus, alcohol, high sugar foods
Focus on reducing triggers rather than complete elimination

✔️ General Digestive Wellness

Chew food properly and eat mindfully
Avoid excess fluid with meals
Balance meals to reduce blood sugar spikes and sustain longer periods between meals
Mind-body connection is crucial: stress reduction, mindful anticipation of meals, and respecting hunger cues support digestion

✔️ Key Points:

Silent reflux (LPR) often goes undiagnosed because symptoms differ from classic heartburn.
Digestive issues are multi-layered: bacterial, structural, hormonal, neurological, and dietary factors all interact.
Gallbladder health is central to fat digestion; those without one require targeted support.
Healing the vagus nerve and supporting the gut involves both lifestyle adjustments and dietary strategies.
Short-term, targeted dietary interventions are helpful, but long-term diversity in diet is crucial for gut microbiome health.