Dr. Dominique Vanier, ND
Episode Summary
What causes acid reflux and heartburn — and is GERD always caused by too much stomach acid?
In this episode of Girls Gone Wellness, naturopathic doctor Dr. Dominique Vanier, ND joins Victoria and Jeanette for a detailed discussion about gastroesophageal reflux disease (GERD), heartburn, acid reflux, regurgitation, proton pump inhibitors (PPIs), H. pylori, reflux hypersensitivity, functional heartburn, diet and natural treatment options.
Dr. Vanier begins by explaining the difference between heartburn, regurgitation, acid reflux and GERD. GERD is a chronic upper gastrointestinal condition in which stomach contents reflux into the esophagus often enough to cause troublesome symptoms or tissue damage. Heartburn and regurgitation are two of its most common symptoms.
The episode also explores the different GERD phenotypes, including erosive esophagitis, non-erosive reflux disease (NERD), functional heartburn and reflux hypersensitivity. Dr. Vanier explains that some people have visible esophageal damage, while others experience reflux symptoms without structural damage. In some cases, symptoms may be related to altered pain perception or sensitization within the gut-brain axis rather than excessive acid exposure alone.
A major theme of the episode is the misconception that low stomach acid causes GERD. Dr. Vanier explains that she and colleagues reviewed the research and did not find evidence supporting low stomach acid as a recognized cause of GERD. She also discusses why routinely treating reflux by adding hydrochloric acid is not a standard evidence-based approach.
The conversation also examines proton pump inhibitors (PPIs) such as pantoprazole. Dr. Vanier explains when PPIs are clinically appropriate, how they are commonly used as an initial GERD treatment, and why proper timing matters. She also discusses concerns with unnecessary long-term PPI use, including possible associations with small intestinal bacterial overgrowth (SIBO), changes in the gut microbiome, C. difficile infection, low vitamin B12, low magnesium and bone health.
The episode then turns to H. pylori, a stomach bacterium associated with gastric ulcers and stomach cancer risk. Dr. Vanier discusses the complicated relationship between H. pylori and GERD, how H. pylori is tested, and why conventional eradication therapy remains the most evidence-supported approach when treatment is indicated.
Food and lifestyle are also major topics. Do you need to cut out coffee, chocolate, spicy foods, tomatoes, citrus or alcohol if you have reflux? Dr. Vanier explains that some foods are more likely to aggravate reflux symptoms, but reactions are highly individual. She cautions against broad, long-term elimination diets and emphasizes the importance of eventually reintroducing foods when appropriate.
The episode also covers stress and acid reflux, eating before bed, elevating the head of the bed, dietary fat, probiotics, demulcent herbs such as deglycyrrhizinated licorice and slippery elm, acupuncture and the gut-brain connection.
For anyone experiencing chronic heartburn, acid reflux or regurgitation — or wondering whether they really need to eliminate foods, take supplements or stay on a PPI indefinitely — this episode breaks down what the research actually says and why reflux treatment needs to be individualized.
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What is GERD?
GERD stands for gastroesophageal reflux disease, a chronic condition in which stomach contents repeatedly move upward into the esophagus and cause troublesome symptoms or tissue damage. Common symptoms include heartburn and regurgitation.
Is heartburn the same thing as GERD?
Not exactly. Heartburn is a symptom, while GERD is a chronic gastrointestinal disorder. Someone can experience occasional heartburn without meeting the criteria for GERD.
What is the difference between acid reflux and GERD?
Acid reflux describes the movement of stomach contents upward into the esophagus, while GERD refers to chronic or recurrent reflux that causes significant symptoms or complications. The term “acid reflux” is often used casually to describe GERD symptoms.
What is non-erosive reflux disease (NERD)?
Non-erosive reflux disease, or NERD, is GERD without visible esophageal injury on endoscopy. A person can still experience classic reflux symptoms even though no erosions are seen during a scope.
What is functional heartburn?
Functional heartburn is a disorder of gut-brain interaction in which someone experiences heartburn symptoms without evidence that abnormal acid exposure is causing the symptoms. Altered sensory processing or heightened esophageal sensitivity may play a role.
What is reflux hypersensitivity?
Reflux hypersensitivity occurs when normal reflux events are perceived as unusually uncomfortable or painful. Someone may have normal amounts of reflux but experience symptoms more intensely because of sensitization in the gut-brain system.
Can GERD be caused by low stomach acid?
The episode strongly challenges this claim. Dr. Vanier explains that she did not find research supporting low stomach acid as an established cause of GERD, and increasing stomach acid is not a standard evidence-based treatment for reflux.
Should I take hydrochloric acid for acid reflux?
Not routinely. Dr. Vanier explains that adding hydrochloric acid is not a standard recommendation for GERD, particularly because the common claim that reflux is caused by low stomach acid is not well supported by research.
What are PPIs and how do they treat GERD?
Proton pump inhibitors, or PPIs, reduce stomach acid production. They are commonly prescribed for GERD, peptic ulcer disease and H. pylori treatment and are often used as an initial eight-week trial for chronic heartburn or regurgitation.
When should a PPI be taken?
Dr. Vanier explains that PPIs are generally most effective when taken 30 to 60 minutes before a meal, often before breakfast. Taking them incorrectly may reduce how well they work.
Are PPIs safe to take long term?
PPIs can be appropriate long term in some situations, but they should not automatically be continued indefinitely. Dr. Vanier discusses potential concerns associated with longer-term use, including changes in the gut microbiome, SIBO risk, C. difficile infection, low vitamin B12, low magnesium and possible effects on bone health.
Can PPIs cause SIBO?
Long-term acid suppression may increase the risk of small intestinal bacterial overgrowth (SIBO) in some people. Dr. Vanier discusses this as one reason why patients on long-term PPIs should be periodically reassessed.
What is H. pylori?
Helicobacter pylori, or H. pylori, is a bacterium that can live in the stomach lining. It is associated with peptic ulcer disease and an increased risk of gastric cancer in some individuals.
Does H. pylori cause GERD?
The relationship is complicated. Dr. Vanier explains that research does not show a simple direct relationship and that some studies have found H. pylori infection to be less common in people with GERD.
How is H. pylori tested?
Testing may include breath testing, blood testing or biopsy during an upper endoscopy. The most appropriate test depends on the person's clinical situation.
Can H. pylori be treated naturally?
Dr. Vanier explains that she has not seen strong enough evidence showing that natural therapies can reliably match standard eradication therapy in terms of long-term clearance and clinical outcomes. When eradication is indicated, conventional antibiotic-based treatment remains the most evidence-supported option discussed in the episode.
Do I need to avoid coffee if I have GERD?
Not necessarily. Research on coffee and GERD is inconsistent, and Dr. Vanier emphasizes that food triggers vary substantially between individuals. If coffee reliably worsens symptoms, reducing it may be helpful, but universal avoidance is not necessary.
What foods commonly trigger acid reflux?
Foods commonly associated with reflux symptoms include high-fat foods, chocolate, citrus, tomato-based foods and spicy foods. However, the episode emphasizes that not every person with GERD reacts to the same foods.
Should I do an elimination diet for GERD?
Not routinely. Dr. Vanier cautions against removing large numbers of foods unnecessarily and recommends a more individualized approach based on specific, reproducible triggers.
Can I eventually reintroduce foods that trigger reflux?
Often, yes. The episode discusses temporarily reducing a specific food when it consistently causes symptoms and then attempting a gradual reintroduction later, rather than assuming the food must be avoided forever.
Can stress make acid reflux worse?
Yes. Stress may exacerbate GERD and reflux symptoms, particularly through the gut-brain connection and heightened symptom sensitivity. Stress management may therefore be one component of a broader reflux treatment plan.
Does eating before bed make acid reflux worse?
It can. Dr. Vanier discusses leaving approximately two to three hours between eating and going to bed, especially for people who experience nighttime reflux symptoms.
Does elevating the head of the bed help GERD?
Yes, it may help some people with nighttime reflux. Elevating the upper body or using a wedge pillow is a common lifestyle strategy discussed in the episode.
Can probiotics help acid reflux?
Possibly, but the research is not definitive. Dr. Vanier explains that probiotics are highly strain-specific and may be more useful in certain individuals, particularly when gut-brain interaction or microbiome changes are part of the clinical picture.
What herbs may help with acid reflux?
The episode discusses demulcent herbs such as deglycyrrhizinated licorice and slippery elm. These herbs may help soothe and support the upper gastrointestinal lining, but Dr. Vanier emphasizes that they should be used as part of a broader individualized treatment plan rather than as the only intervention.
Does an alkaline diet cure GERD?
No. Dr. Vanier describes this as an oversimplification. Some people may feel better when reducing highly acidic or personally triggering foods, but there is not a universal “alkalizing diet” that treats GERD.
Is acid reflux caused by eating too much sugar?
Not necessarily. Dr. Vanier rejects the idea that sugar alone explains GERD, emphasizing that reflux is influenced by multiple anatomical, physiological, dietary and nervous-system factors.
Can pregnancy cause acid reflux?
Yes. Pregnancy can increase reflux because of increased abdominal pressure and anatomical changes. GERD and heartburn are common during pregnancy.
Can obesity increase the risk of GERD?
Increased abdominal pressure associated with obesity may contribute to reflux. Dr. Vanier discusses this as one of several physiological factors that can increase the likelihood of GERD symptoms.
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This transcript has been edited for clarity and readability while preserving the substance of the conversation.
Jeanette
Welcome Dr. Vanier thank you so much for being here today.
Dominique Vanier
Thank you for having me I'm super excited to talk about this topic today.
Jeanette
Yes, we are so excited to have you on today. to talk about gastroesophageal reflux disease or what others may know as heartburn I think this is such a common condition to the point where we've almost normalized it as a society I find that people. We'll have symptoms of reflex or heartburn and they'll just take an acid whenever they have it and they'll go about their day as if everything is kind of okay and I don't think we talk about it or think about it much more than that. But we have some great options on treatment and management of symptoms. So I'm excited to talk about that all today.
Dominique Vanier
Yeah, absolutely.
Victoria
Let's start with having you just tell us a little bit about what made you interested in gut Health specifically.
Dominique Vanier
Okay, yeah, that's a good question I love talking about this. So my I mean my main focus in practices is all things digestion. from well I see a lot of irritable bowel syndrome I see lots of gastroesophageal reflux disease to Crohn's colitis celiac. My journey with GI really started when I was in my early twenty s I you know started experiencing adverse digestive symptoms right? at the end of university which I later found out is actually pretty common. Ah for women to be diagnosed with GI issues around that age. I was I was. Later diagnosed with IBS I had seen two GI specialists I'd seen a lot of other specialists.
All tests were normal as is the case with IBS. and so that led me to you know change my career around eventually to become a naturopathic doctor with a GI focus. I also have. Really strong family history of digestive issues. So like this is not new to me because I have like primary siblings parents cousins that all have digestive issues and most recently a year ago. my daughter who was one at that time she was a few weeks old. Started experiencing projectile vomiting which was misdiagnosed as Colic when really she had pretty significant reflex as a baby so that's a probably a good segue into this topic where like I you know eat breathe.
All things GI like whether it's with my life or with or with work and I have lots to say on the topic.
Victoria
Yeah, it sounds like ah I know for us we've talked about this quite a bit in our field and you definitely relate? when we have our own experience in something. It makes us passionate and I think it makes us better doctors. But it's funny how you had this passion for gut Health and then you had this experience with your daughter and how it's nice that at least you were equipped to work with that right.
Dominique Vanier
Absolutely right? like working in Healthcare and especially in this area you know, made me realize that initial diagnosis was incorrect. So. And even like reading the research right about Reflux in infants like it I felt very privileged to have that underlying knowledge to figure out what to do at that point. Yeah.
Jeanette
Definitely. Okay, so as I mentioned before this episode is all about heartburn acid Reflux and GERD. However, these terms are used interchangeably a lot So I want you to clarify here are these the same thing or what are they.
Dominique Vanier
So really by definition. There's there's 2 symptoms of GERD and that is heartburn and regurGItation. I would say like acid reflux is not actually the medical the medical name Although it's GERD is really commonly referred to as acid reflux especially like when discussing this with patients and so but truly like the 2 the 2 terms according to you know ACG guidelines American College of Gastroenterology is heartburn and the regurGItation. So yeah, it can be confusing. But once you get the lingo down. It's it's pretty straightforward.
Victoria
It's funny because when I told a couple of friends of mine that are not in medicine that were doing an episode on GERD and I was telling friends that actually do struggle with this kind of Symptom picture. They were like what the heck is that and you sometimes forgot that we use these terms. But. It's not like it's not obvious to other people what they are and I've noticed that I use GERD interchangeably and it's just we just started clinic a few weeks ago and I'm just now remembering like oh this is literally different thing right? and there's also a million different.
Dominique Vanier
The land is. Bright. Yeah.
Victoria
Phenotypes of Gerd is what I'm now learning specifically from your work. I would love if you can talk a little bit about those different phenotypes in my head I'm thinking of things like that like Erosive Esophageitis or one that I always laugh at NERD.
Dominique Vanier
Present.
Victoria
Or even just like the disorders have got brain interaction that sort of thing.
Dominique Vanier
Yeah, yeah, absolutely yeah, yeah, I will say like there's a lot more research now that's starting to divide these areas. which is which is good and I think that's probably where a lot of like the complexity of the confusion can lie. And maybe I'll start off by the actual definition of GERD so GERD. It's a chronic upper GI disorder that develops when the stomach contents will reflux into the oesophagus for 2 like with 2 different factors happening either in inappropriate amounts or inappropriate frequency. and then that's going to result in like troublesome symptoms or even like corrosive issues.
and so we can kind of we can divide that into 4 areas. so we've got like your erosion which is called erosive esophaGItis that's where again we have an inappropriate acid and but we're going to have. Some sort of visible damage when somebody has a scope. Okay, so like this type of damage that we can see on scopes is going to is what's going to be like the differentiator between erosive esophaGItis and other types of GERD. And when you said NERDs. So that's the non-erosive reflex disease so that's where somebody's going to have these typical symptoms. but they're not going to have any visible injury or damage when somebody has the scope.
Victoria
Is you.
Dominique Vanier
So that's more on one side of the spectrum and now we have a lot more like attention and awareness that's being drawn to what we call issues of like sensitization or perception. Where there's no damage. Anatomically there's nothing wrong, but somebody can still experience these acid reflux regurGItation type of symptoms and that's where we have this functional heartburn reflux hypersensitivity. And so again, this is on the other end of the spectrum for what I just talked about a second ago and those are now underneath the umbrella of what's called disorders of gut-brain interaction and so.
I know this can be complex and really like it does it does trickle down into the patient. Ah population is complex because some patients will respond well to medication some don't respond at all some respond really well to naturopathic treatments some don't at all and then we can also see like this layering effect. Which again like is just kind of it's just all on top of each other Sometimes we have an IBS picture on top of reflex heartburn regurGItation right? So looking at the person in front of you as well as like really identifying what's causing somebody's reflex heartburn regurGItation is.
Pretty important on how to navigate the path forward with them.
Victoria
Definitely I'm thinking about how we've learned the physical exams that we should be doing on patients who present with symptoms like that apply to GERD and I'm thinking of things like checking for erosion in the mouth for example and now.
Dominique Vanier
In here. The head is that.
Victoria
I'm starting to question of course maybe that could be something that we might see but now I'm wondering with these like disorders of the gut-brain or non-erosive issues like we're We're not going to see those signs and symptoms and how many patients are just kind of being brushed off.
Dominique Vanier
Right? Well and you know like again research is a bit early here but they're starting to be able to divide like what percentage of patients actually have true GERD and which ones have the issue of Alter perception two thirds.
Victoria
If they don't fit that.
Dominique Vanier
Are now in the category of altered perception. So that's referring to this these functional type of reflux conditions the functional heartburn and the reflux hypersensitivity. So if 66% of the patients you see presenting in clinic are actually more of an issue of like the sensitization piece than yo. We're not. We're not going to see. That erosion in the mouth when we're doing physical exams right? Yeah yes, yes.
Jeanette
That makes so much that makes so much sense like as you mentioned before because there's so many different phenotypes and why some people will respond some people won't respond and it makes it so much more important that you need to find a practitioner who is aware of all these different kind of phenotypes.
Victoria
Wow! yes.
Jeanette
You can get the correct treatment because as a patient if you have NERD but you're treated for GERD right? That could be quite frustrating if you've gone down all of those other avenues but you're just not finding the right treatment right.
Dominique Vanier
Yeah, and NERD is still underneath the category of true GERD. But it's where there's no like damage that they see on a scope and certainly like some patients with NERD won't necessarily respond to PPIs Although most of the time they will. So again, it's it's yes, like to your point exactly as we do want to make sure that. The practitioner is probably like gut focused right? because then they're they're immersed in the research they know what to how to navigate the next steps forward if somebody's still having symptoms or even if they want to get off their medication What that looks like right? yeah.
Jeanette
Definitely.
Victoria
Yeah, oh my goodness I'm already like mind blown right now we just started this episode. There's so many things that we didn't know I feel like this is just so good that we're we're starting off with this. I yep.
Dominique Vanier
Yeah, well I wilson to like another point there. It's at the canadian guidelines for GERD are from 2004 so they are 20 years old like with our episode right now is in 2024 right and they haven't been updated.
Victoria
Oh wow.
Jeanette
While.
Victoria
Oh my gosh.
Dominique Vanier
They don't they don't reflect even like the updated guidelines for the disorders gut-brain interaction how to navigate that and they use like the own old rome criteria. so you know ah the us though like the us guidelines were updated two years ago but certainly like it's.
Victoria
Right.
Dominique Vanier
It's not just like in schooling right? like even just the guidelines themselves are not keeping up with like what this massive body of research is showing.
Victoria
Yeah, we talked about this a little bit with Dr. Kim Bretz just about how we feel kind of unequipped to be dealing with this stuff and she told us that gastroenteroloGIsts are also feeling this way like we're not really being taught enough about this new and emerGIng. Research I mean and is it even really that new like it if it hasn't been updated in that long.
Dominique Vanier
Yeah, yeah, yeah, and that's that's a good point right? It's just yeah, the integration is just you know needs to come along a little bit quicker. But yeah.
Victoria
Yeah.
Dominique Vanier
To your to your point? Yes, absolutely right? Like I think I know what Dr Kim was referencing like they've done some surveys of gastroenteroloGIsts I think in the U K and possibly in Canada the us too of just their comfort. Their comfort level of dealing with disorders of gut-brain interaction and practice. and this is absolutely an area where naturopathic medicine. Can help because we have the time right? We have you know we have We have the tools. Yeah.
Victoria
I love that I think that's really exciting for our career. there's another topic that I think anyone who deals with gastrointestinal upset of any kind if they had to Dr Google they're going to see a lot about.
Dominique Vanier
Yeah, yeah, me too.
Victoria
H. pylori or H. pylori correct me if I'm saying it wrong? but I know a lot of people know what this is because they've done their own their own kind of research on it and I'm wondering if there's a connection between H. pylori and GERD because we know that it's that kind of burning in the stomach. Is there a link between the 2.
Dominique Vanier
That's a really good question. I will say that it's like the rest of gut health. It's it's complex. there may be some sort of inverse relationship there isn't a direct relationship at least that we've seen in the in the research.
Victoria
Yeah.
Dominique Vanier
We know that the prevalence of H. pylori infection at least in ah like some at least 1 systematic review. So the prevalence of H. pylori infection is significantly lower in patients with compared to without GERD. Okay, so patients with GERD less likely to have H. pylori infection. There may there may be some sort of like protective effect. that GERD provides we're not. We're not actually sure some other research showed that H. pylori Eradication may lead to the development of new erosive gerrd. So once we get rid of H. pylori we then may see the onset of GERD. So it can be a bit confusing.
Victoria
Oh.
Dominique Vanier
I Like to think of them as pretty separate at least at this point in time. but like you know, certainly like with H. pylori if somebody does have H. pylori. the universal like global guidelines say that so they need to be treated in order to reduce their risk of gastric cancer.
Victoria
Right.
Dominique Vanier
However, people are not being tested at least in Canada Unless they're presenting with symptoms which would then warrant testing right? Yeah.
Victoria
Right? Ok because that was my follow up question. You know, do you think that H. pylori always needs to be treated even in a patient. Let's say that doesn't present with these signs and symptoms of damage.
Dominique Vanier
Yeah, it's interesting right? Like I mean well one I'm evidence based and I tend to really lend on the guidelines. but there's a play I think it's in Korea and I will do a shadow to my colleague. Dr Christina Carru she's done a lot of like further investigation in this area on H. pylori.
Victoria
Yeah.
Dominique Vanier
But there's because she's referenced this or she looked at this research and there's a place in Korea where now they are like preemptively screening individuals as they enter adulthood for H. pylori so they may or may not have symptoms that doesn't matter and that's reducing I think gastric cancer. prevalence. Just by virtue of just treating so different jurisdictions in the world are taking different approaches to this? but certainly like if somebody does have the symptoms and they do test positive in Canada I would say yes the triple the quadruple therapy is what we want to do and we will deal with if there's any dysbiosis.
This that happens after that. Yeah and I will say oh I will say too like anytime somebody's going for an endoscopy I know we didn't really touch much on that with them with how we actually diagnose gerrd.
Victoria
Yeah, that makes sense.
Jeanette
That's interesting. That's good. Sorry go ahead.
Dominique Vanier
Maybe I'll segue to that and then we'll come back to H. pylori how is GERD diagnosed. We GIve them an eight week PPI trial and if they're still having issues or if there's more alarm symptoms and we'll send them for a scope which is through the mouth into the stomach in the first part of the small intestine. And then at that point they're going to take a biopsy right? So they can see on the biopsy whether somebody has an H. pylori infection which is one way of testing for H. pylori often. Family doctors will possibly start with a blood test or the or they'll do the breath test which is a little bit more accurate.
And but then if somebody's going for a scope Anyway, they're going to Biopsy and they're going to see does this person have H. pylori living in their stomach.
Jeanette
Okay, that is good to know because I know sometimes depending on who you talk to some SayHPylori is like a commensal. It can be left alone. Some people say like no matter what treat it. So it's good to know that there are some guidelines out there. with regard to treating that. I just have one.
Dominique Vanier
With me.
Jeanette
Question as well regards to H. pylori because I know everyone talks about H. pylori online and social media is there anything naturopathically or like supplement-wise that you can do to eradicate H. pylori or is it the antibody route that you kind of have to go through. Because there's a lot of misinformation on that.
Dominique Vanier
I would say there is no research that I have seen that makes me feel confident regarding the eradication regarding the long-term eradication regarding the recurrence rates and regarding the reduced risk in some sort of outcome that we are trying to control. We absolutely do not have that research. And we don't have that research compared to the standard treatment which is your triple or your quadruple Therapy. So like as a practitioner. Yes, so there's certainly options Available. What's what's the best option for that patient I say that's more of an individually individualized based treatment but also.
Like the confidence is just really not there at least from my perspective on the options available just because if we are trying to reduce. Let's say like some sort of risk of Gastric cancer. Maybe they have a family health history there I'm much more inclined to go down the convention Hole. Avenue right? and support what their family doctor would be recommending to them.
Jeanette
Definitely when you talk about it like that's definitely not something to mess with for sure. so I know you talked about PPIs quickly. there's a lot of negative talk about PPIs on the internet as you're quite aware of. Do they have a time in the place and are we prescribing and taking them correctly.
Dominique Vanier
So maybe I'll start with the like the clear clinical indications for PPI if somebody has peptic uler ulcer disease. if they have like you know an n set so or like an Advil n set associated ulcer. In the eradication of H. pylori absolutely like that PPI is going to make that antibiotic so much more effective and actually like it brings out the H. pylori when we use it a PPI. So like I know a lot of people don't want to don't necessarily want to use that the PPI the acid blocker in their therapy but it. It makes the therapy really effective.
and then of course and inured so but yes, PPIs ah are now like it's pretty much in ingredientances that they are being overprescribed. so there like there is a time and a place they are actually quite effective right? like that this is. This is the empirical treatment as in like without testing and somebody presents with chronic regurGItation and heartburn somebody is going to be GIven an eight week trial of a PPI often pantoprazole. That's the most common one that's prescribed at which point reevaluation should occur. It's that point that reevaluation point that doesn't.
Necessarily always happen in clinical practice where you'll end up seeing patients that have been on a PPI for like five years ten years and nobody really reevaluated whether they should still be on it. They may have had an endoscopy that showed. No.
Victoria
Ah.
Dominique Vanier
Esophageal damage right? which again increases their likelihood of being able to come off of a PPI or they may not even had an endoscopy in which in which point like you know when would a scope be indicated at that point. So you know a lot of now the guidelines including like the american guidelines that just came out two years ago are acknowledGIng that PPIs are overprescribed and that there is no universal recommendation on when the PPI should be stopped.
They say it's somewhere between eight weeks to six months And that somebody should be GIven that opportunity to stop it unless they have significant damage which would have been identified previously.
Victoria
It's interesting and you did touch on this because I was thinking it as you were talking about it. A lot of times you'll hear people say that they went to either their family doctor or a walking clinic especially in Ontario lots of probably walking clinic visits. for this kind of acid reflux picture. And they're GIven a PPI and then they're not really told the next steps. So. It's good to know that this that this actually is standard of care. This is normal. This is actually helpful. but it's interesting because is there.
I Guess anything wrong with taking them too long like when does it become concerning if the doctor especially a walk-in doctor is not following up.
Dominique Vanier
Right? Yeah, I actually did like I did a deep dive into this research at the end of last year when I presented to a bunch of my colleagues on this topic and so yes, we can. We can start seeing some issues more long term right? like. PPIs do increase the risk of SIBO like trueSIBO small intestinal bacterial overgrowth because they can actually start to change the way. The bacteria is in the small intestine so we may see another issue arise at some point. there. There seems to be some research where it can Affect. Somebody's bone mineral density being on PPI's long-term which may increase their fracture risk.
we know that it can shift some of the bacteria in the large intestine so somebody is actually at increased risk of C. difficile if they're on PPI's long term. We know it may affect there B12 Absorption. It may cause hypomagnesemia which is low Magnesium. You know there's a few other things right there like the research again is not amazing here but like even if you just look at the Us guidelines. It does start to talk about some of these adverse potential effects like. That could happen when somebody's on a PPI long term. So. So yeah, and of course we don't want those things to happen right?
So if somebody doesn't need to be on this medication for a long time. then they don't need. They know they should be working with their practitioner to figure out a way to come off of them.
Jeanette
B. And I know we talked earlier about disorders of gut-brain interaction and how like Reflux can play a role in that. So if someone is on a PPI and they're still experiencing those symptoms would that like increase your suspicion for that type of disorder.
Dominique Vanier
That's a really good question. Maybe right like we want to kind of go through a little bit of an algorithm there a lot of patients don't even take their PPI properly. Yeah, a lot of them. Don't take it 30 to 60 minutes before breakfast they may take it after a meal it is. It is absolutely most effective and supposed to be taken before meal and I actually I should have prefaced this way earlier. PPIs are not in the scope of naturopathic doctors on Ontario. So if you're listening to this, go talk to your family doctor or your GI specialist.
Victoria
I will. Right.
Dominique Vanier
But you know one of the things with naturopathic doctors at least here where we're regulated Ontario is that like we those that have that have completed their prescribing extra prescribing certificate are knowledgeable at that about these areas. So certainly like I'm asking patients if they're on a proton pump inhibitor when are you taking it right. sometimes patients are offered like a double dose right? like there's there's kind of ways to figure out is it is it truly that somebody's not responding to it. Could it be that they need a double dose.
you know the guidelines say if somebody has tried 2 PPIs GIving them a third is not actually going to make them. But like dramatically or maGIcally start to respond right? So people are typically GIven to and then it's like that's like next step in the algorithm. What should we be doing next? patients with disorders of gut-brain interaction may or may not respond to PPIs and that's where it is very confusing. Because it doesn't make sense right? If This is an issue of like perception or sensitization where we're just feeling those acid events much more acutely even though they're normal acid events compared to somebody else.
then you would think that like you know GIving a PPI like.
Victoria
And then.
Dominique Vanier
Maybe wouldn't help them right because it's just an issue of perception but they again like these people may or may not respond to a PPI. and so you know at that point like maybe they would do something called Ph monitoring test which is done through like your GI specialist but it can be just. Can be complex because it's really not this clear black and white. Do this blood test and determine if you have like a functional GI disorder or a disorder of gut-brain interaction with your stomach with reflux.
Jeanette
There's so many layers to this where it's really not black and white as you mentioned crazy. I know again on social media which is the complete opposite of what we're talking about with PPIs and their mechanism of action. But for some reason.
Dominique Vanier
You know.
Jeanette
There's this huge talk about how low stomach acid causes Heartburn symptoms So is there any research to support that low stomach acid causes this or too high stomach acid or what's going on there.
Dominique Vanier
Love how you've asked me this question so my colleagues and I at the end of last year and we presented to like 700 clinicians on this topic. Not 1 research paper not 1 Not one said that there's said that low stomach acid is a cause of GERD.
Victoria
Oh.
Dominique Vanier
Like full stop and I know it's pretty common on social media and even in like you know in wellness professions right? to say like well maybe you have low stomach acid. what we do know is that taking a PPI which then.
Victoria
Wow.
Dominique Vanier
Causes like lower stomach acid by definition. It's going to suppress your stomach acid may shift like the microbiome in the small intestine right? like I mentioned before we may see like that increased risk of small intestinal bacterial overgrowth but to treat somebody with GERD by GIving them more. Acid. Let's say like Hydrochloric acid is generally not a recommendation. There are so many other ways to be supporting that person. Yeah.
Victoria
Wow, that's so unbelievable that there's not 1 single paper like where did we get that from and we just take it and run with it just like so many other misconceptions in the whole health and wellness fields.
Jeanette
Very interesting.
Victoria
Sometimes like Jeanette and I will be researching something and we're like oh my goodness like there's not 1 single thing that tells us this and all of us have just taken it to heart. It's so that's why I'm glad like we have people like you on her podcast who can really kind of set. Set it straight for us because it's so easy to kind of fall down the rabbit hole of Google and of blogs and just kind of ignore the fact that we don't have the research to support those things. I did want to move into the conversation of elimination diets and food and how.
Dominique Vanier
For sure.
Victoria
What we're eating might be impacting us is it impacting us. so on our episode with Dr. Bretz we talked a little a little bit about how elimination diets maybe aren't that necessary in most cases but Jeanette and I were wondering with a condition like this where you hear people say you know spicy foods chocolate acidic foods. Are you know triggers for this condition. Do you do elimination diets. Do you recommend the removal of these foods.
Dominique Vanier
It's interesting, right? and I know what like I'm pretty sure I know what? Dr came was saying and but we've we've had a lot of discussions like over. Say the last five years where patients with IBS patients underneath the umbrella of disorders of gut-brainin interaction that we are always on this like path to find that next food. Maybe it's this next food. Maybe if I take out this other food. Okay, then what let's look at this other food and take it out and take it out.
Victoria
You can.
Dominique Vanier
And like I joke around where like your food is just going to taste like cardboard eventually. where it's it's not it's not 1 year and you're going to have no enjoyment. You're not going to want to go out with your friends and then so on and so forth right? Like Dr You know Dr. Bretz It calls it like whack-a-mole where it's like all these all these small changes that I'm making to my life on the on the quest and the path of feeling better. We actually change our quality of life. So substantially by the end of it that the quality of life decreases and that includes like just cutting out all these foods when it comes to when it comes to true.
GERD. Yes, there are some foods that are more likely to aggravate somebody's symptoms like we know that through the research but we also know it just in all the like you know thousands of conversations I've had with patients. you know ones that are like chocolate high and fat much more likely to aggravate somebody's symptoms like so aggravate the regurGItation aggravate the heartburn. The citrus, the spicy, the tomato. interestingly coffee like maybe not so we have like at least 50 studies done on coffee and GERD some have found no difference. some have found a reduction like it's pretty..
It's just inconclusive or you know, kind of conflicting. even with alcohol like a lot of people say that they have aggravations with alcohol. but then some studies have showed that like when they've were reintroduced alcohol. It didn't recouse symptoms like it's just it's a bit confusing right? So I'd say like this is more on a personalized basis. Somebody's.
Victoria
Ah.
Dominique Vanier
Reactions to food will be different than the next person's who's been diagnosed the same condition. But when you look at the like the functional issues of perception with acid reflux right? So the disorders of gut-brain interaction side of things. I am not a big fan of elimination diets in there because it can. It can really increase the risk of disordered eating patterns. We know that through the research from irritable bowel syndrome and other disorders of gut-brain interaction and it's not the cause of the condition. So while we are more likely to see reactions to food.
We also have to think about how the brain is communicating to the gut and I know Dr. Brat's probably talked about like it's it's an issue of but like miscommunication right? or the what like the sensitization or the wires are just kind of they're mis miswiring.
Victoria
Right.
Dominique Vanier
We want to think about like what are the other mechanisms here and can we focus on that a little bit more than just cutting somebody's food like totally out of their diet forever.
Victoria
Ah, Definitely I like that you mentioned that it's personalized too because I mean for me I don't I don't have GERD I wouldn't say I have GERD. But I notice especially during exam season and I can't tell you if it's stress or if it's like the 10 plus coffees I'm consuming a day. But I know at some point in that day like I have that cup of coffee and I'm like oh God I should have stopped at the last one because I get that kind of feeling of acid reflux but it's interesting. It's just kind of a person to person thing and I do definitely want to touch on the stress piece and if that's related. soon.
Dominique Vanier
Right? yeah. Is.
Victoria
But I did want to ask just on this topic if there is something where a patient feels like for example, every time they drink a carbonated beverage. They get that kind of feeling or spicy foods is it something that you should maybe just kind of reduce or take out of your diet just that one single food. Like could we do it from that perspective and then could they eventually add those foods back in or is that something that like no, that's always going to trigger you.
Dominique Vanier
For sure for sure, right? like and I have that conversation all the time where it's like if you know that food is bothering you and that's and we can like really drill down on that one food. Yeah take it out for a little bit and again there's no. I think I've said this like maybe 3 times already. There's no like universal research guidelines that agree on how long something should be taken out of the diet. again, it's totally individualized, but as a.
Victoria
Yes.
Jeanette
Yeah.
Victoria
And so.
Dominique Vanier
Personally as a practitioner I Always come back to that food at some point in the future and see if we can re-ad it back in. Can we re-ad it back in smaller volumes. Can we read? We add it back in twice a day every second day twice a week like what's that going to look like because somebody's enjoyment of their diet is really important for their quality of life. And I don't want to be that person to take that away from them.
but I will say like if it's one food like let's say it's carbonated a carbonated drink like most of the time people are okay with taking that 1 thing out when we talk about taking out gluten and dairy and soy and nightshades. And coffee and all the things. Yeah, that's a little bit extreme. Yes, for sure I'm in that category too.
Victoria
Yeah, ah. Yeah, it's too much for me Honestly I would rather deal with some acid reflux than get rid of coffee but that's just me.
Jeanette
Okay, so we talked about individualizing the diet a lot but I'm just curious as well. Is there kind of like a genetic picture or like an anatomical picture that would predispose someone to more Reflux events.
Victoria
Ah.
Dominique Vanier
You know from Anatomy Standpoint or like physiology you can think about. anytime we have like kind of space occupying mass pressing up such as pregnancy or obesity we're more likely to have reflux and I will say when I was pregnant. Oh my God I was having the most.
Victoria
And. Yeah.
Dominique Vanier
The most number of timess that I was able to have like just poPPIng them through the night is off. It was just awful and certainly like you know ger reflex in pregnancy is really common. and then go back to your question again I'm so sorry Jeanette I know you there's a first part of that question.
Jeanette
No, it's okay, ah just genetics are people genetically predisposed to this that you know of.
Dominique Vanier
I mean when we look at just ah, generally more and the disorders of gut-brain interactions this is including like I've referenced before your IBS. your you know your functional heartburn reflux hypersensitivity there. There probably is like. we are boring a lot of research now for justorzo gut-brain interaction from IBS because that has oriGInally been the condition that has been studied the most and we know genetically there tends to be some sort of predisposition. but there's so many other factors right? like when I explain it to patients is.
Something turned the light switch on so it may have been you went through like a very like prolonged stressful period. But you have ah you have a strong family history of IBS or you know 76% of patients with IBS have some sort of childhood trauma or adverse childhood events right? So like there. There are this. There's probably this layering effect in genetics. May be 1 of them and then maybe we got a virus and we went to you know dominican and then like came back and like that was the light switch that turned on so it's not the only thing there's there's other things there. Yeah.
Jeanette
I know like for me personally not with GERD but with like IBS I never had really any stomach problems going through undergrad and as you mentioned like this. Going through this program in third year something just triggered it and now like I've been experiencing a lot of like IBS type symptoms. So I think maybe you're just predisposed and something triggers it and then there you go? Yeah, please.
Dominique Vanier
Well yeah, exactly Well we should chat after this? but you know in many comments in the many conversations that I've had with my patients right? because I do I do ask at least in the initial consult like what's your family health history of digestive issues. It's It's quite common to see oh my mom had IBS. Oh my you know? oh there's multiple like multiple other primary or like more distant relatives that have digestive issues that are underneath the category of disorders of gut-brain interaction. Yeah.
Jeanette
Okay, I know we touched about anatomy and pregnancy and obesity and all of that but I was doing a little bit of research and there seems to be maybe an association between like the Diaphragm and heartburn and how like the pressure can influence that have you heard of that or is there any role. That plays at hertburn.
Dominique Vanier
Yeah,, that's a good question like you know there's like can maybe be related to like a hiatal hernia right? which is more like the anatomy side of things. but again like on the ah on the flip side right? like the sensitization. The functional area. Ah, in disorders of gut-brain interaction in general, especially like functional constipation and irritable bowel Syndrome We are starting to see that there may be like a musculoskeletal component via the Diaphragm where the Diaphragm is just not moving appropriately and then we can see an exacerbation of symptoms. So. It's called diaphragmatic accommodation where when we eat food or drink water.
The Diaphragm is supposed to move up to accommodate the increased contents in the stomach for a lot of patients. It can like 1 of. 1 of the things that's part of the whole picture of the Diaphragm is either not moving appropriately or it's pushing downward and then we can see like this major distention happening or like feeling like I'm bloated with just one zip of water which is which is not normal right? So there.
There may there may be a relationship there to reflex I Still think that we need to study this area a lot more but it's it wouldn't be surprising to me again like just borrowing from the research from the rest of the disorders of gut-brain interaction.
Victoria
It's funny that if you were to ask somebody. You know what do you think causes your acid reflux they're going to say something like go spicy food and we just don't even think about the million other reasons why we might be experiencing something like this.
Dominique Vanier
Yeah, yeah, exactly yeah sometimes it's that simple right? like sometimes it just is the spicy food but for a lot of people. It's not.
Victoria
I Do want to touch. Oh right? right? Do you think though, this is just kind of well no, it's on topic but just a little added point here. Do you think though for people who eat something spicy and then get that acid Reflex. It's more just something that happens Occasionally, It's not like an actual disorder for them sort of like what I was saying for me like I know if I drink too much coffee I'm going to experience that but I don't have chronic acid reflux. Ok right.
Dominique Vanier
I think what makes it a disorder is the chronicity of it right? and so and so yes, like you are right there right? which is you know proton pump inhibitor that class of medication would not be indicated. Ah for that situation. It would be more like other anti acid options as we did PrN.
Victoria
Right. Right?
Dominique Vanier
It's about it's really about the chronicity. and like how often it's happening and how long it's been happening where then it then it kind of turns into a actual like disorder who.
Victoria
Right? That makes sense from a supplement perspective I would love to talk a little bit about supplements and herbs. can we start with probiotics I Want to know you know do probiotics play a role in the treatment of a picture like this like of. Acid reflux or heartburn. do you use them in Practice. What's kind of the research there.
Dominique Vanier
I will say like probiotics is said this many times is like a dog's breakfast of research. It's so messy. It's so that's and it's it's it's actually like frustrating when you try to like read through it because. You know you're looking at like a meta-analysis which like for your listeners is like the it's it's it's like the sum of all the research so they'll take like multiple studies and then they'll do like data like analysis on it to like make a conclusion right? and meta-analyses tend to be where we can feel more confident in making decisions in medicine.
probiotics is going to take like multiple strains and then they're going to have like 1 strain in the next study will have like 10 strains and they're going to all like try to mix it together. and they're going to use like strains from yogurt in another study and it's like and the other study is going to have capsules and so. Like the answer is like it's complex I Actually don't know I do know that like some for example in irritable Bowel syndrome. There are definitely some strains or species that are more likely to improve IBS Diarrhea IBS constipation. when it comes to reflux.
Victoria
Right.
Dominique Vanier
They're again like there's been some trials done. it may help It may not it sometimes I feel like it's indicated in practice and sometimes it's not so it's for mes, it's not like a black or white like yes, absolutely like start with a probiotic because that's that's not necessarily yet. However.
Victoria
Funny.
Dominique Vanier
In disorders of gut-brain interaction when we know that it's more of like a sensitization issues of perception. We are feeling these acid events just much more acutely than somebody else. probiotics may be able to help with the way that your brain communicates to your stomach. so you know I wouldn't I'm asking.
Victoria
Wow.
Jeanette
Wow.
Dominique Vanier
Not opposed. Yeah to I'm not opposed to you know using it when it's indicated with for somebody who's experiencing that you.
Victoria
Wow I had no idea about that. That's fascinating I know people see probiotics as kind of a universal answer to any gut related dysfunction. but I think it's I mean like you said the dogs breakfast. It's it's hard to know. When exactly they're they're needed and that's why it's so important to see a practitioner. when you have a condition like this. I did want to talk about herbs as well. We learn a lot about demulcents. in Botanical Medicine I'm interested in what you have to say about those.
Dominique Vanier
For sure. Yeah, yeah I mean I like them I feel like theyre a good tool that we have in practice I do find that their effectiveness tends to match what I see in the research and so demulcents being like deglycyrrhizinated licorice DGL is another one. Sometimes slippery elm right? These are all just really common herbs that we use that are going to like support ucosal function like you know decrease the sensation of having acid splash up into our oesophagus and they support like the stomach lining a little bit right? so. I Actually do tend to use them quite often with patients. and then again if somebody is having right?
like you know if they're having functional and like the functional part of things disorders of gut-brain interaction then we're looking at how do we support their nervous system like how do we better Support. The communication between their gut. You know? So it's going to be multifactorial I'm never just like saying take these demulcents and we'll see you later. It's It's like we are working on these all these touch points that we know are part of like the whole path of physiology of the condition.
Victoria
Right. Okay, okay God I'm glad we talked about that because I have personally seen success in people but you never know right? You never know what the plaSIBO or whether it's really working So it's good to know that it is a part of a treatment plan from a lifestyle perspective. Are there things that people can do.
Dominique Vanier
Are very.
Victoria
For example I'm thinking things like stress reduction or you hear a lot of like elevate your head when you're sleeping don't eat before bed. Some people say fasting. There's all sorts of different things I'm wondering if there's any lifestyle pieces that you typically recommend to patients.
Dominique Vanier
Yeah, wait. Yeah, yeah, definitely stress is stress is going to be that pressure that is going to for a lot of people exacerbate their symptoms. you know like we see it with IBS with dyspepsia you see it with GERD right? Having a wedge pillow or like what she said like elevating the head of the bed tends to be effective or again like there's some good research on that. That's a pretty conventional recommendation. and it's easy to right like from and like you know from an from a cost standpoint. It's it's low and we and we like things like that.
Definitely like being mindful of how close to bed somebody is eating may make a difference too right? So you know GIving like two or three hours ideally 3 hours before somebody's going to bed. may be able to help with their symptoms throughout the night also being mindful of like how high fat their dinner is again like high fat particularly like more the saturated fat rather than the omega-3s I don't tend to see omega-3s like olive oil which is more omega-9 but you know your nuts or seeds I tend to not see those even though they're higher in fat being as much of aggravators as you would with saturated fats.
Victoria
Interesting.
Dominique Vanier
So being mindful of like your you know your dinner What you're eating at dinner how close to your dinner your dinner or if you're snacking after dinner like how close that is to your bed time. and then you know like I haven't looked actually into fasting too much so I don't know if I have any comments there yet but acupuncture. There's some research again, it's.
Victoria
Okay. Even then.
Dominique Vanier
Not that robust may be able to help and when you look at like all the different areas that somebody can be supported in most of the time between their nervous system their diet these lifestyle changes and like you know supplements herbs typically somebody starts to feel. Better with at least like that approach.
Jeanette
Amazing. Okay, so at GIrls gone wellness. Our whole show is about wellness myth debunking. So with you, we would love to do a round of rapid fire myth debunking so you can either say truth myth or it depends I know most of them will probably be it depends but well. GIve it a shot anyway and then some of these be touched on the episode as well. But I just want to really drive home these points. Okay, perfect so myth number 1 or it could be true having acid reflux means you have low stomach acid.
Dominique Vanier
Totally mess answer a.
Jeanette
Okay, GERD or ah GERD is more commonly or sorry GERD is more common in the elderly.
Dominique Vanier
O I think that I think that 1 may depend actually you have a lot of other stuff going on typically so may not be a direct may not be a direct relationship there.
Jeanette
Revenue. Yeah.
Victoria
Right.
Dominique Vanier
Yeah, that's like that's a really good one I like that one I'm going to put that as the answer C depends.
Victoria
This is.
Jeanette
Okay, you have to do an elimination diet in order to manage acid reflux. Perfect acid Reflux is caused by too much sugar in the diet.
Dominique Vanier
Definitely a myth. If only was that simple right? Just take out the sugar and everything resolves. we're gonna and we're we're gonna myth bust that one.
Jeanette
I know.
Victoria
Ah.
Jeanette
Okay, and then this one this one's a good one and act. Oh I don't even know pronounce this Ill call allkkalineizing alkalizing Diet Well Health manage. Go ahead back. You take this one actually? Ah, ah.
Victoria
I And yeah I think I think when I was the. I added this in Maria should have worn Jeanette I added in that an alkalizing diet can help manage acid reflux and the reason I added it in was because before this episode I was doing some research on Instagram and everybody talks about. alkalizing diet so I want to know what your thoughts are on that.
Dominique Vanier
So I mean if you like yeah, it's's it's a good question right? like I'm going to say like that is more a myth in that like the researchers doesn't say like you know, taking out spicy foods and citrus foods now GIves you an alkalizing diet right? like that's not how we look at things and like that's not how it's defined. But yes when we remove some of the higher acid foods a lot of people tend to see an improvement in their symptoms but not everybody so it's more like a mythbusting in also to answers of the above for that 1
Victoria
Okay yeah I like that and I think the problem is probably around the influencers that are trying to sell like Alkaline water and stuff like that.
Dominique Vanier
Yeah, for sure. Yeah, exactly right? It's like yeah follow these instructions but then buy my product.
Victoria
Right? Yes, exactly Ok I'm glad we did that? now we know that you work with more than just acid reflux you are like gut Health guru. and we want to know.
Jeanette
Exactly.
Victoria
I Know we've been mythbusting the whole episode but is there something specific when it comes to gut health that you just want to debunk once and for all that you wish everybody knew.
Dominique Vanier
Well I was oriGInally going to say that there's not 1 research for her own low stomach acid causing GERD. But there's another one. food sensitivities are transient. They are like somebody can be sensitive to a food and at a later point they are not.
Victoria
Yeah.
Dominique Vanier
Our gut Microbiome is always evolving and we can work on like the harmony of our microbiome which the then can translate into ah seeing less sensitivities over time and this can take a long time, especially if we've cut out a lot of foods and kept them out of the diet for a long time.
Victoria
I have.
Dominique Vanier
But I have worked with so many patients where they oriGInally thought that they were sensitive to foods and we re-added them back in small amounts in the beGInning and they were quite surprised at how well they did keeping them in the diet.
Victoria
Wow oh I'm so glad you touched on that because that's a huge one I've fallen into that trap I did an elimination diet that was supposed to be I think six weeks long and it ended up being almost five years and
Dominique Vanier
Wow.
Victoria
When I added foods back in I had zero issues I was so upset because I was like really I have been avoiding I've been brinGIng my own meals to family dinners for this long and I haven't had actually any issues with them.
Dominique Vanier
Yeah. Yes, yeah, exactly yeah your case in point exactly.
Victoria
So I'm glad you touched on that.. That's a really important one? Well I'm so glad that we had this episode. I think I mean I learned a ton So I know our listeners did too. Where can our listeners learn more about you and where can they find more on you and maybe where can they book with you.
Dominique Vanier
For sure. Yeah, so I am an naturopathic doctor reGIstered in Ontario so I am seeing patients Ontario-wide virtually and then I practice in Burlington in person. you can find me on social media on Instagram we can include my handle in the show notes and on FaSIBOok. My website Dr. Vanier ND. com got lots of good stuff on there. and then ah we do have an upcoming free GI summit for the public that's taking place June tenth to fourteenth so I'm one of the speakers I think there's 25 of us. There's naturopathic doctors.
We've got clinical psycholoGIsts pharmacists pelvic floor physios, all things GI I talk about constipation from babies to adults food sensitivities. the link between the like the vaGIna and the and the gut and the microbiome there. And detoxification and there's other topics like mold in the gut. you know gluten dairy is it worth taking it out etc. So and if you're listening to this before June tenth feel free to sign up for our GI summit and we'll include the link also in the show notes. Yeah.
Victoria
Oh that's exciting. We've been talking about that with our colleagues at school. Everybody's very excited about it. So I'm sure you'll have a great turnout. yeah, thank you so much for being here. This was amazing. You're so knowledgeable and we feel so lucky to have had you on.
Dominique Vanier
Oh thank you so much. It was my pleasure. Yeah, it was great conversation today and I hope that what we talked about helps the people listening to this who have digestive issues.
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A mama and gut warrior, Dr. Dominique Vanier, ND is a Naturopathic Doctor in Burlington, Ontario. She has a special clinical focus on digestive issues, including irritable bowel syndrome, inflammatory bowel disease, GERD, and disorders of gut-brain interaction. She is particularly interested in how the gut can affect hormones, the nervous system, immune health, and autoimmunity, and how these interactions may impact patient health outcomes and treatment approaches.
Dr. Dominique has an Honours Bachelor of Science in Chemistry (Environmental Chem) from Queen's University. She completed her chemistry thesis in 2009 on chemical hydrogen storage under the Canada Research Chair in Green Chemistry. Dr. Dominique also has a Master of Environmental Science (M.Env.Sc.) from the University of Toronto and a four-year post-graduate Doctor of Naturopathic Medicine from the Canadian College of Naturopathic Medicine (CCNM) in Toronto. Dr. Dominique is registered in good standing with Therapeutics and Prescribing Authority and Intravenous Therapy through the College of Naturopaths of Ontario (CONO), and is an active member of the Ontario Association of Naturopathic Doctors (OAND) and the Canadian Association of Naturopathic Doctors (CAND).
Dr. Dominique has been a consultant for various organizations in the health industry, including A. Vogel/ Bioforce Canada and the Ontario Association of Naturopathic Doctors (OAND), and formerly developed economic and environmental policy in her role as Senior Policy Advisor for the Ontario provincial government before switching careers to become a naturopathic doctor.
Dr. Dominique recently served five years as the Vice-Chair of the OAND Board of Directors and brings a perspective and understanding of policy and government to naturopathic medicine in Ontario. She lives in Waterdown, Ontario with her baby girl and spouse.