Heartburn. Indigestion. Acid Reflux. According to the media, these symptoms constitute an epidemic that can only be relieved by popping a pill or chugging the right pink liquid. The drug companies are ready, willing, and able to ride in on their white horses and provide the necessary medications to rescue the American public from Aunt Rosa’s chicken cacciatore. What they don’t tell us is that these symptoms can be mostly prevented by diet and lifestyle choices. One more little item they forget to mention is that the medications tend to worsen the symptoms over time rather than relieve them. Maybe we should look into this a bit further…
What is Gastroesophageal Reflux Disease?
Gastroesophageal Reflux Disease (GERD) is also known as Non-Ulcer Dyspepsia (NUD). These terms are used to describe a condition whereby stomach acid abnormally moves into the esophagus, causing heartburn and indigestion. A diagnosis of GERD or NUD is only given when these symptoms are not the result of an ulcer.
The esophagus is a tube (about 10 inches long in adults) running from the throat to the stomach, and is primarily responsible for moving food along that pathway. Muscular contractions are the mechanism used by the esophagus to accomplish this purpose. The lining of the esophagus is composed of epithelial cells that are coated with mucous. These are surrounded by the muscles that contract to transport the food, a process called peristalsis. The lower esophageal sphincter (LES) is a thick band of muscle tissue that acts like a valve to separate the esophagus from the stomach. Normally, the LES remains closed except when food is entering the stomach. This “valve” action keeps stomach acid from entering the esophagus.
The stomach is designed with a protective coating of mucous that prevents the acids it secretes for digestive purposes from harming it. However, the esophagus does not have this protective layer. Therefore, if the LES opens when it should be closed, or does not seal tightly, stomach acid can enter into the esophagus and irritate the tissues causing a condition known as heartburn. Heartburn is the primary symptom of GERD.
It is estimated that over 40% of Americans experience symptoms of GERD such as heartburn and indigestion at least once a month. Perhaps as much as 10% of these have daily attacks. Infrequent symptoms are not too much to be concerned about. We all get indigestion from time to time, usually from something we ate or drank that didn’t agree with us. But chronic heartburn can lead to a myriad of more serious conditions such as esophagitis (inflammation of the esophagus) or ulcers. If experienced more than twice per week, this irritation can become serious, due to the frequent presence of stomach acid and enzymes in the esophagus, where they were never meant to be. Chronic GERD can cause the esophagus walls to become scarred. This can result in the thickening of the tissues, making the esophagus abnormally narrow. Peristalsis can stop functioning properly, and thus food is not transported as efficiently. The patient can also experience difficulty swallowing.
Another complication of GERD to be aware of is that sometimes the repeated irritation will cause changes in the squamous cells of the esophagus lining. The cells are eroded by the acidity, and replaced with abnormal ones. This is called Barrett’s Syndrome or Barrett’s Esophagus, and is a pre-cancerous condition that can lead to an esophageal cancer called adenocarcinoma.
What Are the Symptoms and Causes of GERD?
GERD is predominantly characterized by two commonly found symptoms: heartburn and indigestion. Heartburn, as described above, is the body’s reaction to the contents of the stomach leaking into the esophagus. Indigestion, also called dyspepsia, is a term that covers a variety of digestive tract symptoms such as bloating, nausea, and excess stomach gas. In addition to GERD, indigestion can be caused by anything from diet to serious medical conditions:
- Diet: foods that stimulate excess stomach acid can cause indigestion. For many people, these include: milk and milk products, coffee, tea, and alcoholic beverages.
- Intestinal parasites can cause infections, (such as amebiasis, strongyloidiasis, and giardasis) that can result in indigestion.
- Medications: certain drugs can irritate the stomach lining. Common culprits are aspirin, oral contraceptives, iron supplements, tricyclic antidepressants, and some antibiotics.
- Conditions of female reproductive organs: pregnancy, menstrual cramps, and pelvic inflammatory disease, a general term covering infections and inflammation of the upper genital tract.
- Pancreas and gall bladder conditions can spawn indigestion. These include inflammation of or cancers of the pancreas or gallbladder, and gall stones.
- Digestive tract cancers.
- Diabetes and thyroid conditions can cause indigestion as well.
- Irritable Bowel Syndrome (IBS): many of the symptoms of IBS are similar to those of GERD. Approximately, 30% of GERD patients are also diagnosed with IBS.
Stress and emotional upsets can trigger GERD symptoms too. Researchers believe this phenomenon is related to the “fight-or -flight” response of the body to stressful situations. Some people are even thought to be more susceptible to emotionally caused heartburn and indigestion than others because they have hypersensitive nerve-endings in their intestinal tract.
We know that abnormal operation of the LES results in heartburn, but what causes the LES to malfunction? Researchers are not exactly sure, but there are several leading theories. One cause is thought to be an increase of inner abdominal pressure that pushes gastric juices into the esophagus, causing back flow or upward flow. This is commonly the result of factors such as overeating and/or obesity. Another cause could be a decrease in the muscle tone of the LES, leaving it unable to work properly. An example of a factor that could cause this is ahiatal hernia.
This is a condition where the stomach herniates through the hiatus, the opening where the stomach and esophagus connect. This hernia puts pressure on the LES, again causing it to not work properly.
What Treatments Are Available for GERD?
There are many natural, herbal, and lifestyle remedies that can prevent GERD from ever occurring and will help to lessen symptoms and correct the body’s balance so that GERD cannot prosper. This should be the main focus of treating any illness. Unfortunately, the allopathic or mainstream medical community focuses on treatments, mostly medications, which simply mask the symptoms without getting to the root of the problem. As if that isn’t bad enough, many of these medications actually worsen the condition. This kind of “treatment” creates a vicious cycle that never ends. Does the term “Job Security” ring a bell here?
This kind of pretzel logic is commonplace in the medical world, and the treatment of GERD is an excellent example of it. Sales of antacids and acid blockers is a huge multi-billion dollar business. In fact, as of several years ago, these drugs were the largest selling pharmaceuticals of any kind in the United States. Incidentally, Propulsid was one of the biggest sellers. The FDA pulled it off the market after it killed 111 people by causing fatal heart rhythm problems.
Antacids are designed to neutralize stomach acid and H2 blockers (histamine receptor blockers such as Pepsid AC, Zantec, and Tagamet) work to block the production of stomach acid. The problem with this is that many studies have shown that GERD symptoms are often caused not by too much stomach acid, but by a lack of stomach acid. This deficiency causes the digestive process to malfunction. Thus, these drugs cause the condition to proliferate.
The answer to treating GERD is not to reduce stomach acid. In fact, some very interesting research has been conducted that indicates stomach acid has many beneficial uses in the body. Along with aiding digestion, stomach acid also helps keep a good balance of bacteria and fungi in the intestinal tract. It also helps the body to absorb many critical nutrients. Acid also stimulates pepsin in the stomach, which is necessary to protein digestion.
Abnormally low levels of stomach acid have been linked to several diseases. Depression is one of them. Some forms of depression are caused by a neurotransmitter deficiency which is a result of low stomach acidity. Acne Rosacea is a skin condition that is thought to be a result of low stomach acid levels. Rosacea symptoms–red blemishes on the face, especially near the nose–have shown improvement in patients who were given supplements to increase stomach acid and digestive function.
So if reducing stomach acid is not the answer for GERD, what is? The focus belongs on improving the digestive process. The best results seem to come from stimulating acid production, not lessening it. How is this done? Hydrochloric acid tablets. This therapy is very common in natural medicine circles. The ideal way to institute this therapy is to first have a test called a gastric acid analysis. This will specifically determine a patient’s need for hydrochloric acid supplementation. However, it this is not available or practical, there is a way one can determine for themselves what dosage is best. Simply take one tablet (600mg) with the next large meal. Continue to increase the dosage with each meal until 7 tablets is reached, or until you get a warm feeling in your stomach (whichever happens first). Continue with this dosage, adjusting for smaller meals. After awhile, your stomach will begin to produce a balanced amount of HCl on its own, and you will need to reduce the dosage.
As with virtually anything related to health, proper diet is essential to preventing and treating GERD. Here are some tips:
- Eat smaller portions of food 4-6 times throughout the day. Eat slowly and chew your food thoroughly. Try to eat when your mind is at rest. Avoid meals when you are emotionally upset.
- Avoid foods that irritate your symptoms. These can vary from person to person. There are some generalities though. Stay away from high-fat foods such as most animal fats and fried foods. Eliminate or moderate coffee, soft drinks, alcohol, and chocolate.
- Do not overeat, and if you are overweight, try to lose it. Obesity is definitely a factor with GERD.
- Don’t lie down within 3 hours after eating.
Are There Any Herbal Treatments for GERD?
There are many that have proven effective:
- Peppermint and caraway oils have been helpful to reduce symptoms in most patients. Try them as a tea.
- Licorice: especially DGL (deglycyrrhizinated licorice) aids digestion and reduces acid reflux
- Anise: works well as a tea.
- Turmeric added to warm water.
- Chamomile tea: aids digestion and relaxes you too.
- Ginger helps some folks. Others claim it increases their heartburn and indigestion. See how it works for you.