What is GERD?
Most people will experience the symptoms of heartburn at least once in their lives. For most, hopefully, the painful sensation in the chest is limited to a one-time indulgence in jalapeno-flavored donuts, a significant amount of meat-lovers pizza, a pot of coffee, a few beers and a recent break-up after being fired from a job. For many others, heartburn occurs more frequently and it’s causes are harder to pinpoint.
Heartburn that occurs frequently is called GERD, or gastroesophageal reflux disease. It is a disorder in which the contents of the stomach, (gastro) including digestive juices and partially digested food, get by the barrier between the stomach and the esophagus (the lower esophageal sphincter) and come up (reflux) into the esophagus. This is problematic since the esophagus is not designed for digestion, but is rather a conduit from the mouth to the stomach, where digestion begins.
Acids that break down proteins and enzymes that break down protein, fats, and carbohydrates, are present in the stomach juices. This combination of acid and enzymes irritates the lining of the esophagus producing what most people describe as a burning sensation in the chest. Occasionally people have GERD that is pain free—these people may experience a hoarse voice that is more pronounced upon waking.
The symptoms of GERD can be extremely irritating. GERD that exists for a period of time causes changes in the esophagus. The constant aggravation to the esophageal lining can lead to pre-cancerous changes (called Barrett’s esophagus) that greatly increase one’s risk for cancer. For this reason, it is necessary to take very good care of your esophagus—and by extension, your digestive tract in general, and while we’re at it, the rest of your physical, mental, and spiritual being. Rates of esophageal cancer are increasing in industrialized nations at a rate faster than any other cancer.
Pharmaceutical drugs used for GERD fall into several categories; H2 receptor antagonists (Tagament, Zantac), proton pump inhibitors (Prilosec, Prevacid), and antacids (Tums and baking soda). All of these drugs decrease the acidity of your stomach. The problem, of course, is that the stomach is supposed to be acidic. Acid in the stomach is needed to break down protein into its constituent parts, called amino acids. If the protein is not completely broken down and gets into the blood stream, your body can develop an allergy against that protein. This can cause both food allergies and autoimmune disease.
The problem with pharmaceuticals is that while these relieve symptoms, they do nothing to stop the reflux or the increased risk of developing digestive tract cancers. Also, your stomach detects the low-acid environment that the drug has created and secretes large amounts of the hormone gastrin (a hormone that stimulates the proton pumps to create acid). Elevated levels of gastrin are associated with many digestive tract cancers including esophageal, pancreatic, and stomach cancer.
The risks associated with pharmaceutical drugs for GERD are greatest with long-term use. A recent study by University of Michigan scientists found that mice given proton pump inhibitors for gastritis (inflammation of the stomach lining), acquired more “bad” bacteria and developed more inflammatory changes in their stomach linings than untreated mice. All this being said, there are times when the aforementioned pharmaceuticals may be appropriate to treat GERD. If you are on a prescription pharmaceutical, you should discuss this with your doctor. Do not stop taking any prescription mediation without your doctor’s knowledge and consent.
short term relief:
Rule number one is do not lie down within three hours of eating. Simply being vertical helps your stomach contents to stay where they belong. Lying down with an incompetent lower esophageal sphincter encourages stomach contents to reflux, causing the uncomfortable burning sensation (and damage) .
Rule number two is to avoid those things that cause the LES to relax, especially in the evening:
- Tea (herbal teas are OK)
- Bad fats—especially fried foods
There is also a range of herbal supplements that can be taken to calm the inflammation in the esophagus and help rebuild the damaged lining. Consult a functional medicine physician to determine which herbal supplements would be best to add to your individualized treatment plan.
Long Term Cure:
Chiropractic can work in two ways to help you to heal your GERD. First, chiropractic is the most effective means of treating a hiatal hernia, a common but often overlooked cause of GERD. A hiatal hernia is when the top part of your stomach “pops through” (herniates through) your diaphragm. The diaphragm muscle pinches the top part of your stomach and can cause reflux. A chiropractor trained in reducing hiatal hernias can fix this rapidly and your troubles are over.
The second way chiropractic can help is through manipulation of the spine. Research has shown that people with stomach ulcers who receive chiropractic adjustments heal much faster than people who do not. Often people who suffer from GERD and/or stomach ulcers develop pain in the upper back-between the shoulder blades. This is because the nerve supply is the same to both areas. Chiropractic adjustments to the upper back can “reconnect” the nerve supply to the esophagus and stomach and hasten healing.
Lifestyle changes that could reduce or eliminate the occurance of GERD include the following:
Lose weight if you are overweight.
Eat a good organic whole yogurt on a regular basis, preferably raw.
Eat foods high in good bacteria include kim chee, sauerkraut, kombucha tea, and Miso.
Quit eating refined sugars and carbohydrates. This excess sugar and lack of fiber and nutrients disturbs the balance of bugs in your gut.
Cut down on coffee and alcohol. Do not have either on a daily basis, and when you do have them limit yourself to one cup of coffee or one alcoholic drink.
Cut out bad fats. These include hydrogenated oils, saturated fats from meat products, and many vegetable oils. Instead eat cold pressed organic olive, flaxseed, coconut, and sesame oils, organic butter, avocados, fresh nuts, lean meats and fatty fish.
Eat lots of fresh fruits and veggies. These foods contain the vitamins and minerals that your digestive track needs to function properly. The fiber and minerals also act as an acid buffer.
Check in with yourself regarding your stress levels. Your stress levels can play a large role in the state of your digestive track. If you are high strung, learn some technique of stress reduction. Learn to control your stress by practicing stress reduction daily.
Lastly, avoid taking pain medication unless absolutely necessary. NSAIDs and other pain medications eat the lining of your stomach and esophagus. Even Tylenol, which doesn’t have the systemic effect on your gastrointestinal tract, will eat your esophagus if it spends any length of time there. Tylenol is also the leading cause of liver failure in this country.
GERD can pose serious risks to your health over time. Do not let this disease go untreated. If you follow the outline above, you will be healing yourself at a much more meaningful level. GERD is often a symptom of a much greater problem involving diet, lifestyle, stress, the digestive tract as a whole. As always, it is better to treat the disease, not the symptoms.