Gastroesophageal
reflux disease or GERD is the medical term for
what we know as acid reflux. It is a condition in
which the liquid contents of the stomach
regurgitate into the esophagus causing
inflammation and damage to the esophageal lining.
The acid that is regurgitated most often consists
of acid, bile, and pepsin. Stomach acid is used in
the digestion of food and can be a major irritant
to the esophagus due to its tendency to damage
tissues. Unlike the lining of the stomach which
has a thin layer of protective mucus, the lining
of the esophagus has no defense against stomach
acid and other harmful substances.
Interestingly,
reflux of the stomach's liquid contents into the
esophagus occurs in most normal individuals
probably as frequently as in patients with GERD.
In patients with GERD, however, the refluxed
liquid contains acid more often, and the acid
remains in the esophagus longer.
The
body has mechanisms to protect itself from the
harmful effects of reflux and acid. Three such
mechanisms are recognized.
1. Most
reflux occurs during the day when persons are
upright. In the upright position, gravity causes
the refluxed liquid flows back down into the
stomach.
2. In
addition individuals have a natural reflex to
swallow whether or not there is reflux. Each
swallow carries any refluxed liquid back into the
stomach.
3. Lastly,
the salivary glands in the mouth produce saliva,
which contains bicarbonate. With each swallow,
bicarbonate-containing saliva travels down the
esophagus and neutralizes the small amount of acid
that remains in the esophagus after gravity and
swallowing have removed most of the
liquid.
But
at night, when an individual is not upright and
the production of saliva is reduced, the reflux
causes the acid to remain in the esophagus longer
and causes more damage.
The
most common symptoms of GERD are heartburn,
regurgitation and nausea. Chronic GERD may lead to
ulcers, strictures, Barrett's esophagus, cough,
asthma, inflammation of throat and larynx,
infection of lungs, and fluid in the sinuses and
middle ears and even cancer.
Generally,
GERD is diagnosed primarily by its symptoms. It
symptoms are relieved by taking antacids or acid
blockers then the diagnosis may be confirmed. But
other tests like upper GI series, pH probe or
upper endoscopy may be
ordered.
Acid
suppression continues to be the mainstay in the
treatment of GERD. The drug therapy aims at
reducing the amount of acid and improves
abnormalities in muscle function of the lower
esophageal sphincter, the esophagus and the
stomach. However, the symptoms re-appear as soon
as the drugs are stopped. Surgery is considered in
extreme cases but has not been found to be of much
help. However, most cases are mild and are better
managed with a holistic approach that starts with
lifestyle changes such as:
1.
Elevating
the upper body in bed at night.
2.
Changes
in eating habits like smaller and earlier night
meals.
3.
Avoiding
foods that promote reflux such as chocolate,
caffeinated beverages, alcohol, peppermint, fatty
foods.
4.
Stop
smoking.
5.
Taking
probiotics and natural herbs which aid in
digestion.
6.
Chewing
gum stimulates production of saliva and increases
the rate of swallowing helping to neutralize the
acid.
7.
Eliminating
stress, regularizing sleep
cycle.
So
what
is GERD?
From the holistic point of view, GERD is a warning
sign of a major internal imbalance that needs to
be properly addressed. Therefore, alternative
treatments (e.g. homeopathic remedies, herbal
remedies, dietary, detoxification and lifestyle
changes) that fix the internal cause of GERD, have
considerable advantage over most conventional
treatments that merely touch the surface of this
condition.
