Gastroesophageal reflux disease, or GERD, affects 7 to 8 million people in the US alone. Heartburn/acid reflux is its most common symptom. While most people have suffered from heartburn at some time, GERD symptoms can also include:
regurgitation of stomach contents into the mouth,
difficulty swallowing, and
The worst long-term complication of GERD is esophageal cancer, caused by continual irritation of the esophagus (the long tube that travels from the mouth to the stomach) by stomach acid.
Let’s take a look at normal digestion to help us understand why things can go awry.
During the course of eating a meal, food that is swallowed travels the length of the esophagus, entering the stomach. There is a sphincter muscle at this juncture, which opens to allow food to pass into the stomach, but (usually) prevents food from the stomach from going back into the esophagus.
Acid is produced in the stomach along with enzymes that begin the process of protein digestion. These enzymes work optimally in an acid environment, and work only minimally in a neutral or alkaline environment.
The stomach is not large enough to hold an average-sized meal, and usually begins to empty before we’re done eating.
Within about 15 minutes of beginning a meal, the stomach begins to empty into the first part of the small intestine (the duodenum, pronounced doo-AH-den-um). The acidity of this partially digested food (known as chyme, pronounced kime) triggers the release of digestive fluids into the small intestine. These fluids include bile from the gallbladder to help with fat digestion, as well as enzymes from the pancreas, which break down proteins, fats, and carbohydrates.
As this first bit of chyme digests, the duodenum “speaks” to the stomach, telling it to release more chyme into the duodenum to continue the process of digestion. Once all the chyme is broken down and absorbed, the process of digestion is complete.
What Causes GERD?
GERD can be caused by malfunctions in any part of this process. In my clinical experience, GERD is caused by (in order):
Stomach acid deficiency
In gallbladder dysfunction, bile is secreted in insufficient quantities, which slows digestion of the chyme in the duodenum. The duodenum then tells the stomach to stop emptying. This can lead to an overacid, irritated stomach, which can lead to reflux of stomach contents back into the esophagus, causing heartburn.
In stomach acid deficiency, which is progressively more common in people over 30, the chyme coming out of the stomach is not acid enough to trigger the secretion of ample digestive fluids. Again the chyme is very slow to digest, slowing stomach emptying. In this situation, the food in the stomach begins to ferment. Think about it… you’ve got a pile of food dropped into a warm, wet bag. After awhile, it starts to ferment, developing organic acids, which can again reflux into the esophagus.
A similar situation happens in pancreatic dysfunction. The key point is slowed stomach emptying.
Hiatal hernia is the condition where the top part of the stomach slides up through the diaphragm. This can cause the sphincter muscle between the esophagus and stomach to malfunction, allowing stomach contents to reflux into the esophagus.
All of these problems can be caused by poor food choices and especially by eating on the run, and/or while stressed. Think of how many times in the past week you’ve wolfed down a meal, then launched back into whatever stressful thing you were doing. With these kinds of eating habits, it’s no wonder GERD is so prevalent.
Conventional medical treatments for GERD all focus on neutralizing or decreasing stomach acid production. Interestingly, antacids like Rolaids can often relieve heartburn due to an unintended “rebound” effect. The antacid can lower already-low stomach acid levels to the point where the body is prompted to secrete more acid, jump-starting the digestion process. As the stomach becomes weaker due to habitual antacid use, however, its ability to produce acid weakens, blunting the “rebound” effect. In addition, many antacids contain aluminum, which is toxic to the nervous system.
Histamine antagonists like Tagamet and Pepcid, and protein pump inhibitors like Prilosec, Prevacid, and Nexium, all decrease stomach acid production. There are several problems associated with the use of these medications. First, they all compromise the digestive process. Protein digestion requires proper stomach acid levels. Lacking that, our bodies are deprived of the building blocks needed to repair damaged tissues (like an irritated esophagus, ironically). This is a rob-Peter-to-pay-Paul situation, where the esophagus is saved at the expense of the health of the rest of the body. Secondly, these medications have significant side effects. In one case that went to court, the makers of Tagamet were held liable for a man’s case of liver failure and subsequent liver transplant. Tagamet slows the detoxification of certain poisons by the liver, and in this case the gentleman, who had been taking Tagamet for GERD, suffered from liver failure within days of applying weed-and-feed to his lawn.
Treatment of GERD using natural methods is safe and effective. Gentle methods like cranial therapy, visceral manipulation, acupuncture, Chinese herbs, and other supplements can often resolve the causes of GERD in a reasonably short period of time.
Remember to make time to eat each meal in as calm and relaxed a manner as possible. Food is meant to be enjoyed!
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