Extinguishing the feeling of perpetual fire burning in your stomach.
What is covered: In this post I am going to start with defining GERD or heartburn, will try to explain the reasons for this condition, and the GERD diet, foods to avoid, and comprehensive treatment for GERD .
In simple terms, GERD or Gastroesophageal reflux disease is defined as reflux of stomach contents back into the food pipe (oesophagus). Commonly known as acid reflux or heartburn.
It is one of the most common issues that I see in the clinic. It is estimated that 20% of people in the US will experience these kinds of symptoms weekly. And the worse is that the prevalence of GERD is increasing steadily.
The typical symptoms of this condition are burning in stomach, burning in the chest, burning in the throat, stomach fullness, and nausea. Although one of the hidden symptoms which many people don’t realize is a constant sore throat. Lot of people complain they’ve had a sore throat for a long time and they kept on thinking it is related to their sinuses or allergies but in reality, it was because of GERD.
Understanding the Mechanism of GERD
Classically it is understood that GERD happens because of excessive acid. But now we know the symptoms happen because of stomach contents refluxing back in the oesophagus (the food pipe), and may or may not be related to excessive acid.
The lower oesophagus sphincter prevents the stomach contents to spill back into the food pipe but in people with GERD symptoms, this sphincter relaxes more often or at the wrong times which causes the symptoms.
The symptoms typically happen because of these contents irritating the food pipe. And the long term sequel if left untreated can lead to erosion and ultimately to Barrett’s oesophagus.
- Poor diet: Most of our diets are heavy on simple carbohydrates, unhealthy fats, processed food and have foods which your body can be sensitive to like gluten and dairy. They can cause irritation/ inflammation to your stomach and can lead to this reflux, hence all those symptoms.
- Obesity: There is a direct correlation between obesity and reflux symptoms. But, like everything else it’s not an absolute cause; I have seen several people who have normal weight still suffer from these symptoms on a regular basis.
- Hiatal hernia: If the hernia is really big it can certainly lead to these symptoms and sometimes do not respond to traditional treatment options.
- Poor gastric motility: Lot of my patients suffer from poor gut motility, what it means is that the regular movement of food that should happen through our Gastrointestinal tract doesn’t happen and their gut motility is slow. The food sits longer in the stomach and that increases their chances for reflux.
- Gastric Distension: People will often feel that their symptoms are worse after a big meal. In our busy times often we eat fast and that doesn’t give enough time for our food to move through the stomach, which leads to stomach distension and ultimately to reflux.
- Low stomach acid: Contrary to popular belief, some people can actually have low stomach acid which does not allow for proper digestion and this undigested food can sometimes reflux back and lead to symptoms, this is a rather non conventional causes of GERD, which is the reason why a lot of people don’t get better with acid supression medications.
- Stress: An important reason that also plays a role in GERD is stress. In our stressful state, we impair our neurological function and digestive functions, which in turn contributes to GERD symptoms.
Conventional Treatment of GERD
Most of my patients have been started on antacid medications, especially proton pump inhibitors like Prilosec. These medications are supposed to be used only on a short term basis and only in severe condition. But in the present situation, these medications are being used excessively and for a long amount of times. Patients have been taking these medications for years and are finding it very difficult to get off these medications. The reason being nobody has actually looked at the root cause of GERD and help them to get off these medications.
Functional Medicine treatment for GERD
In Functional Medicine, we address the root cause of any problem, and so it is with GERD. Hence with Functional Medicine treatment of GERD you don’t have to take medications for life long.
Here are all the suggestions that can be useful to treat GERD according to Functional Medicine protocal.
- Diet: Food plan which is low in simple carbohydrates, small meals, no meals 3 hours before bedtime. Foods to avoid during this time will be gluten, dairy, chocolate, tomatoes, citrus fruits and vegetables, carbonated beverages, onion/garlic, high-fat meals. Also avoid alcohol.
- Work on weight loss
- Stress: Work on stress reduction through mind based exercises. Stress is a huge contributor to GERD and a simple 5-minute meditation daily can relieve a lot of symptoms.
- Supplements that help the mucosa of the stomach and reduce symptoms:
- DGL ( Deglycyrrhizinated Licorice )
- Slippery elm,
- Aloe vera,
- Zinc carnosine.
- Supplements to reduce stomach distension and also help with motility:
- D Limonene.
- Trial of stomach acid: Betaine supplements are available and can be tried for people who have not gotten relief from the above methods to see if they are deficient in stomach acid.
- Acupuncture can be helpful in reducing the symptoms and improving gut motility also.
- Visceral manipulation will also work for some people if nothing else has worked.
What works for my Patients
In my clinic, the approach is always geared towards working on lifestyle first and combining it with supplements.
So people go on our GERD diet, which restrict foods which are listed above and gut healing foods. If people are overweight or obese we work with them with a comprehensive plan to lose weight. I am a big believer of meditation so recommend them to Heartfulness Meditation, a simple 5-6 minute daily guided relaxation technique.
I start them on a blend of supplement which has DGL, Aloe vera, Slippery Elm to be taken 15 minutes before meals. If they do feel distension I tell them to do ginger tea with their meals, and also ask them to walk for 5-10 minutes after their lunch and dinner if possible that helps with this distension also. One more thing that has helped is fennel seeds, you can eat them raw or makes teas out of them.
Majority of my patients will get better with this intervention but if they dont, then we start looking for other reasons and some other potential therapies listed above to help.
To summarize in this post we covered the definition of GERD or acid reflux, what are the symptoms of heartburn, the various causes of GERD, and what are some of the natural ways or Functional Medicine ways of tackling GERD.