GERD is an extremely common condition. Over time, the abrasive stomach acid causes reflux esophagitis (inflammation of the esophagus). GERD is also called “heartburn,” although it has nothing to do with the heart. It may produce a burning discomfort behind the sternum which may extend up into the throat or may not produce any symptoms at all. If reflux occurs during sleep when you are horizontal, you may awaken with a sore throat or a husky voice and an irritating cough.
GERD is caused by the acid contents of the stomach regurgitating or flowing backwards into the esophagus. The lining of the esophagus is not designed to handle these high acid conditions, which leads to inflammation, and in severe cases, scarring and ulceration of the lining of the esophagus.
This condition can become quite serious because it’s a risk factor for esophageal cancer. Esophageal cancer rates are currently rising at a frightening pace. If you suffer with GERD, there are some vital things you should know.
The stomach produces a lot of hydrochloric acid during eating and for good reason, because without it, you cannot digest proteins efficiently and you will not absorb calcium and other minerals from foods. There is a circular muscle around the lower esophagus, which divides it from the stomach, and this normally remains contracted to prevent back flow of stomach acid. During swallowing, this muscle normally relaxes, allowing food to pass from the esophagus into the stomach, after which it should remain contracted. If this circular muscle becomes weakened or too relaxed, reflux can occur after meals.
If you are overweight and/or have a fatty liver, this will cause too much pressure on the stomach, and reflux becomes worse. If you eat a lot of sugar or refined carbohydrates such as cakes and cookies, this will feed unhealthy bacteria in the stomach and this will make your stomach inflamed and overly sensitive to the hydrochloric acid. Thus is it vital to avoid sugary foods.
In some people with reflux there is also a hernia (protrusion) of the upper part of the stomach through the diaphragm into the lower chest. This is called a hiatus hernia and can be hereditary and is more common with age and in those who are overweight. A hiatus hernia will often disturb the function of the circular muscle around the lower esophagus. This increases reflux and heartburn symptoms. These symptoms are much worse after eating a large meal and while bending over.
If you suffer with long standing esophageal reflux it is important to see your gastroenterologist regularly, because prolonged exposure of the fragile esophageal mucosa to acid can result in an increased risk of esophageal cancer, severe scarring and narrowing (stricture formation). The passage inside the esophagus can become so narrowed that a stricture develops. This causes difficulty in swallowing normal amounts of food and results in pain, obstruction, or vomiting up the food that gets stuck. Surgery to enlarge the lower esophagus may then become necessary.
The most common drugs are Proton Pump Inhibitors (PPIs) and Histamine 2 Receptor Antagonists. Examples of these drugs are esomeprazole and pantoprazole.
These drugs are amongst the world’s most commonly prescribed drugs. They are used to medically treat gastric and duodenal ulcers and GERD. They may also be used to prevent stomach and duodenal ulcers associated with the use of non-steroidal anti-inflammatory drugs. PPIs reduce the production of stomach acid by blocking the enzyme in the wall of the stomach that produces acid.
There may be side effects from using these drugs long term and they include :
- An increased risk of developing osteoporosis (bone loss)
- Impaired absorption of minerals (such as magnesium, zinc and calcium)
- An increased risk of vitamin B 12 deficiency –this can be serious as B 12 is required for the nervous system to function normally. In people taking antacid drugs, an annual test for vitamin B 12 blood levels should be done. If vitamin B 12 levels are found to be low, B 12 injections must be given every 6 weeks.
High dose therapy with PPIs and/or Histamine -2 Receptor Blocker drugs can significantly increase the risk of hip fractures.
Long term side effects of these drugs have even proven to be fatal in some extreme cases. An article in the JAMA Internal Medicine 2013 cites a 50% increased death risk post-discharge from hospital in elderly patients who have been given too many drugs (known as poly-pharmacy), including the proton pump inhibitor drugs. It is best to use the smallest dose of these drugs possible to try to avoid these potentially serious side effects.
Natural therapies and weight control can often bring great relief to those with excess stomach acidity or reflux.
Try these simple techniques to reduce reflux
- If you are overweight, it is vital to lose weight, and the best way to do this is with a diet low in sugar and grains, and high in vegetables and protein, such as in my syndrome X book.
- Meal sizes should be small, as large meals increase pressure inside the stomach.
- Do not drink with your meals and confine your fluid intake to between meals.
- Do not eat food during the 3 hours before retiring to bed. It is wise to drink alkaline beverages during this time such as herbal teas, aloe vera juice or celery, mint, cucumber and carrot juice.
- Elevate the top of your bed by 6 to 8 inches by placing blocks under the head of the bed or purchase an electric bed with an adjustable slope angle.
- Avoid tight fitting clothes around the middle and do not bend over after meals.
- If you are constipated, reflux and bloating will be worse. If a healthy diet isn’t enough to help you go to the toilet, Colon Cleanse capsules should help.
- Avoid excessive coffee and alcohol. Some people find that spicy food such as chilli or curry will aggravate symptoms, so trial and error is required.
- A diet low in sugar and deep fried foods will reduce symptoms of heartburn and reflux.
- Consume a diet high in vegetables to reduce the symptoms of heartburn.
- Raw juices or green smoothies can help to alkalinise the stomach between meals. Alkaline juices or smoothies contain plenty of green produce such as green apples, celery, cucumber, mint, parsley and fennel combined with carrot; these foods alkalinize your gut thereby reducing excess stomach acidity.
- If you are taking long term antacid drugs such as PPIs, it is wise to sip organic apple cider vinegar during your meals to increase acid for the digestive processes. Dilute 1 to 2 tablespoons of the apple cider vinegar in 3 tablespoons of water and sip slowly during your meals. You may also benefit from a digestive enzymes supplement which should help to improve your digestion and reduce abdominal bloating. Taking a probiotic supplement should also help to reduce bloating.
Glutamine is an amino acid that can reduce inflammation in the lining of the stomach and good results can be achieved by taking one teaspoon of pure glutamine powder twice daily in coconut or almond milk.
If you get an acute attack of heartburn it is fine to use an antacid preparation for quick relief. Avoid aluminium containing antacids; instead choose potassium or sodium bicarbonate, magnesium carbonate or hydroxide instead.
The above statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any disease.