GERD is a very common disease, with 25-40% of Americans symptomatic GERD at some point in their lives, but 7-10% of Americans experience it on a daily basis. It is more common in adults over 40 years old, but can occur at any age.
Given the endless commercials for antacids on TV, Americans are well aware of this condition. The typical symptoms include heartburn, regurgitation of stomach contents, and problems swallowing. However, there are a lot of different, but very common, symptoms that can occur, such as a chronic cough, especially after eating; sense of lump in throat; hoarseness or sore throat; bad taste in mouth and/or wearing down of enamel on teeth; ear infections or chronic sinus trouble; and, asthma. Many times patients may have a “silent GERD” whereby they do not feel the heartburn, but they have one or more of these other symptoms and their GERD can thus be missed for awhile.
The pathophysiological reason people develop GERD is that the sphincter between the esophagus and the stomach, the “Lower esophageal sphincter”, fails; it loses its patency, its ability to tightly close. When that does not happen, when the stomach churns it can shoot acid, food, bile up into the esophagus. The stomach has different types of cells in it than the esophagus–it has columnar cells which make mucous and protect its own cells from the damage of the hydrochloric acid it produces. The esophagus is made of squamous cells, cells like on your skin. They do not produce mucous so when acid washes against it, it can cause pain, irritation, and cellular damage over time.
In standard care, gastroenterologists will generally dose proton pump inhibitor drugs to patients presenting with GERD symptoms. If it works, the diagnosis is made. There are some imaging tools they use, as well, such as an EGD, an esophagogastroduodenoscopy, whereby a long tube is inserted in a briefly anestized patient to evaluate the tissues to see if they are changing in any serious way, and check for the pressure changes at the lower esophageal sphincter.
A typical MD making a GERD diagnosis will tell patients to lose weight, avoid alcohol, chocolate, citrus juices, tomato products, peppermint, coffee, onions; they should eat small meals several times a day; they should not lie down for several hours after eating and elevate the head of the bed at night to try to prevent reflux during the night.
There are several drugs for GERD patients. The over-the-counter antacids contain calcium carbonate (causes rebound acidity), aluminum hydroxide (aluminum is toxic) and magnesium hydroxide (unabsorbable magnesium); and they are not that effective. Other OTC meds are the H2 receptor antagonists, such as Zantac. They block about 70% of acid production.
However, the typical medication a patient is prescribed are the Proton Pump Inhibitors: Nexium, Aciphex, Prilosec and Prevacid (their lowest dose is OTC; higher is prescribed), Protonix, and Kapidex. These drugs are terrible drugs and are the first I always strive to get my patients off of.
PPIs were designed for short-term use, to heal up a peptic ulcer, but now patients stay on them for months or even years. There are huge side-effects to using them: dyspepsia, belching, decreased absorption of B12, calcium, iron, magnesium; bone fractures; decreased gallbladder functioning; increased risk for food poisoning, pneumonia, clostridium difficile infections.
So, how does a naturopathic physician successfully treat GERD?
GERD is almost always caused by a food allergy, which weakens the LES and causes inflammation of the stomach lininig.
I will test all GERD patients with for an IgG food allergy, which is drawn through the blood. We can test up to 200 foods in this very efficient and informative manner.
We also have patients do a diet diary to see how if their diet is promoting inflammation.
We also analyze the patient for a decreased production of stomach acid. Although this seems at first hard to understand, stomach acid production is needed for the LES to get the signal to tightly close. If a lower amount of typical stomach acid is produced, the LES stays open and that decreased acid can still reflux up into the esophagus. Sometimes patients need to get stomach acid to prevent its reflux.
We also give gentle botanicals to heal up the lining of the stomach and probiotics, if they have been on PPIs, to regenerate good bacterial in their intestines.
In this way patients heal from GERD. They remove their food allergy(ies). Their stomach is healed. They get off their PPIs, and they can eat citrus, tomatoes, wine, coffee, peppermint, as those do not CAUSE GERD, they just irritate the tissues that are irritated by the unknown food allergy. Once that is gone, they can open up their diet to enjoy MORE foods.
Come see a physician at AIMS, if you have GERD. Our success is excellent with curing you of this condition.
Arizona Integrative Medical Solutions
4657 S. Lakeshore Drive, Suite 1
Tempe, AZ 85282
Mon-Fri: 8:30-5:30 pm
Our office is located near Baseline Road and Rural Road in Tempe, Arizona