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American’s gastrointestinal (GI) tracts are burning up with “heartburn.” Heartburn is not the accurate term; it is called GERD (gastroesophageal reflux disease). Millions of Americans are diagnosed with some sort of symptoms of GERD with 15 million experiencing symptoms daily and 60 million having flare-ups at least once per month. Over 60% of the population will have an acute episode of GERD within a 12-month period (http://www.healthline.com/health/gerd/statistics).
When we swallow our food it goes down through the esophagus to the stomach with digestion continuing on through our intestines. GERD is defined as the “return of the stomach’s content back up into the esophagus” (http://www.webmd.com/heartburn-gerd/guide/reflux-disease-gerd-1#1). Since the stomach contains acids, there is a resulting burning sensation. If not treated, the long-term complications of GERD include esophagitis (inflammation of the esophagus), ulcers, strictures (narrowing), what is called Barrett’s esophagus (changes in the tissue lining) or even cancer. So, how can you treat GERD? The approaches include lifestyle changes, dietary changes, surgery or medications, which include either prescribed, OTC or natural remedies. When looking at lifestyle changes, the following contribute to reflux: obesity, smoking, overeating, and eating too close to bedtime (2-3 hours) or simply lying down right after a meal. Eating smaller portions is a good habit to develop. It also helps to wear loose-fitting clothing around the abdomen. By elevating the head with extra pillows while sleeping, symptoms of reflux can be reduced (https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/treatment). The dietary changes may involve trial and error, but in general foods that produce too much acidity are to be avoided or modified in the diet. Thus, the culprits are typically the following foods:
Some medication categories include: Antacids (such as Maalox, Rolaids, Mylanta, etc.) can be used for milder symptoms of GERD. Be aware that these drugs can cause diarrhea or constipation. H2 Blockers (Zantac, Pepcid, Axid, Tagamet, etc.) decrease acid production and provide more immediate and short-term relief of symptoms. These medications can cause headaches, nausea, stomach pain, as well as diarrhea or constipation, like the antacids. As previously addressed, there can be possible drug interactions if you are taking other medications, either prescribed or OTC. PPIs (proton pump inhibitors) actually reduce the amount of acid that the stomach makes. Some samples include the brand names: AcipHex, Nexium, Prevacid, Prilosec,or Protonix. They are often time-released so one tablet lasts all day, and they are typically prescribed for more severe symptoms, chronic symptoms, and when ulcers or erosive gastritis or esophagitis are present. Ideally they are meant to be taken short-term. PPIs are OTC or in prescription form. A important precaution to consider with PPIs includes the increased risk of being infected with “C. Diff” – clostridium difficile. This is a result of PPIs causing a change with the normal flora of the GI system. C. Diff is a serious infection that causes severe diarrhea. It requires stringent treatment since the cause is the result of an antibiotic-resistant organism, which can be deadly (If you are interested in more information, please see my previous articles about this topic, found in my archives on my website). Herbal or natural remedies: The philosophy of natural or homeopathic approaches to treating GERD looks at how to prevent and/or manage it. There are homeopathic medications, which are prescribed by the provider and these remedies are relatively safe since the FDA approves them. Naturalists claim that GERD is not always a result of excessive acid production but actually too little stomach acid when such conditions are present like a hiatal hernia or H. Pylori (a stomach infection). Therefore, fermented foods are recommended, such as yogurt, fermented vegetables, chutney, and certain fishes. Although PPIs and H2 Blockers may be helpful for acute episodes of severe complications of GERD, the naturalists claim that these medications become counter productive after a while and the person becomes dependent on them. Traditional medicine recognizes this problem as well, but people with chronic GERD are still often kept on PPIs and H2 Blockers indefinitely. The idea is to seek balance within the GI system. Some remedies include the use of ginger teas, apple cider vinegar, baking soda, pine nut oil, and aloe water (purified is best). This actually coincides with the dietary suggestions by traditional medical doctors and nutritionists. However, constant dietary and body changes make it difficult to manage a balance in stomach acid production. Some other suggested products include vitamin Bs, (especially folic acid), licorice, slippery elm, lemon balm, and chamomile (http://www.mayoclinic.org/diseases-conditions/gerd/basics/alternative-medicine/con-20025201). Finally, the last area to remedy is to look at the water that you are drinking. Acidity is measured by pH. Normal pH is 7.0 (considered neutral). Something is acidic when it has a pH below 7.0; a pH above 7.0 is considered alkaline. It’s a good idea to test your water source at home – not only for your house pipes, but also for your body pipes. Some health proponents claim that alkaline water is beneficial, especially for gut problems and athletes because it enhances the buffering capacity (http://www.huffingtonpost.com/john-berardi-phd/alkaline-water_b_7762588.html). However, it’s best to also review this with your physician if you have any specific health issues such as renal problems. The jury is still out about water pH and overall health since some scientists claim there is no evidence to prove the health benefits of alkaline water (http://www.watertechonline.com/ph-paranoia-understanding-alkaline-water-claims/). I discovered that bottled water varies in its pH. Here are some samples: Acidic
Surgery is not that common in the treatment of GERD. There are more potential complications with surgeries than with medications. Lifestyle and dietary changes are the safest approach, along with the short-term use of medications if necessary. Having occasional acid reflux is normal, but having it frequently is not. It is important to treat GERD with the various choices. Often it entails “trial and error” in approach to find out what works best for you.
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