Digestion: GERD is a very common problem

Naturopathic medicine is generally very effective at eradicating GERD without the use of drugs, and patients can usually stop their medications and have a healthy stomach.

by Dr. Mona Morstein — 

Last year, Pharmacy Times published a list of the top-selling pharmacy drugs for 2010, and Nexium®, a proton-pump inhibitor used to treat gastroesophageal reflux disorder (GERD), or heartburn, was in the number two spot. The sales of Nexium brought in more than 6 billion dollars to AstraZeneca, the pharmaceutical company that created it.

GERD is a common problem for Americans and presents in many ways. Symptoms can be burning esophageal pain, a lump feeling in the throat or a chronic cough that is generally worse after eating. A good percentage of patients who suffer from asthma have GERD, which causes or aggravates their bronchial condition. Patients can have a bad taste in their mouths, as well.

Due to GERD, the esophagus is washed with acid regularly, which can cause the cells in it to change into precancerous cells — called Barrett’s Esophagus — or even into cancerous cells over time. Advertisements for Nexium on television note that taking this “purple pill” may decrease esophageal cancer by stopping the acid from washing the esophageal cells.

What causes GERD? The main problem is the lack of integrity of the lower esophageal sphincter (LES), which connects the esophagus to the stomach. Food enters the stomach when the LES relaxes, and it can leave the esophagus and fall into the stomach. When food enters the stomach, digestion begins with the secretion of stomach acid, which activates the enzyme in the stomach to start digesting proteins.

The release of stomach acid is supposed to signal the closing of the LES; but if the sphincter does not close tightly, acid can backwash up the esophagus. The stomach has many cells that produce mucous to protect itself from the acid it produces. The esophagus has no mucous cells to protect it, so the acid can cause serious damage over time.

Some changes can reduce the risk of developing GERD — losing abdominal weight, not overeating, eliminating acidic foods such as coffee and tomato sauce, avoiding peppermint and sleeping with the head elevated in bed.

The main allopathic medicine treatment for GERD is antacids. One can buy over-the-counter antacids such as such as Zantac® and Pepcid®, which are called H2 blockers. These decrease stomach acid production by about 70 percent. The newer antacids, called proton-pump inhibitors (PPIs), can shut down the acid production by nearly 98 percent. Prilosec® in a low dose is sold over-the-counter, but higher doses of it and others are only given by prescription.

Unfortunately, these are very problematic drugs and are the first ones I want my patients to stop taking. PPIs are known to cause bad bacteria to grow in the gut; lack of absorption of calcium, B12 and iron; increased risk of gastroenteritis (food poisoning) and pneumonia; decreased gallbladder functioning; thinning of the bones; and chronic indigestion and belching — all very serious conditions.

In the worst-case scenario, if drugs do not work, medical doctors will do a surgery called a fundoplication, whereby they wrap the stomach around the esophagus as a kind of block to acid backwash.

Naturopathic medicine is generally very effective at eradicating GERD without the use of drugs, and patients can usually stop their medications and have a healthy stomach.

Food allergies are highly associated with loosening the LES and causing GERD. A food allergy test can be a powerful tool for figuring out which specific foods do not work for one’s system. Removal of these foods will stop the GERD, and medications can be reduced and eventually stopped.

Here are a few helpful supplements, which are recommended to some patients:

Hydrochloric acid — In some patients, low stomach acid production occurs. This means there is not enough acid to tighten the LES, and the little that is produced can escape up into the esophagus. Adding stomach acid capsules can strengthen the integrity of the LES so that there is no acid backwash up the esophagus.

Slippery elm — This helps heal the esophagus and stomach linings.

Licorice extract — Like, slippery elm, it helps heal the esophagus and stomach linings.

Gentle and inexpensive antioxidants — These can heal the precancerous tissue if Barrett’s esophagus has developed.

Melatonin — This helps food leave the stomach more efficiently so there is less acid activation in the stomach.

In a case study, a 48-year-old male patient presented with terrible GERD for 25 years. He was on three medications, two of them PPIs, and he still had awful daily symptoms. His gastroenterologist had scheduled him for fundoplication surgery in two months. A food allergy test revealed he was allergic to dairy and eggs. A stomach-healing supplement was added to his diet. One month later, he was off two of his three medications and had no GERD symptoms. He was avoiding dairy and eggs, but he could now include fried foods, alcohol, coffee and tomatoes in his diet — things that for 25 years had set his stomach and esophagus on fire. After 30 more days, he was off his third medication and still GERD free. His doctor cancelled his fundoplication surgery. If he ate any dairy products (the eggs were not a problem), he had a return of symptoms for several days, but otherwise, he was GERD free, off medications and could eat virtually anything he wanted. Needless to say, he was ecstatic.

 

Dr. Mona Morstein is a naturopathic doctor at Genesis Healing Centers in Tempe, Ariz. 480-284-8155.

Reprinted from AzNetNews, Volume 31, Number 6, December 2012/January 2013.

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