Everyone today sees advertisements on Television and Radio for the treatment of Gerd. I find it interesting that one commercial will advertise foods or a restaurant that’s menu propagates GERD while the next commercial provides a medication to treat the symptoms of GERD.
GERD leads to the backward flow of the gastric contents from the stomach or esophagus into the esophagus or into the throat region. The contents could be undigested food particulate matter to liquid acid.
Symptoms can include: heartburn which sometimes can mimic a myocardial infarct (heart attack) TO regurgitation, silent or microscopic aspiration leading to the person coughing. This refluxing can lead to a set up for aspiration pneumonia.
Other complications include esophagitis which is an inflammation of the esophagus to chronic inflammation leading to cellular changes and the eventual possibility of developing cancer.
There is an anatomical flap of tissue that separates the stomach from the esophagus. This flap or sphincter of tissues is known as the Lower Esophageal Sphincter or LES. When this sphincter becomes incompetent due to a pressure change or a valve abnormality then fluids or particulate food matter will flow backwards into the esophagus or in the patient’s throat.
Patients that are Diabetic, Obese, Smokers and those whom have dietary choices can potentiate GERD. These patients are at higher risk.
Current treatments include the following:
Now let us take a deeper dive into the convergence and divergence in treatment methods of traditional and non-traditional (Integrative and Functional Medicine) Medical practice.
In both traditional and Integrative and Functional Medicine practice it is important for everyone to chew their food more thoroughly to break down the food into small particles that can be digested.
The human body is an amazing machine. Along with chewing our salivary glands produce saliva that has many factors that assist in breaking down the food. These include: mucin, bicarbonate, prostaglandin E2, and various growth factors.
As the food moves into the stomach it is churned or mixed back and forth. Acid is needed to further breakdown the food into its basic nutrients. Other organs such as the pancreas and gallbladder release enzymes and bile to breakdown fats, proteins and carbohydrates into smaller structures that our body uses as building blocks.
So, what happens if a person takes a H2 blocker, Antacids, or proton pump inhibitors chronically. I myself took these medications every day for years due the stress of being an anesthesiologist.
Long term use of these medications show the following adverse outcomes:
Nutritional depletions in the following vitamins; B12, Folic Acid, Vitamin D, Calcium, Magnesium, Iron, Zinc and protein Beta Carotene. All of these elements are essential for our bodies normal physiological function. In their absence the bodies function will go off the track and we end up complaining of a variety of symptoms.
Increased risk of developing poor Kidney or Renal function leading to insufficiency.
Increased risk of developing Clostridium Difficile infection. This can be a devastating intestinal bowel infection leading to watery uncontrolled diarrhea.
Increased risk of osteoporosis and osteopenia and fractures.
Irritable bowel syndrome
Increased risk of community acquired pneumonia
Increased risk of respiratory illnesses along with asthma
Association of increased risk of Alzheimer’s
Many times, the GERD can be avoided. Integrative and Functional Medical Physicians will order extensive testing to elicit the root cause of the reflux. Sometimes just performing a food allergy test leads to the culprit.
I truly believe that H2 blockers, antacids and proton pump inhibitors have their place in treating patients. However, at some point these medications should be weaned.
Below is a step by step techniques that is used in the weening of PPI’s:
Remove all wheat from the diet. The human gut has no ability to break down gluten. Gluten will cause a rise in zonulin and thus enterocyte separation in all humans. Removing wheat will often resolve someone’s need for PPI.
Remove Dairy as much as possible. Especially milk, cream and ice cream. A little cheese a couple times per week may be tolerated but all other dairy is ideally removed.
Order a IgG & IgE food panel and remove inflammatory foods. These foods need to be out of the diet for 2 weeks minimum before attempting PPI reduction.
Add a probiotic to help stabilize the immune response. Higher doses if the patient has a long history of gut or autoimmune issues.
Below are natural treatments for GERD which include the following:
Sodium bicarb (Arm & Hammer baking soda) can be taken at bedtime to neutralize any pepsin in the esophagus. This is a good habit to employ throughout this process. Sodium bicarb is healthy for kidney function and actually protective. The amount of sodium is negligible and not a contraindication for hypertensive patient unless they are acutely sensitive to salt which is the vast minority of hypertensives.
Patients should commit to dietary changes and refrain from eating allergic foods. Avoiding alcohol is necessary along with modifying diet weight loss and other provocative causes such as stress , sleep and hormone evaluations.
Finally, patients can find relief from acid reflux disease by alternative methods such as the above. Patients can find an Integrative and Functional Medicine physician that can treat such diseases. The Center for Antiaging Aesthetic and Rejuvenation Medicine can assist in this and other medical issues.