Gastroesophageal Reflux Disease: You and Your Healthy Belly - Part 2


Written by Clare Abercrombie, Lauren Houser, CRNP and Georgia Tetlow, MD Do you or a loved one suffer from heartburn or acid indigestion? Are you experiencing intense heartburn during pregnancy? Approximately 15-20% of people experience either acid reflux or heartburn once a week. These symptoms are commonly experienced by the condition known as GERD--gastroesophageal reflux disease. We touched on the risks of the long term use of PPI's, a common treatment for GERD, but wanted to explore the condition in more detail. If you understand the physiology, skip to the bottom for integrative recommendations!

What is GERD?

The stomach and esophagus are part of the gastroesophageal tract which spans from mouth to anus. Reflux simply means to flow back or return. Gastroesophageal reflux occurs when the stomach’s contents including acids flow up from the stomach into the esophagus. Normally, a valve known as the lower esophageal sphincter (LES), prevents stomach contents from traveling into the esophagus. When the LES valve consistently malfunctions, either because it is weak or relaxes inappropriately, gastroesophageal reflux occurs. As part of this process, reflux can occur as a reaction to certain foods, and/or when the normal downward kinetic motion of gastric contents is interrupted.

What are the symptoms of GERD?

While heartburn and acid reflux are the most common symptoms of GERD, patients may also experience nausea, coughing, vomiting, hoarseness or loss of voice, and difficulty swallowing. It also common to notice a dry cough or sore throat. If the condition goes untreated, the cells lining the esophagus can become inflamed and damaged, causing the esophagus to swell and narrow. Long-term these effects may put you at risk for developing esophageal or stomach cancers.

What are the Causes of GERD?

Increased pressure within the gastrointestinal region may cause a GERD flare-up. This pressure could be caused by: wearing constrictive or tight clothing, pregnancy, being overweight, hiatal hernia or having abnormal fluid in the belly. Contrary to popular belief, GERD is not thought to be caused by excessive acid production in the stomach; rather it is, at least in part, the malfunction of the LES valve. There is certainly a mind body component to reflux--if you are suffering from anxiety, depression, or emotional stress you may have noticed heightened GERD symptoms. Other risk factors include smoking, excessive alcohol consumption, poor diet and diabetes.

Integrative Approach to GERD

An integrative medicine approach to GERD involves a holistic, multi-faceted treatment plan that includes mind-body therapy, nutrition/diet changes, exercise, certain medicines to heal the digestive tract, and other lifestyle changes.  The first step is to address triggers--for example to identify and eliminate key foods/beverages that cause reflux. These foods and beverages may include but are not limited to: alcohol, chocolate, coffee, cow’s milk, orange juice, tea, spicy foods, and tomato juice.

The next step is to support the gut in healing the inflammation that results from the reflux. Supplements such as arginine, peppermint, spearmint, and certain essential oils may be recommended by your practitioner to help alleviate pressure on the belly--some of these agents act as an anti-spasmodic. Licorice (Glycyrrhiza glabra) is an important herb utilized in repairing damaged cells and preventing possible abnormal cell growth within the esophagus. It's best to use licorice with the glycyrrhizin removed--called DGL, or deglycyrrhizinated licorice--if using longterm.

Meditation, breathing exercises, keeping a health journal, and aerobic exercise help patients heal and cope with anxiety or emotional stressors that can trigger GERD. An integrative practitioner can develop a specific tailored regime, utilizing both conventional and complimentary approaches to holistically treat GERD.