GERD, Continued
Unfortunately, some of the people who have inadequate stomach acid take medication to reduce their stomach acid, which makes the problem worse. Your body will always try to heal itself and stay balanced. So it makes more acid to try to come up to the level it had before…..and more heartburn happens. Plus, without enough stomach acid, you are not digesting your food, which is creating gas, bloating, bad breath, or discomfort when that semi-digested food goes on to its next destination in your small intestine. To top it all off, if you don’t have enough stomach acid, you cannot extract the nutrition out of your food or make B12, which also leaves you feeling tired and terrible.
What about those folks who DO seem to have too much stomach acid? Those are sometimes people who eat a lot of acidic foods, like orange juice, tomatoes, and even vinegar. Their stomach acid is either normal or a little high but a lot of acidic foods on top of that make them ill.
In both types of people, we see some eating habits (timing, amount of food, high fat food, shallow breathers, wearing tight bra or tight waistband) among the problems causing these symptoms. When the mouth and stomach sense a high fat food, it relaxes the opening at the top of the esophagus (the tube that connects your mouth with your stomach). This makes it very easy for stomach contents to rise up into the throat and feel like burning. Now if you imagine combining a high-fat and an acidic food, you can see why pizza and lasagne tend to create heartburn in anyone. Don’t worry, being treated for this does not mean pizza is off the menu!
Some people may also have a bacteria called H. pylori in their gut causing problems, such as an ulcer. These need to be remedied as soon as possible. An ulcer is quite serious and can lead to a bleed in the abdomen. If ever you see your bowel movements (yes, take a look at them every time you go!) looking like coffee grounds, please go see your doctor right away.
What about the news that’s been around for years that apple cider vinegar (ACV) is so good for everyone? Well, there’s nothing that’s good for absolutely everyone. The people who swear it helped their digestion are likely the people who make too little acid. The ACV has now boosted their digestion to normal. The people who have normal or increased stomach acid may find ACV almost unbearable, as it will give them heartburn. Either way, while it’s a nice little helper, it won’t solve the underlying problem.
What about silent GERD? This is a form of GERD where the person doesn’t know they have reflux, and yet the acid is still coming up the esophagus. The most obvious sign of this is when people are chronically hoarse or have a “gravelly” voice. The stomach contents are irritating the vocal cords in the throat.
A danger that must be mentioned is Barrett’s esophagus. This is the result of having chronic GERD for a really long time. Like I said above, your body is always trying to heal and balance itself. Well, it knows very well that acid will destroy the tissue in your esophagus, so it miraculously transforms some of its cells into the types of cells that make mucus (goblet cells). That mucus provides a barrier over the acid-injured area to try to rescue it. Unfortunately, sometimes this change becomes permanent and can lead to esophageal cancer. In those patients, careful management by their doctor and using acid-reducing medications will be necessary and even life-saving. This is why occasional heartburn is okay but chronic heartburn where you are using Rolaids daily or you are having voice changes tells us it is time to address this with a plan.
A comprehensive plan to treat GERD may include:
acupuncture
Chinese herbal formulas
cupping the ribs, chest, and abdomen
Chinese dietary therapy
enzymes
behavior modification
acupressure
These together can all greatly help this condition. Within a few weeks you will feel better. Within month or two of consistent, regular treatment you will feel much better. If you are being followed by a doctor for this condition and would like me to notify him or her of changes we are trying, I am happy to do so. Coordinated care is the best care.