GERD
What is GERD?
Belching? Bloating? Indigestion? Are you suffering from any of these symptoms?
Shortly after eating, do you notice a burning sensation in your chest? If so, you are likely experiencing HEARTBURN, the most common symptom of gastroesophageal reflux disease (GERD)!
In this article we’re going to cover:
- What Causes GERD
- Why GERD is a problem that cannot be ignored
- The Symptoms of GERD
- What you can do to treat GERD
Before you get into this article, if at anytime you want to book a free consultation to speak with a Naturopathic Doctor about GERD, click here.
GERD is one of the most prevalent digestive disorders that occurs when stomach contents flow back into the esophagus. The reflux of stomach acid into the esophagus irritates the esophageal lining and results in the symptom classically known as heartburn. Occasionally, GERD can be asymptomatic or present with atypical symptoms such as a chronic cough or post-nasal drip.
Why is it a problem – what causes GERD?
Most individuals will experience the sensation of heartburn at some point in their life and when it becomes a more frequent problem, it is diagnosed as GERD. The majority of research suggests that GERD is caused by a failure of the lower esophageal sphincter (LES), which is a muscular ring that connects the stomach to the esophagus.
An optimally functioning LES acts like a door and is closed at rest to prevent the acidic stomach contents from refluxing into the esophagus and opens when swallowing to allow food to get into the stomach. Inappropriate relaxation or poor tone of the LES causes stomach contents to re-enter the esophagus, resulting in the symptoms of GERD.
Spontaneous relaxation of the LES is usually triggered by gastric distention after eating, and that is why most people tend to experience acid reflux after eating a large meal. GERD may also be caused by gastric outlet obstruction, a hiatal hernia, decreased esophageal motility, medications, alcohol, tobacco, obesity, pregnancy and food sensitivities.
What are some of the symptoms of GERD?
- Burning sensation in the chest
- Acid regurgitation
- Sour/bitter taste in mouth
- Indigestion
- Bloating
- Belching
- Bad breath
- Tooth decay
- Coughing
- Sore throat
Symptoms of GERD usually occur shortly after eating and for some people, reflux can be worse at night.
Untreated GERD can lead to serious complications such as Barrett’s esophagus, esophagitis, esophageal strictures, and esophageal adenocarcinoma, so it is crucial to seek the care of a qualified health care practitioner especially if you are experiencing any accompanying red flag symptoms (ex. unintentional weight loss, severe chest pain, difficulty swallowing, vomiting, gastrointestinal bleeding).
What are some of the diseases associated with GERD?
- Asthma
- Cardiovascular diseases: hypertension, hypercholesterolemia
- Sleep disorders: obstructive sleep apnea, insomnia
- Psychological disorders: major depressive disorder, anxiety disorders
- Gastrointestinal disorders: decreased esophageal motility, gastric outlet obstruction, hiatal hernia
- Diseases of the musculoskeletal system and connective tissue
- Obesity
- Type II diabetes
How can Naturopathic Medicine help?
GERD can usually be diagnosed based on symptoms and history alone, however your doctor will decide if it is necessary to send you for any further diagnostic testing.
The typical naturopathic treatment protocol for GERD consists of a combination of 5 key steps: lifestyle modifications, avoiding triggers, soothing the gastrointestinal tract, strengthening the lower esophageal sphincter and supporting digestion.
- Lifestyle Modifications:
- Adjust your eating habits– Individuals experiencing symptoms of acid reflux should eat smaller, more frequent meals to avoid overeating. Eating large quantities of food can cause distention of the stomach and cause spontaneous relaxation of the LES, resulting in acid reflux. You should also eat meals at the same times every day to establish routine and avoid eating too quickly as this is proven to aggravate symptoms of GERD.
- Avoid eating before bed– If you are someone who experiences symptoms of acid reflux at night, avoid eating 3-4 hours before bed. When lying down, our bodies are not in an optimal position for digestion due to gravity, and therefore can result in acid refluxing into the esophagus. Therefore, it is also beneficial to go for a walk after consuming a meal.
- Elevate the head of the bed– Raising the head of the bed by 20cm with a block or using a wedge pillow is an effective way of reducing symptoms of nighttime reflux. Sleeping with your head and chest elevated can prevent the acid from refluxing into the esophagus.
- Weight management– Being overweight can cause or exacerbate symptoms of GERD due to the increased intra-abdominal pressure. There is an association between increased BMI and severity of acid reflux symptoms thus weight management is key in overweight patients experiencing symptoms of GERD. Speak to a Naturopathic Doctor to discuss healthy long-term weight loss strategies and a plan that is right for you.
- Avoid triggers:
- Identify triggers and remove them– With the help of a Naturopathic Doctor and a diet diary you can identify potential triggers of your acid reflux. This can be accomplished by tracking what you eat, monitoring when your symptoms of reflux occur, and eliminating potential triggers from your diet.
- Research has identified certain triggers that are more commonly associated with GERD. The list below is a good starting point to try removing from your diet. However, this list may not apply to everyone and that is why it is important to identify your own triggers.
- Common Triggers of GERD
- Coffee
- Chocolate
- Spicy foods
- Sugar
- Dairy products (milk, eggs)
- Tomatoes
- Lettuce
- Peppermint
- Carbonated beverages
- Citrus fruits
- Fried foods and high-fat meals
- Alcohol
- Tobacco
- Pork
- Gluten, brewer’s yeast
- Protect and soothe the gastrointestinal tract:
- As GERD can be very irritating to the lining of the gastrointestinal tract, it is important to protect the gastrointestinal tract from any further damage and soothe any irritation.
- Naturopathic doctors often use demulcent herbs such as marshmallow and slippery elm as they contain mucilage that coats the gastrointestinal tract to prevent any further acidic damage to the esophagus and also soothes any symptoms of heartburn the patient is experiencing. Deglycyrrhizinated licorice (DGL) is another great demulcent that can be used to protect and soothe the gastrointestinal tract, and can be consumed before or after meals.
- Strengthen the lower esophageal sphincter:
- As mentioned above, a weakened or dysfunctional LES can result in esophageal reflux. Interestingly, melatonin has a functionally important role in the gut and therefore melatonin supplementation has been studied as a treatment for GERD. Melatonin has many different mechanisms of action and can be an effective treatment for GERD by decreasing stomach acid, increasing mucous production and stimulating the contractility of the lower esophageal sphincter.
- Digestive support:
- Individuals suffering from GERD tend to have trouble digesting their food. Many factors can contribute to decreased digestive function such as stress, food sensitivities, and poor eating habits. In order to properly digest our food, our bodies need to be in a parasympathetic rest and digest state. Therefore, it is crucial to manage stress, enjoy your food, and chew slowly while eating to experience optimal digestion.
- If you need more digestive support, bitter herbs such as gentian are consumed before meals to prepare the body by stimulating digestion. Some patients with more pronounced gastrointestinal symptoms may also benefit from digestive enzymes to further break down foods so they are more easily absorbed.
Before starting any supplements or a treatment plan, it is important to get assessed by a Toronto Naturopathic Doctor to see if GERD is the cause of your symptoms and what the best treatment plan is for YOU!
You can book a free consultation by clicking here.
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140167/
https://www.aaaai.org/Conditions-Treatments/related-conditions/gastroesophageal-reflux-disease
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728193/
https://n.neurology.org/content/88/16_Supplement/P3.057
https://www.ncbi.nlm.nih.gov/books/NBK557452/
https://pubmed.ncbi.nlm.nih.gov/27250962/