By Marie Regis, M.S., L.Ac.
Classic Esophageal Reflux Disease or GERD, also called Acid Reflux, has become alarmingly high in recent years. Conventional treatment with acid-blocking medication (Proton Pump Inhibitors) is often ineffective and can lead to serious side-effects over the long term. Studies have found that Acupuncture and Chinese Herbal therapy are more effective than medication for the treatment of this common ailment.A
Increased incidence of GERD
In the past, GERD used to be mainly seen in overweight middle aged people. Not any more. A 2010 study found that of a randomly picked sample of 686 US citizens, “40% had reflux disease, 22% having GERD, and another 18% had LPR (airway reflux). The most striking and unanticipated finding was that 37% of the 21 to 30 year old age group had reflux.” Conventional treatment with acid blocking medication was intended for short term use only due to unhealthful side effects. Many are ignoring the directions for these drugs and taking them for months or years. “Blocking stomach acid fosters the growth of bacteria that cause gastritis and are associated with GI cancer, pneumonia and with antibiotic resistant bacteria”.T
Types of Reflux
- Acid Reflux, or GERD (Gastro Esophageal Reflux Disease) happens when digestive juices from the stomach rise up causing irritation and inflammation in the esophagus
- LPR (Laryngo Pharyngo Reflux) Airway Reflux is where the stomach juices enter the Larynx (voice box), which is part of the Trachea.
- With GERD, there will be discomfort in the upper abdomen or chest
- With LPR, also called Silent reflux, there are no such symptoms. Instead, people may experience sinus congestion or irritation, sore throat, a feeling of a lump in the throat, coughing or asthma, hoarseness especially upon waking, difficulty swallowing.
Western pathophysiology
- GERD is caused by the malfunction of the lower esophageal sphincter, a valve at the top of the stomach that is supposed to keep digestive juices in. These juices, consisting primarily of the digestive enzyme Pepsin and stomach acid, cause inflammation and erosion along the esophagus.
- LPR (Laryngopharyngo Reflux) is caused by dysfunction of the Upper Esophageal Sphincter, allowing fluids to rise into the Trachea, or airway, and from there into the Larynx or voice box. The lining of the airway is thinner and much more vulnerable to attack. It is the Pepsin, a digestive enzyme that digests protein, that attacks the lining of the Trachea in the presence of acid. Pepsin can settle into the cells of the lining and be activated by acidic foods even if the person temporarily is not experiencing Reflux. The Pepsin then attacks protein in the lining. Long term reflux can lead to Oesophageal cancer.
Eastern pathophysiology and treatment
Chinese medicine considers that reflux is often due to dysfunction of the stomach, liver, and spleen/pancreas. Stress affecting the liver and stomach is a major factor in this disease, contributing to increased acidity, inflammation and causing stomach juices to go up instead of down. Emotions such as chronic worry, anger, frustration or rebellious attitudes are common culprits. Stress also impairs the spleen’s ability to transport and transform digestive fluids. Food in the stomach fail to be digested and assimilated. As a result, the stomach contents backflow into the esophagus. Reflux esophagitis in TCM focuses on transforming turbid fluids, supporting stomach function and restoring the downward movement of stomach Qi (energy) to prevent counterflow. This focus restores normal functioning of the lower esophageal sphincter (LES), enhances gastric motility, and improves gastric emptying.
Food and drinks to avoid
- Additives in prepared foods (canned or bottled food and drink) designed to acidify the food to help preserve it. This has been required by the FDA since 1973 to prevent spoilage. Ie: Citric Acid.
- Acidic foods such as tomatoes, peppers, citrus fruit.
- Coffee and chocolate
- Saturated fat
- High Fructose Corn Syrup and other sugars in foods
- Organic pollutants such as DDT, PCB’s and Dioxins
- Gluten and flour products
- Carbonated beverages including soda and seltzer
Other factors
- Alcohol consumption
- Smoking
- Stress
- Lying down immediatly after eating
- Over-eating or late night eating (within 3 hours of bed time)
- Dry mouth, especially after head and neck irradiation for cancer
Treatment of Reflux and LPR
- AVOID harmful foods and bad eating habits listed above
- Lower your stress with meditation, Tai chi, Qi gong or Yoga
- Consult with an Acupuncturist, and schedule a series of treatments to gradually restore normal digestive function. Often at least 4-6 bi-weekly treatments are necessary to provide lasting change.
- Always consult with your medical doctor to rule out other medical conditions
Studies
- According to a study by Hebei Privincial Hospital of Traditional Chinese Medicine in China, Acupuncture plus Chinese Herbal Medicine outperformed omeprazole (Prilosec, Zegerid) for the treatment of acid reflux. Important features of Chinese Medicine protocols is that they produce a high total effective rate, low relapse rate, and no significant adverse effects.
- A 2007 study by the University of Arizona studying patients who did not show improvement with a standard PPI dose, showed that Acupuncture plus standard PPI dose was more effective than the accepted protocol of doubling the standard PPI dose