Did you know that one out of every ten Americans has heartburn every day and up to 1/3 of the population has heartburn every week? That’s a lot of people! In addition, drugs that target heartburn are the 3rd best-selling drugs in the world totaling $24 billion in sales worldwide and growing! We have always known it as heartburn until it was recently given an official title of GERD or Gastroesophageal Reflux Disease. GERD basically occurs when the contents of the stomach such as acid and food reflux into the esophagus. GERD that is untreated can cause irritation to the esophagus resulting in cancer and erosion. Unfortunately, we are finding out that suppressing stomach acid to treat the symptoms of GERD can lead to a lot of long-term health problems including:
-Vitamin B12 deficiency (fatigue, depression, dementia, neuropathy)
-Mineral deficiencies: calcium, magnesium, iron, zinc
-Irritable Bowel Syndrome
-Small Intestinal Bacterial Overgrowth
-Increased Risk of Intestinal Parasites and Yeast
What a drag that the treatment for GERD can cause so many other problems. But this makes sense that suppression of stomach acid will cause problems because it is extremely important for the digestion of food so your body can absorb and utilize nutrients. Stomach acid is important for the digestion of proteins into amino acids as well as properly digesting food and breaking down vitamins and minerals. If this is impaired, the immune system in the intestine can be affected resulting in leaky gut, food sensitivities, allergies, asthma and all the problems listed above. The good news is that GERD can be managed through good nutrition and supplementation.
The interesting thing about medications used to treat GERD is that they suppress stomach acid production yet 40% of individuals with GERD actually have deficient stomach acid production. Taking medications for GERD can also lead to continued behavior of the things that caused the GERD in the first place. If you just suppress symptoms and not address the cause, there is no reason for the individual to make healthy changes.
GERD is essentially a result of inflammation due to some type of irritant such as Helicobacter Pylori or food sensitivity that sets off the immune system and disrupts normal intestinal movements called peristalsis. This affects the sphincters that prevent regurgitation into the stomach and esophagus.
Some of the most basic recommendations to help with GERD include avoiding spicy foods, decreasing portion sizes, late-night eating, fried foods, smoking, citrus, garlic, onions, tomatoes, caffeine, alcohol, chocolate, carbonated beverages, and mint. The more bodyfat you have the greater the risk of experiencing GERD. Obese patients who lost just 20 pounds showed significant improvement in their symptoms. Our modern day society has created “eating on the run” and eating too fast which can also be a major trigger of heartburn. Another strategy that works well is elevating your head in bed or lying on your left side.
Hypothyroidism can cause GERD because the tone of the lower esophageal sphincter is decreased allowing regurgitation of unwanted acid and food. Treatment of hypothyroidism usually resolves the symptoms of GERD. Stomach acid is required for thyroid hormone absorption so the thyroid problem may not improve if the patient is also taking medications that suppress stomach acid production. A thorough thyroid evaluation should be done in anyone who has the symptoms of GERD.
If you are taking any of the following drugs, they could actually be causing the symptoms of GERD: antidepressants, calcium channel blockers, alpha and beta-adrenergic blockers, anticholinergics, sedatives such as benzodiazepines, theophylline, nitrates, progesterone, NSAIDS, steroids, aspirin, potassium, and bisphosphanates.
Stress can lead to GERD because of the direct connection between your nervous system and the tone of the digestive system and the sphincters in the stomach. Deep breathing and relaxation helps to normalize the stress response and balance the tone of your digestive tract.
Zinc deficiency can lead to GERD because zinc is important for the health of the intestine, balancing your nervous system, reducing inflammation and it helps with food allergies. Not only that, but zinc is important for normal stomach acid production and it suppresses helicobacter pylori infection. Magnesium deficiency can also lead to GERD because magnesium is important for normal peristalsis of the intestines.
Gluten intolerance and Celiac disease can be major players in GERD and studies have shown that a gluten-free diet results in complete resolution of symptoms. Food allergies in general can be a source of GERD because they trigger inflammation in the stomach and intestines. IgG food sensitivity testing can provide a good picture of the foods that your are reacting to.
When the bacteria in the gut become out of balance which is known as dysbiosis, yeast and bacteria can overgrow resulting in inflammation and abnormal digestion. This overgrowth of yeast and bacteria can disrupt the tone of the intestine resulting in the symptoms of GERD. Stool analysis from a good functional medicine lab can provide information about infections, inflammation and digestion that may be contributing. Eating foods that are high in sugar or high-glycemic foods that spike blood sugar can cause GERD. High-fat foods can have the same effect.
The gut bacteria Helicobacter Pylori or H. Pylori has been shown to be connected with GERD. H. Pylori is a major factor in the formation of stomach ulcers but it also will contribute to the symptoms of GERD as well as being connected to various autoimmune diseases. H. Pylori is identified through blood testing, stool tests or breathe test. We like to use a variety of herbal medicines and supplements to get rid of H. Pylori effectively.
In summary, the first and most important thing to do is identify the cause of the GERD in each individual. It’s important to rule out any infections such as Helicobacter Pylori, yeast, parasites or bacteria in the intestine which may be contributing. The next step is to identify food sensitivities through testing to see which may be triggering inflammation and symptoms of GERD. And of course lastly we do a thorough diet review and discuss any lifestyle factors such as high stress levels and eating habits that may be contributing. Once the cause is identified and holistic management options are started, GERD can be a thing of the past.