Great Smokies Medical Center of Asheville

Causes and Treatments of GERD

An estimated 60 million Americans suffer from Gastro-Esophogeal Reflux Disease (GERD), 15 million of them with daily episodes. GERD is a condition where digestive fluids from the stomach backwash into the esophagus, the tube that carries food/liquid from the mouth to the stomach and throat. Symptoms may include heartburn, an acidic taste in the back of the mouth, burning under the breastbone, and chest pain that can be confused with the pain of a heart attack. At times patients may have no symptoms other than chronic hoarseness, sore throat, gingivitis, or bad breath.

Conditions that predispose one to GERD include being overweight (which increases the amount of intra-abdominal fat and pressure), presence of a hiatal hernia, wearing tight clothing, overeating, eating rich foods, and drinking alcohol and coffee.

A healthy stomach naturally produces concentrated hydrochloric acid to digest food. pH is a measurement of acidity on a scale from 0-14. The normal pH of the stomach is very acid at 1-2, and the normal pH of the esophagus is slightly alkaline at 7-8. The mucous membranes of the stomach protect the stomach from being digested by hydrochloric acid. The esophagus, however, is not protected from these hydrochloric acid so it can become irritated or damaged by this exposure, resulting in the symptoms of GERD.

Conventional therapies for GERD include treatment with special types of antihistamines, especially Zantac, Tagamet, and Axid, as well as other medications called Proton Pump Inhibitors (PPIs) like Propulsid and Nexia. These drugs decrease stomach acid production. The long-term blocking of stomach acid production, however, is a valid health concern as acid is required for the breakdown of protein, a nutrient needed as a building block of body tissues, and also is required for absorption of minerals essential for health. By prescribing such drug treatments, an assumption is made that GERD symptoms are caused by excess acid production in the stomach, often without testing for the presence of excessive acidity.

GERD is a response to an acid/alkaline imbalance in the stomach, from either excess or deficient stomach acid. The fact that GERD is often caused by inadequate stomach acid production is usually overlooked. Too little stomach acid can trigger the backwash response, especially in older individuals. Studies suggest that 60% of individuals over age 60 make too little hydrochloric acid, with the percentage increasing with advancing age.

Natural therapies for this condition can include a surprisingly effective simple technique of food combining-avoiding starches and sugars (bread, potatoes, pasta, fruit, desserts, etc.) and protein (meat, eggs, fish, etc.) at the same meal. Supplementing hydrochloric acid (HCl) by capsule, always dosed to the size of a meal, has resulted in complete relief of GERD for some patients. Herbal treatments are useful, including a special form of licorice called deglycyrrhizinated licorice, often combined with other herbs such as plantain, slippery elm, and marshmallow root.

Red blood cell or hair analysis often reveals an overall decrease in essential minerals, since stomach acid is critical for the absorption of minerals. Mineral supplementation taken with acidic lemon water can help remedy this deficiency. Delivering specific electrical stimulation to a group of autonomic nerves called the celiac plexus in the upper abdomen that control the functions of the stomach and esophagus can be helpful in reducing the symptoms of GERD.

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