Confused about Acid Reflux, Heartburn and GERD

Acid reflux is the backflow of stomach acid, pepsin, bile and indigested liquids in food, into the oesophagus. The LES, seperates the oesophagus from the stomach and prevents the normally acidic stomach contents from backing up into the oesophagus. This reflux happens when the sphincter relaxes more than normal allowing the content of the stomach to reflux. This reflux can progress to oesophagul reflux disease or GERD which is caused by the chronic prolonged reflux of the gastric contents back up into the oesophagus that sets up an inflammatory response. GERD may be characterized by the painful burning sensation known as heartburn and may be associated with non cardiac chest pain.

Heartburn: The most common symptom of acid reflux, but it can also be caused by: 

Stomach ulcers: Sores caused by GI tract erosion 

Gastroparesis: Condition that prevents stomach from properly emptying 

Functional Heartburn: Related to stress or anxiety, not stomach acid levels 

TriggerHow it affects acid refluxHow to Alleviate Symptoms
Certain foods– Irritate the stomach lining, signaling the lower esophageal sphincter (LES) to open 
– Directly irritate the LES 
– Weaken the LES causing it to open 
Crowd out: 
● High-acid foods: 
○ Spicy foods 
○ Citrus 
○ Tomatoes 
○ Chocolate 
○ Alcohol 
○ Coffee 
● Peppermint & spearmint 
● Smoking
Magnesium deficiencyInhibits relaxation of sphincter muscle at bottom of the stomach (pyloric sphincter)Milk of Magnesia
Eating a lot of food too quickly– Too much pressure in the stomach 
– Slower digestion
Eat slowly 
Be mindful of portion sizes
Hiatal herniaThe stomach is pushed up into the diaphragm, which inhibits locking of the LES.Be aware of what causes too much pressure on stomach muscles: 
● Excess vomiting/coughing 
● Pushing too hard during bowel movements 
● Pregnancy 
● Obesity 
Low stomach acid/bacterial overgrowthPoor digestion and bacterial overgrowth can lead to food intolerances, which create gas that puts pressure on stomachAvoid food intolerances

Signs and symptoms : Heartburn or acid reflux is the most common symptom associated with GERD although additional symptoms may include difficult or painful; swallowing, esophageal stricture, regurgitation, nausea, coughing, wheezing, asthama, chronic sinustitus and non cardiac chest pain. 

Lifestyle modification and Alternate therapies

Instead of using excessive medications, treatment strategies include lifestyle modifications and alternate therapies that may help with chronic reflux conditions.

Lifestyle modifications include :

  • Weight loss
  • Head of bed elevation
  • Avoidance of tobacco, alcohol
  • Eat smaller meals
  • Avoid stress during meals
  • Avoid tight clothing
  • Avoidance of late night meals

Alterante treatments include:

  • Accupuncture
  • Breathing exercises
  • Stress management techniques such as yoga, Qi gong and meditation 
  • Laughter
  • Massage
  • Socialization
  • Sleep adequate- 8 hours per night
  • Prayer
  • Music therapy
  • Dance
  • Saunas
  • Exercise

Digestive support :

  •  Probiotic
  • Magnesium
  • Zinc
  • Digestive bitters/ Digestive enzymes
  • Curcumin
  • Antioxidants : Queretin and vitamin E
  • High strength multivitamin
  • Glutamine
  • Glutathione
  • Omega 3
  • Green tea
  • Neem

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