Heartburn drugs are among the most frequently prescribed medicines in the U.S. with sales exceeding $13 billion annually. In the year 2000 Prilosec was the world’s most frequently prescribed drug with sales topping $6 billion annually. Now Nexium, “the purple pill” made by the same manufacturer, has taken the lead. These drugs block production of stomach acid thereby providing symptomatic relief from heartburn. Unfortunately, symptomatic relief gained by the use of pharmaceutical drugs does not come without a cost.
Stomach acid has many functions. It kills ingested bacteria, virus, mold and parasites before they cause bodily injury. Stomach acid converts minerals into a form the body can absorb. Acid is essential for digesting proteins in preparation for absorption in the intestinal track. When acid production is blocked, a person is at a significantly increased risk for antibiotic-resistant infections, pneumonia, bone fractures and possibly cancer.
People taking Fosamax for osteoporosis often experience the side effect of acid reflux. To address this they are given acid blockers such as Nexium. In the end any benefit from the Fosamax may be outweighed by the use of Nexium.
Specific stomach cells that produce acid also produce a molecule which binds to vitamin B12 for absorption. Stop the acid and slowly, over time, B12 deficiencies begin to show. From 10 to nearly 50 percent of elderly people tend to run low on B12. Add in acid blockers and B12 deficiency anemia and fatigue are nearly a sure bet.
To date there are only animal studies linking the use of acid blockers with stomach cancer. It is noteworthy that the tumors didn’t show until a third of the animal lifespan had passed. Acid blockers have not been on the market long enough to show if this will hold true with humans.
Over the course of years, erosion of the esophagus from GERD can alter the make-up of cells lining the esophagus. This alteration leads to a condition called Barrett’s Esophagus and can only be identified with an endoscopic exam. The endoscopy is a test in which a tube with optical and biopsy capabilities is inserted down your throat to your stomach to see and sample your stomach and esophageal lining. Barrett’s esophagus is a concern because it is an inflammatory condition, which can be a precursor to cancer.
The primary cause of GERD is a compromise of the sphincter where the esophagus enters the stomach. This allows stomach acid to rise up the esophagus, irritating unprotected tissue and causing discomfort. Common causes of sphincter compromise include stomach ulcers, bacterial imbalance, hiatal hernia and stress. A hiatal hernia results when a portion of the stomach gets pushed up alongside of the esophagus compromising the sphincter.
Symptoms of GERD
- Burning or discomfort in the stomach area or near the stomach.
- Burning or discomfort in the esophagus.
- Reflux with acid coming up the esophagus.
- Reflux especially at night lying in bed.
- An aching pain or pressure below/beneath the sternum.
- A sense of heat or mild acid in the throat and/or excessive burping.
- Persistent/chronic cough.
Usually I’ll try a therapeutic trial to find out if the condition readily resolves. If not, endoscopy as mentioned above, barium swallow with x-ray (to identify hiatal hernia), and/or blood test for unwanted bacteria (H. pylori) in the stomach are all considerations.
Natural Treatment Considerations
GERD is a condition that responds to different therapies, all depending on the individual. This means that you really need to listen to your body and refine the following therapies for optimal results. Frequently I find that a person with keen observation and willingness to change can fashion an anti-GERD diet that will resolve their symptoms without any other therapeutic intervention by using the following guidelines.
- Avoid foods and liquids that weaken the esophageal sphincter, at least until you feel better: coffee, caffeine, black tea, green tea, ice water, alcohol, salsa type products, tomato sauce, citrus or apple juice, peppermint in any form (tea, Altoids, etc.), chamomile, turmeric, B vitamins, oats, nicotine, chocolate, pop and carbonated drinks, sugar, deep fried food and heavy oily meals, large meals and chewing gum. Adhering to this avoidance list can often heal GERD.
- Favor a more alkaline diet which consists of vegetables, fruits, grains in moderation such as millet, quinoa, amaranth, rice and buckwheat and seeds and nuts (not peanuts). Consumption of wheat and the wheat family (see website newsletter Wheat) will often predispose to GERD symptoms. Limit your intake of acid producing proteins including pork, bacon, ham and beef.
- Avoid large amounts of water during and after dinner or near bed as this promotes reflux.
- For those taking vitamin supplements, try a ten day trial without them and see if this takes care of the problem. The B vitamins in particular can be a problem. Antacids are acceptable for only occasional use, for example, once or twice a month. Taken more frequently antacids will promote GERD. A good natural alternative for temporary relief made by Rx Formulations is Acid Block taken as directed.
- Ginger Root: The very best and reliable way to close the sphincter going into the stomach is to swallow a chunk of ginger root about 1/2 inch in diameter and 1/2 inch thick. Peel off the outer bark and swallow, being careful not to choke on it. You can chew it a few times if you like the heat or cut it into small little pieces and add them to applesauce or something mushy and then swallow. You can take this as often as needed, and after a few days or a week you’ll find you need it less and less often. If you are not getting good relief in a day or two you can try juicing the ginger and taking about 1/2 to one teaspoon as often as needed.
- For many individuals, taking three to six mg of melatonin at bedtime for 30-40 days will resolve the lax lower esophageal sphincter compromise. You may need to continue taking it for a longer period to totally correct the condition.
- Citrus extract D-Limonene as directed will often resolve GERD issues.
- Avoid bed within three hours of indulging in a large meal.
- For some, raising the head of the bed from four to six inches will prevent stomach contents from washing up into the esophagus while sleeping. If you don’t want to raise the whole bed, you can buy a foam wedge that will raise you up without altering the bed.
- Lying on your left side should also reduce the tendency for stomach contents to reflux while lying in bed.
- Do not wear constrictive clothing, especially around the waist.
GERD is generally the result of inappropriate lifestyle habits. Once these habits are identified, the condition can usually be corrected without the use of any medications. If your condition does not completely resolve with the above suggestions, I suggest a consult with a naturopathic physician. Tests may need to be run, and a more comprehensive treatment regimen using natural products may be required.