Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) occurs when material from the stomach or small intestine repeatedly enters the esophagus. Some individuals have GERD for many years. Complications, such as serious damage to the esophagus, respiratory diseases, and ear, nose, and throat conditions can occur, but are more likely with older people.

Signs and Symptoms

Heartburn—a burning sensation in the chest, throat, neck, or back—is the primary symptom of GERD. Other symptoms include:

  • Regurgitation
  • Difficulty or pain with swallowing
  • A full sensation in the neck
  • Belching
  • Chest pain (similar to angina)
  • Laryngitis
  • Chronic cough
  • Wheezing
  • Hoarseness
  • Sore throat
  • Bad breath
What Causes It?

GERD has many possible causes:

  • Spicy foods, tomato-based foods, citrus fruits, fatty foods, chocolate, coffee, alcohol, and certain medications

  • Overeating, burping intentionally, wearing tight-fitting clothes, bending over frequently, lying down soon after eating, and smoking

  • Physical condition (particularly being overweight)

  • The effectiveness of the valve at the bottom of your esophagus in preventing material from your stomach from entering the esophagus

  • Medical conditions
What to Expect at Your Provider’s Office

Your healthcare provider can generally diagnose GERD by discussing your symptoms, what you eat and drink, medications you are taking, and your lifestyle. Your provider also may order diagnostic tests.

Under the concepts of functional medicine, assessment is oriented toward determining what is impeding your body’s ability to function normally. While some of the conventional medical approaches may help in this determination, they may not necessarily apply to a functional approach. Your healthcare provider will determine which assessment tools are most helpful in establishing a treatment strategy specific to your health needs.

Treatment Options

Treatment options include the following:

  • Avoiding food, drinks, and medications that can cause GERD
  • Modifying your lifestyle as needed
  • Raising the head of your bed about six inches
  • Taking antacids and other medication to relieve symptoms as needed
Surgical and Other Procedures

In rare instances, your healthcare provider may recommend surgery.

Complementary and Alternative Therapies

Changes in your diet can help decrease the irritation of GERD. Herbs may be very effective at healing esophagitis.

Nutrition
  • Digestive enzymes may help if you have heartburn.
  • Avoid sweets, oils, fats, and caffeine.
Herbs

Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

Some herbs typically used to help digestive problems actually make GERD worse. The following herbs can be used to treat GERD:

  • Licorice (Glycyrrhiza glabra) is an anti-inflammatory and antispasmodic, and relieves pain in the gastrointestinal tract. Chewable lozenges may be the best form for treating GERD. Take 380 to 1,140 mg a day. Do not take licorice if you have high blood pressure or use it for a prolonged period of time.

  • Slippery elm (Ulmus fulva) protects irritated tissues and promotes their healing. Take 60 to 320 mg a day. You may mix 1 tsp. powder with water three to four times a day.

  • In addition, a combination of four of the following herbs may be used as either a tea (1 cup three times a day) or tincture (30 to 60 drops three times a day):
    • Valerian (Valeriana officinalis)- bitter, sedative, especially for anxiety or depression or poor digestion

    • Wild yam (Dioscorea villosa)- antispasmodic, anti-inflammatory, especially for fatigue from long-term stress and poor digestion

    • St. John’s wort (Hypericum perforatum)- pain reliever, antidepressant

    • Skullcap (Scutellaria lateriflora)- antispasmodic, sedative, calming, especially for disturbed sleep

    • Linden flowers (Tilia cordata)- antispasmodic, mild diuretic, gentle bitter, especially for dyspepsia (gas)
Homeopathy

Some of the most common remedies used for GERD are listed below. Usually, the dose is 3 to 5 pellets of a 12X to 30C remedy every one to four hours until your symptoms get better.

  • Arsenicum album for burning pain that feels better with warmth

  • Carbo vegatabilis for bloating and indigestion that is worse when lying down, especially with flatulence and fatigue

  • Lycopodium for heartburn that feels worse with eating

  • Nux vomica for heartburn with cramping and constipation
Acupuncture

May be helpful to normalize digestion and relieve stress.

Following Up

Contact your healthcare provider if the medication does not help or if you experience side effects, such as cramping or diarrhea.

Special Considerations

GERD is quite common during pregnancy, particularly in the third trimester. Chewable papaya tablets may provide relief and are safe to use.

Supporting Research

Andreoli TE, Bennett JC, Carpenter CCJ. Cecil Essentials of Medicine.3rd ed. Philadelphia, Pa: WB Saunders Co; 1993:285-287.

Barker LR, Burton JR, Zieve PD, eds.Principles of Ambulatory Medicine. 4th ed. Baltimore, Md: Williams & Wilkins; 1995:443-446.

Bartram T.Encyclopedia of Herbal Medicine.Dorset, England: Grace Publishers; 1995:217.

Dambro MR, ed.Griffith’s 5 Minute Clinical Consult. Baltimore, Md: Lippincott Williams & Wilkins; 1999:422-423.

Kelley WN, ed.Essentials of Internal Medicine. Philadelphia, Pa: JB Lippincott Company; 1994:104-106.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany, Calif: Hahnemann Clinic Publishing; 1993:39-43, 102-103, 229-231, 272-275.

Stoller JK, Ahmad M, Longworth DL, eds.The Cleveland Clinic Intensive Review of Internal Medicine. Baltimore, Md: Williams & Wilkins; 1998:595-599.

Werbach MR.Nutritional Influences on Illness. New Canaan, Conn: Keats Publishing Inc; 1987:210.

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The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.

 

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