Gastroesophageal reflux disease (GERD) is a disorder in which contents of the stomach or small intestine repeatedly move back up into the esophagus (tube connecting the throat to the stomach). This regurgitating action is called reflux. Reflux causes heartburn, and although most people have an attack of heartburn at some point in their lives, persistent reflux and severe heartburn may indicate GERD.
Normally when a person swallows, the muscular walls of the esophagus move in waves to push the food down into the stomach. Right after the food enters the stomach, a band of muscle (the lower esophageal sphincter) closes off the esophagus. If the muscle fails to close tightly enough, the stomach contents can back up into the esophagus causing heartburn and other symptoms of GERD.
Substances in the digestive juices from the stomach (namely, acid, pepsin, and bile) can damage the inner lining of the esophagus, causing inflammation ulcers (open sores) and, possibly, precancerous changes to cells (called Barrett’s esophagus).
Signs & Symptoms
Heartburn—a burning sensation under the sternum in the chest—is the primary symptom of GERD. Heartburn often occurs after a meal and worsens at night, when you are lying flat. It is more likely to occur following a heavy meal or if you bend, lift, or lie down just after eating.
Other symptoms of GERD include:
Regurgitation of food
Belching
Nausea and vomiting
Chronic cough, wheezing
Sore throat, hoarseness or change in voice, difficulty swallowing
Chest pain
GERD is common in infants and young children, but is generally mild.
If an infant has the following symptoms, however, call a physician as soon as possible:
Ongoing coughing
Wheezing, gasping
Severe vomiting
Frequent burping
Causes
GERD can often be traced to the malfunctioning of the lower esophageal sphincter (LES). The LES is a muscle responsible for opening and closing the lower end of the esophagus, which it accomplishes by relaxing and contracting at appropriate times. The LES may weaken or lose tone, allowing the contents of the stomach to escape back up the esophagus.
Any of the following may compromise the LES:
Pregnancy
Low stomach acid
Obesity
Hiatal hernia - A condition in which a portion of the stomach protrudes through an opening in the diaphragm where the esophagus normally fits snuggly and passes into the stomach.
Recurrent or persistent vomiting
Certain foods (alcohol, caffeine, peppermint)
Smoking cigarettes
Some medications including calcium channel blockers (a class of meds used for high blood pressure such as amlodipine, diltiazem, felodipine, nifedipine, nisoldipine, and verapamil), anticholinergic drugs (including benztropine, biperiden, dicyclomine, hyoscyamine, isopropamide, and scopolamine), iron pills, non-steroidal anti-inflammatory drugs (NSAIDs including aspirin and ibuprofen), dopamine (for Parkinson's disease), sedatives, bisphosphonates (alendronate and risedronate for osteoporosis), and beta blockers (such as atenolol, labetalol, metoprolol, nadolol, pindolol, and propranolol, for high blood pressure or heart disease).
Lifestyle Changes You Can Make
Making changes to or avoiding certain habits can go a long way to relieving or preventing your symptoms of GERD.
The following are typical suggestions for people with GERD:
Avoid behavior that does not allow food to easily move down into and through the stomach. This includes bending, lying down, or participating in jarring exercises soon after a meal.
Don't eat heavy meals.
Avoid acidic foods and drinks. These include caffeinated beverages, decaffeinated coffee, and orange juice.
Avoid alcohol, chocolate, spearmint, and peppermint. These can relax the low esophageal sphincter.
Avoid carbonated beverages.
Avoid eating fatty foods, including full-fat milk, which also may relax the lower esophageal sphincter tone.
Lose weight if you are overweight.
Quit smoking.
Avoid medications that provoke symptoms.
If you experience more frequent symptoms at night, you may be relieved by:
Raising the head of your bed about six inches.
Avoiding bedtime snacks. “In a study published in The American Journal of Gastroenterology, the researchers found that eating dinner within three hours of going to bed was associated with a sevenfold increase in the risk of reflux symptoms.”
Stress may worsen symptoms. Therefore, relaxation, such as yoga, tai chi, and meditation are worth considering as part of your whole, comprehensive treatment plan.
Medications
The main aim of drug treatment is to control the acidity of the stomach. There are several different types of medications used for GERD, and each works in a different way. Over-the-counter antacids neutralize the stomach acids; histamine H2 blockers interfere with the production of acid; and proton pump inhibitors suppress molecules in the glands responsible for the release of acid.
Drawbacks of drug therapy for GERD
Did you know that proton pump inhibitors (PPIs) are the third-most common prescribed medication, and over 110 million prescriptions are written every year? PPIs only temporarily relieve reflux symptoms and do not demonstrate efficacy in all patients. Additionally, side effects are common, including impacting nutrient bioavailability. PPIs are even associated with an increased risk of death.
Anti-reflux drugs are like a double-edged sword. They may be very effective in suppressing gastric acid secretion, but strong inhibition of gastric acid (HCI) secretion can at the same time cause an array of digestive problems. This is because people who are taking these agents do not secrete adequate gastric acid and enzymes for digesting food that is present in the stomach. This, in turn, causes indigestion, bloating, flatulence, constipation, esophageal candidiasis, plus possible side effects affecting other organs. These side effects are more severe when a high protein diet (high content of meat, cheese, dairy products, and beans) is consumed, since protein digestion is initiated in the stomach and is essentially the only type of enzymatic digestion that occurs there.
Gina Picks for Healing Supplements
Zinc carnosine - Zinc is an essential mineral, often present in metalloenzymes, that plays key roles in the gastrointestinal (GI) tract, gene expression, stabilizing cell membranes, immune function, reproduction, sexual maturation, and other biological processes.
Zinc-carnosine supports the healthy ecology, natural defenses, and integrity of the gastric mucosal lining.
Relieves gastric discomforts such as occasional heartburn and indigestion, upset stomach, mild nausea, bloating, belching, and burping.
Promotes a healthy gastric bacterial balance.
Provides antioxidant protection for gastric mucosal cells.
Helps maintain the integrity of the protective gastric mucosal lining by supporting healthy mucus secretion.
Some research indicates that zinc-carnosine may protect gastric mucosal cells without altering prostaglandin metabolism.
Gastro-supportive benefits demonstrated in over 20 published studies.
Same raw material used successfully by healthcare practitioners in Japan since 1994.
DGL - The root of licorice is abundant with novel phytochemicals, namely hispaglabridin B, isoliquiritigenin, and paratocarpin B, that have a plethora of biological effects in the human body, including anti-inflammatory, liver support, stomach support, antioxidant effects, and other beneficial activities.
GI Integrity - For chronic GERD decreasing inflammation, repairing the lining of the gut and ensuring adequate waste removal are a key focus of treatment. GI Integrity is a perfect combination of herbal supplements, zinc carnosine and key amino acids to support GI integrity and function, promote nutrient absorption and waste elimination.
GERD is a disease with potentially very serious outcomes. It is highly recommended that you visit with a healthcare provider that can help you find the root cause of your symptoms to address this problem effectively.
References
Gut.1969 October; 10(10): 852–856. PMCID: PMC1552999
Maathuis, F. J. (2009). Physiological functions of mineral macronutrients. Current opinion in plant biology, 12(3), 250-258.
Mahmood, A., Fitzgerald, A. J., Marchbank, T., Ntatsaki, E., Murray, D., Ghosh, S., & Playford, R. J. (2007). Zinc carnosine, a health food supplement that stabilises small bowel integrity and stimulates gut repair processes. Gut, 56(2), 168-175.
Boldyrev, A. A. (2012). Carnosine: new concept for the function of an old molecule. Biochemistry (Moscow), 77(4), 313-326.
Davison, G., Marchbank, T., March, D. S., Thatcher, R., & Playford, R. J. (2016). Zinc carnosine works with bovine colostrum in truncating heavy exercise–induced increase in gut permeability in healthy volunteers, 2. The American journal of clinical nutrition, 104(2), 526-536.
Sharif, R., Thomas, P., Zalewski, P., Graham, R. D., & Fenech, M. (2011). The effect of zinc sulphate and zinc carnosine on genome stability and cytotoxicity in the WIL2-NS human lymphoblastoid cell line. Mutation Research/Genetic Toxicology and Environmental Mutagenesis, 720(1), 22-33.
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