Gastroesophageal Reflux Disease--GERD
(below is summarized from Nutritional Medicine, by Dr. Alan Gaby, M.D., along with other recommendations taken from other mentors and my own clinical experience.)
GERD has acid contents of the stomach coming up into the esophagus with symptoms of heartburn, regurgitation or nausea. Long term GERD can damage the esophagus and the sphincter and its tissues leading to pre-cancerous condition.
Obesity and cigarette smoking can trigger GERD.
Some things that help GERD:
1. Slow down eating, chew longer. The very process of mastication increases various factors in saliva which can reduce GERD.
2. Do not eat big, high caloric meal too close to bed time. This will reduce the amount of acid reflux, which is more likely to occur when laying down.
3. Avoid: Caffeine-containing foods or beverages because they directly affect the esophageal sphincter. For some chocolate does the same. Others include: alcohol, citrus fruits, tomatoes, onions, peppermint and spearmint.
4. Eat smaller, more frequent meals with low to moderate fat content.
5. Some people with GERD responded well to the Atkins diet (very low carbohydrate)
6. Food allergies can be a cause of GERD. Use a food elimination diet to determine your food allergies.
7. Calcium carbonate may relieve symptoms, such as Tums EX.
8. On the other hand, too often LOW stomach hydrochloric acid may be the cause of GERD, because the esophageal sphincter has a chemosensor which responds to stomach acid. Too low stomach acid (i.e. the pH is too high) will not trigger the sphincter. I find this very common in my patients. So even though you may feel acid coming up in your throat, your acidity is too low and counterintuitively you need extra hydrochloric acid with your meals as Betaine HCl (with pepsin).
If you are still young, (< 50), if you have low stomach acid, then I would recommend doing a GI (gastrointestinal) test panel, because you may well have an infection which is lowering your stomach acid. As you age, your stomach acid may drop because of other issues. Typically, it is correctable, until you are in your 70s or even 80s.
The proper way to take Betaine HCl with pepsin is to titrate the amount. This amount varies from individual to individual and as your stomach recovers and is able to make its own hydrochloric acid (HCl), you will need less. To titrate start with 1 pill/cap of Betaine HCl with each meal. Do that for a few days, then increase the dose to 2 and so on. Do not exceed about 6 caps. When you definitely notice a flushing feeling or some other heat-like sensation, stop and back up one pill/cap. That is your dose.
If taking Betaine HCl causes your stomach to burn or otherwise have pain, then you may well have too much inflammation in your stomach. Discontinue the Betaine HCl and you may need treatment to reduce your stomach inflammation first. Please call if you have this.
9. Beta-Carotene: 25 mg/day for 6 months improved reflux and improved the tissues of the esophagus.
10. Sodium alginate: from seaweed, used in food preparation; reacts with gastric acid to form a gel that lies on top of the stomach contents and physically inhibits reflux. Studies show this does better than antacids. 10ml of a water suspension (no amounts given) 4 times per day for 2 weeks. Complete symptom relief within 30 minutes for most patients.
11. Eat an apple. This does not cure, but it can definitely stops the reflux.
Hope this helps,
Chuck Belanger, L.Ac.