The Causes of GERD and the Problem with Conventional Treatments

The Causes of GERD and the Problem with Conventional Treatments

The Causes of Heartburn / GERD

Heartburn is mainly caused by too much gastric pressure in the stomach. 1 This gastric pressure causes stomach contents to blow through the LES and up through the esophagus where it is then stopped by the UES and sent back down into the stomach. Increased gastric pressure can be caused by:

  1. Too many opportunistic bacteria in the small intestine causing gas to travel upwards putting pressure on the stomach (SIBO). 2
  2. Excess opportunistic H. pylori in the stomach which are producing gas and causing stomach pressure to increase, therefore weakening the LES. 3
  3. Over-ingestion of prebiotic food and drinks (beans, fermentable vegetable matter, rice, excess lactose). 4
  4. Ingestion of GMOs. 5
  5. Tight fitting clothing (belts mainly) putting excessive pressure on the intestinal tract forces the stomach upward and increases gastric pressure. 6
  6. Incorrect posture which leads to more pressure being put on the stomach by the spine. 7
  7. Weakened LES due to increased pressure causes more stomach contents to be forced up through the esophagus. 8
  8. Lack of digestive enzymes and stomach acid that causes poor digestion of food which can lead to increased gas buildup. 9
  9. Candida overgrowth causing excessive fermentation and gas production. 10
  10. Constipation that leads to an increase of toxins, gas and bacteria in the colon that slows gastric emptying. 11
  11. Lack of chloride in the diet which can lead to a decrease in stomach acid. 12
  12. Poorly functional gallbladder, liver, or pancreas that can lead to either digestive enzyme or bile problems. 13
  13. Having a hiatal hernia. 14
  14. Improper defecation posture. 15
  15. Having a Parasite Infection. 16

To correctly treat heartburn you have to choose which above cause is creating your suffering. Some problems may overlap so tackle each problem accordingly.

GERD

Gastroesophageal reflux disease is a condition in which mucosal damage is done to the esophagus, from chronic stomach acid and pepsin being trapped between the stomach and the upper esophageal sphincter. This “trapping” gives the patient the characteristic feeling of heartburn. Having GERD can cause injury to the esophagus, including esophagitis, strictures, or even cancer from chronic inflammation if left untreated.

The most common symptoms of GERD are heartburn and dysphagia (trouble swallowing.) A person with GERD can also display symptoms like regurgitating acid and food, have a sore throat, chest pain, increased salivation, and nausea. If GERD is left untreated, it can cause a reversible condition called Barett’s esophagus where the epithelial lining of the esophagus turns into squamous or intestinal mucosal epithelium and can cause a greater risk of developing esophageal cancer.

Diagnosis of GERD is usually made by acknowledgment of symptoms by a doctor. However, an endoscopy can be done to get an idea of how damaged the esophagus is and the general function of the LES and stomach. During an endoscopy, a flexible wire with a camera at the end is swallowed, and the camera takes pictures down the esophagus and into the stomach. One of the best tests used in the diagnosing of GERD is an esophageal PH monitoring test. This test is sometimes performed in the hospital for at least twenty-four hours and during this test, a flexible catheter with a PH monitor on the end is placed through the nose down into the esophagus. It can be uncomfortable to have a tube put down your nose and into your throat, but it can be useful in the diagnosis to determine if you are suffering from reflux. 17

Conventional Medicine Failed Treatment’s for GERD / The Average GERD “Cycle”

GERD Standard Treatment

Conventional medicine attempts to treat GERD with acid-reducing medications, and as a last resort surgery. Acid reducing medications like H2 antagonists or proton pump inhibitors mechanism of action is that they limit the stomach’s production of stomach acid. In theory, this sounds like a great idea for someone who has GERD. If you limit the stomach acid that irritates the esophagus from the stomach, a person with GERD should feel much better. 18

H2 antagonist – Examples: Pepcid AC, Zantac – H2 antagonists are the safest of the stomach acid reducing drugs because they only last for about six hours and work by lowering histamine levels in the stomach which lowers stomach acid production. H2 Antagonists can still cause the same problems of lowered levels of stomach acid like PPI’s if taken for a long period of time, even if they have a smaller side effect profile. 19

Proton pump inhibitors – Examples: Prilosec, Prevacid – PPI’s are safe medications as long as a patient takes the medication for one month. If you take a PPI longer than a month, then some extra issues might develop from the lack of stomach acid. Patient’s who take PPI’s long-term start to have a whole host of problems including B12 deficiency, 20 bone fractures, 21 Increased risk of C. diff Infection, 22 magnesium deficiency, 23 food allergies, 24 and SIBO. 25 These drugs inhibit the hydrogen/potassium ATPase enzyme system in the gastric cells that secrete stomach acid. These drugs were developed because they last longer that H2 antagonists and usually block acid for 1-2 days. 26

The problem with acid-reducing medications is once you take them long term; the medication does not correct any of the above problems that were the cause of GERD in the first place. By taking a PPI long-term; all the medication is doing is “masking” the symptoms, instead of tackling the original cause of the disease. Taking a PPI for a long time leads to the average person losing the intrinsic factor of the stomach (becoming deficient in B12,) weakening their LES over time, developing a magnesium deficiency, developing food allergies from improper food digestion, and even developing SIBO from the lack of stomach acid reducing excess bacteria from their food intake. The lack of stomach acid causes a whole host of problems that the person did not originally have, and since the cause of their GERD is not dealt with to begin with, the person is dependent on using the PPI for the rest of their life.

This “masking” of the symptoms also explains the worsening GERD attacks one has after discontinuing the PPI. The body tries to up-regulate stomach acid to take care of the original issues that started because of PPI medication being taken for so long (SIBO, limited protein digestion in the stomach, weakened LES.) The up-regulation of stomach acid causes worse GERD symptoms than one previously had, because of increased abdominal pressure injunction with the excessive acid production. The average person goes back on their PPI and the cycle continues until the doctor recommends a mostly useless surgery for relief, Nissen Fundoplication. 27

Nissen Fundoplication

A Nissen fundoplication is a generally useless and harmful surgery for the average GERD suffer. When a person has the Nissen procedure done they have the top part of the stomach (gastric fundus) stapled around the LES or the lower part of the esophagus so that it is strengthened and reflux into the esophagus is blocked. 28 Like other conventional GERD treatments, this seems like a great idea in theory. Studies show that 90% of patients are cured of their GERD, which is a great thing, right? 29

But the problem with this is that most of them are now left with a host of problems like “gas” bloat syndrome, dysphagia, and gastric dumping syndrome. 30 A fundoplication can also become undone over time and occurs on average in about 10% of the people that have had the surgery. 31 “Gas” bloat syndrome is a syndrome where the stomach can not properly expel gas through burping and even in some extreme cases a person can even burp or vomit at all which can cause extreme pain. “Gas” bloat syndrome has about a 41% occurrence rate in people who have had a Nissen done and though it can go away in about two months; occasionally for some people they have it until the surgery is either redone or reversed. 32 This surgery should be avoided at all costs!

  1. http://chriskresser.com/the-hidden-causes-of-heartburn-and-gerd
  2. http://www.siboinfo.com/symptoms.html
  3. http://gut.bmj.com/content/54/suppl_1/i13.full
  4. http://chriskresser.com/fodmaps-could-common-foods-be-harming-your-digestive-health
  5. http://chriskresser.com/are-gmos-safe
  6. http://www.webmd.com/ahrq/treating-acid-reflux-disease-with-diet-lifestyle-changes
  7. http://www.ucdmc.ucdavis.edu/welcome/features/20081204_heartburn/index.html
  8. http://www.ecaware.org/what-is-esophageal-cancer/risk-factors/acid-reflux-gerd/
  9. Rubin, Jordan /Brasco, Joesph. Restoring Your Digestive Health,Twin Streams Publishing, 2003.
  10. http://www.drlwilson.com/articles/candida.htm
  11. Rubin, Jordan /Brasco, Joesph. Restoring Your Digestive Health,Twin Streams Publishing, 2003.
  12. http://www.bobcotton.com/gerdsalt.htm
  13. Balch, Phyllis. Prescription for Nutritional Healing, Avery Publishing, 2010.
  14. http://www.westonaprice.org/digestive-disorders/acid-reflux-a-red-flag
  15. http://www.slate.com/articles/health_and_science/science/2010/08/dont_just_sit_there.html
  16. http://www.preventionandhealing.com/articles/Acid_Reflux_and_Rebellious_Stomach-NEW.pdf
  17. Beers, Mark, The Merck Manual, Merck Research Laboratories, 2006
  18. Beers, Mark, The Merck Manual, Merck Research Laboratories, 2006
  19. Beers, Mark, The Merck Manual, Merck Research Laboratories, 2006
  20. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886361/
  21. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886361/
  22. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886361/
  23. http://www.fda.gov/drugs/drugsafety/ucm245011.htm
  24. http://www.ncbi.nlm.nih.gov/pubmed/21121928
  25. http://www.ncbi.nlm.nih.gov/pubmed/21128930
  26. Beers, Mark, The Merck Manual, Merck Research Laboratories, 2006
  27. Dr. Brownsetin, David, Drugs That Don’t Work and Natural Therapies that Do!, Medical Alternative Press, 2007
  28. Beers, Mark, The Merck Manual, Merck Research Laboratories, 2006
  29. Beers, Mark, The Merck Manual, Merck Research Laboratories, 2006
  30. http://www.gastro.theclinics.com/article/S0889-8553%2805%2970102-3/abstract
  31. Beers, Mark, The Merck Manual, Merck Research Laboratories, 2006
  32. http://www.hon.ch/OESO/books/Vol_6_Barrett_s_Esophagus/Articles/vol2/art023.html
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