Healing GERD: just as nature designed

My favorite explanation of a natural approach to healing reflux is based on the simple truth that the body has its own innate wisdom. Some may say that the creator or engineer of our bodies has infinite wisdom, and to heal heartburn, it is good not to stray too far from this outlook.

What naturopathic docs explain is that the stomach is supposed to be a sack of hydrochloric acid; a person is just not supposed to feel the acid. When patients have GERD or gastroesophageal reflux disease, the real problem is not that they have too much acid, they’re just feeling it. 

Since this condition affects approximately one-third of the population in the U.S. at least once per month, it makes sense to pay attention to the body’s wise design. A full 10 percent of adults experience GERD symptoms daily or weekly. Typically after a meal, acid from the stomach moves up into the esophagus and irritates the inside lining, creating the sensation of heartburn. Over time, the stomach acid can damage the lining of the esophagus so much that the cells become pre-cancerous, a condition called Barrett's Esophagus. Other GERD symptoms include tooth enamel decay, coughing, asthma, wheezing, gingivitis and halitosis.

So, what is in place to protect the stomach and esophagus from corrosive actions of digestive enzymes and acid? The two key protective measures are a thick mucus layer, and a pressure gradient.

With the mucus barrier, there is a direct relationship that happens chemically - when the presence of HCL acid is increased, there is increased production of mucus and bicarbonate ions at the mucosal surface.

To most naturopaths, it makes sense that the stomach has many mechanisms to protect itself and create this amazing function of bathing our ingested food with HCL. Ironically, stress reduces HCL production, which in turn leads to a decrease in mucus protective actions, and reduction in the pressure gradient at the esophagus base.

A sympathetic nervous system (aka fight or flight) response to stomach cells results in reduced digestive secretions, whereas a parasympathetic nervous system (aka rest and digest) has restorative action to the GI tract. Most people suffering from GERD acknowledge that it worsens when they are highly stressed.

As we age, stomach acid levels decline, and acid is further decreased by coffee consumption and poor diet. Low stomach acid levels actually cause the sphincter muscle on top of the stomach to relax, allowing what little stomach acid there is to reflux and cause heartburn. A healthy, and often higher amount of stomach acid can keep the lower esophageal sphincter muscle tight, preventing acid from refluxing. Naturopathic doctors try to heal gastric reflux by increasing the person's stomach acid.

Concerns about proton pump inhibitors

Proton pump inhibitors are used to treat GERD symptoms. These medications include Aciphex, Nexium, Prevacid, Prilosec and Protonix, in addition to H2 blocker medications such as Axid, Pepcid, Tagamet and Zantac. These medications prevent reflux by blocking the stomach's ability to produce acid, lessening damage to the lining of the esophagus. These medications often provide relief, but many people also become dependent on these drugs. There are serious concerns about the long-term use of PPIs, including gastric and colorectal cancer, gastrointestinal bacterial infections, community-acquired pneumonia, nutritional deficiencies, osteoporosis, central nervous system effects including memory loss and possibly dementia, and damage to the kidneys and liver. PPI medications are only palliative. They do not address the underlying cause of heartburn or GERD, or heal the condition. People with GERD may be told to take PPI medications for the rest of their lives.

What is more restorative for clients with GERD is not to suppress function, but actually restore it. Hydrochloric acid is key to not only break down proteins and absorb minerals, but also as a natural barrier against infection (the acid kills pathogenic bacteria, viruses and parasites). My daughter is currently visiting Thailand, and as she sent me pictures of the street vendor food she has been thoroughly enjoying, she also commented that I need not worry. She is for sure taking the capsules of hydrochloric acid she brought along to be more protected from food-borne microbes.

To heal GERD, and not just treat symptoms, it is key to foster the health of the body’s protective mechanisms. That person who used to suffer from GERD will now be able to walk around with a stomach full of hydrochloric acid and not even feel it. Just like nature intended.

Natural remedies that heal reflux

Dietary changes as well as nutrient and herbal supplementation can heal GERD symptoms. Before taking supplements, consider consulting with a naturopathic doctor about getting a blood test to evaluate food allergies, or doing an elimination diet to see if symptoms improve when you remove potentially allergenic foods. Often, avoiding dairy products, citrus fruits, tomatoes, chocolate, caffeine, peppermint, fatty foods and alcohol can heal the issue. Other natural products used to alleviate GERD symptoms include:

• Betaine HCL to add acid to the stomach.
• Deglycerinated licorice to soothe the lining of the esophagus and prevent further complications of GERD such as Barrett's esophagus.
• Digestive enzymes to help digest food better.
• Marshmallow, slippery elm, plantain, aloe and other demulcent (soothing) herbs.
• Chiropractic visceral manipulation, a form of gentle bodywork to help alleviate GERD symptoms with a hiatal hernia.

Kim Furtado, ND, is a naturopathic doctor at Quakertown Wellness Center in Lewes. She specializes in science-based, patient-focused, natural medicine. For more information or to make an appointment, call 302-945-2107 or go to www.DrKimFurtado.com.