Subscribe

Gastroesophageal Reflux Disease, Part 1


By Ronald D. Whitmont, M.D.
Created: January 4, 2011 Last Updated: January 14, 2011
Related articles: Health » Western Medicine
Print E-mail to a friend Give feedback

WEAKENED IMMUNITY: Taking GERD medication can weaken the immune system and predispose one to infections. (Photos.com)

WEAKENED IMMUNITY: Taking GERD medication can weaken the immune system and predispose one to infections. (Photos.com)

Gastroesophageal Reflux Disease or GERD is a fairly common illness in the United States today. An estimated 40 million Americans suffer from recurrent heartburn, and when it happens at least twice weekly it is designated GERD.

This condition may have many causes, but both diet and lifestyle are two important factors that can help prevent it.

There are many symptoms of GERD, including heartburn, acid indigestion, reflux, chest pain, abdominal pain, foul taste in the mouth, regurgitation, hoarseness, chronic cough, asthma, and sinusitis.

Conventional management of GERD typically requires long-term drug therapy that ultimately fails to control the symptoms. Long-term treatment causes significant side effects, including osteoporosis, bone fractures, and infections.

Most cases of GERD can be cured through a simple program of modifying lifestyle, diet, and exercise coupled with classical homeopathic treatment.

Causes

Reflux into the esophagus is a natural phenomenon that affects everyone on occasion. GERD is the frequent occurrence of the backward motion of stomach acids (and sometimes bile) through the lower esophageal sphincter (LES) and into the esophagus.

The LES is the mechanical, circular valve that separates the esophagus from the stomach. All physiologic sphincters, which are made up of circular groups of muscle, are highly efficient but imperfect. It is not uncommon for these valves to leak on occasion.

The LES, which is situated at the level of the diaphragm (the largest muscle in the body), relies, in part, on the integrity of the diaphragm to augment its activity. If the diaphragm is weak, compromised, or atrophied due to the presence of a hiatal hernia, abdominal distention, or inactivity, then the efficiency of the LES will be reduced. For this reason, GERD is much more common when there is coexisting obesity or pregnancy.

Physiology

The stomach relies on acid to initiate the digestive process in breaking down foods. Acidification is essential for proper enzyme action and absorption, but it also appears to play an important role in activating the immune system.

Stomach acid is one of the body’s first lines of defense against many infectious organisms. Acid inactivates most bacteria, viruses, and fungi before they can cause infections of the GI (gastrointestinal) and respiratory tracts. Stomach acid may also play a role in activating the immune system through the extensive network of immune glands lining the GI tract.

Dysfunction of the acid barrier may lead to a cascade of events that not only affects nutritional status but also eventually alters immune integrity, even leading to allergy and hypersensitivity reactions.

Conventional Treatment: Medications

The main components of conventional treatment are drugs that either neutralize acid (antacids), suppress acid production (H2 blockers and proton pump inhibitors, or PPIs), or stimulate motility of the stomach.

The short-term effect of these interventions provides temporary relief of GERD symptoms in about 68 percent of patients although some studies suggest that these medications are barely better than placebo. These medications were never intended for long-term use since their side effects can be significant. 

When acid production is initially suppressed, the body endeavors to restore it. Over time, the body overcomes some of the suppressive effects of these drugs and restores some acid production.

The end result of this interplay between drugs and the body is that the efficacy of these medicines is reduced, and more medications are needed to produce the same level of symptom relief. Stronger medicines, combination drugs, or simply more-frequent dosing is required to achieve the initial level of symptom suppression.

Long-term side effects of acid suppression therapy include osteoporosis, hip fractures, vitamin and mineral deficiencies, and infections. Since stomach acid is essential for proper digestion and absorption of nutrients, long-term suppression will cause deficiency states.

This is particularly true for proteins and vitamin B12, which rely on the presence of an acid environment for proper breakdown and absorption. The PPIs increase the risk of bone fracture even more by directly inhibiting the bone-forming activity of osteoblasts.

Another long-term effect of acid suppression therapy is increased frequency of respiratory tract infections, including sinusitis, bronchitis, and pneumonia. Since the acid environment inside the stomach is one of the first lines of immune defense, it makes sense that once this chemical barrier is eliminated, the door to infection swings wide open.

This is Part 1 of a three-part series. 

Next week: Part 2 on conventional lifestyle modifications and alternative treatments

Ronald D. Whitmont, M.D., is a classical homeopathic physician and internist who practices in New York. He is a clinical assistant professor of family and community medicine at New York Medical College.

Tags:



   

GET THE FREE DAILY E-NEWSLETTER


Selected Topics from The Epoch Times

Harvey Frommer on Sports