Conventional wisdom advocates a series of seemingly logical but ultimately ineffective modifications of lifestyle that increase the risk of developing chronic gastroesophageal reflux disease (GERD).
These modifications include raising the head of the bed at night, not lying down within three hours after eating, wearing loose-fitting clothing, eating only small and frequent meals, avoiding spicy foods, and eliminating the consumption of food in the evening before bed.
Complying with these modifications actually weakens the lower esophageal sphincter (LES) and, over time, further reduces the chances of recovery from GERD.
If a muscle or a sphincter like the lower esophageal sphincter (LES) is weak, then stressing it with exercise is one of the best ways to strengthen it. Avoiding exercise and eliminating stress will ultimately weaken the muscle more, leaving room for dependency on medications rather than cure.
Cold-turkey withdrawal of medications in cases of GERD is usually associated with a significant worsening of symptoms. This, of course, encourages long-term adherence to these products and fosters the belief that this condition is incurable. The real reason why treatment withdrawal is so difficult is that the condition is actually made worse by these treatments!
Conventional treatment does not cure GERD, but it can make it less noticeable.
There is a known association between GERD and a condition known as Barrett’s Esophagus (BE). BE carries an increased risk of cancerous transformation of the esophagus. This condition requires periodic monitoring by a gastroenterologist.
GERD does not cause BE or cancer of the esophagus, nor do conventional medications protect against the incidence of either of these conditions.
GERD is more common if the bacterium H. pylori has been eradicated from the stomach. When H. pylori is eliminated (through the use of antibiotics), there is an increased tendency to develop GERD and its associated complications. The probiotic H. pylori appears to protect the LES, prevent GERD and BE, and reduce the incidence of cancer of the esophagus.
Alternative Treatment, Lifestyle Changes
A combination of lifestyle changes can help strengthen the LES and promote a healthier digestive tract while lowering the incidence of GERD and other GI disturbances. Treatment involves dietary modification, supplementation, specific physical exercises, and homeopathy.
Smoking cessation and weight loss (if obese) offer universal benefit to most medical conditions, including GERD.
Refined carbohydrates have been found to directly contribute to the incidence of GERD. Elimination of refined sugars and highly processed foods while substituting complex carbohydrates and whole grains significantly reduces the risk of GERD. Whole-food-based vegetarian diets also assist in preventing GERD.
A diet high in complex carbohydrates and low in simple sugars is helpful in maintaining LES integrity. Whole foods that include the skins of fruits and vegetables, whole grains, seeds, and foods with high-fiber content in their natural state are beneficial. Highly processed and refined foods low in fiber should be avoided altogether.
High-fiber diets not only assist the LES but also stimulate gastric motility and peristalsis, leading to more-rapid emptying of the stomach contents into the small intestines. When food is emptied more rapidly from the stomach into the intestine, it is less likely to regurgitate backwards through the LES into the esophagus.
Eating meals slowly and chewing thoroughly is also an effective means of reducing the risk of developing GERD since gastric emptying is slower when food is inadequately chewed. Food may back up in the stomach and lead to regurgitation if it is consumed too rapidly without proper chewing.
There also appears to be evidence that consumption of spicy food, including cayenne pepper and ginger, reduces the symptoms of chronic indigestion and GERD. Capsaicin is a chemical in red pepper that blocks nerve signals and leads to diminished pain sensation. Ginger may contain similar ingredients. Evidence suggests that these spices relieve symptoms of GERD, but they probably don’t cure it.
This is Part 2 of a three-part series.
Next week: Part 3 on more alternative treatments for GERD
Dr. Whitmont 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.