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Gastroesophageal Reflux Disease, Part 3


By Ronald D. Whitmont, M.D.
Created: January 20, 2011 Last Updated: January 20, 2011
Related articles: Health » Western Medicine
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PROMOTING HEALING: The plough is one of the yoga exercises that can strengthen the lower esophageal sphincter and prevent GERD. (Photos.com)

PROMOTING HEALING: The plough is one of the yoga exercises that can strengthen the lower esophageal sphincter and prevent GERD. (Photos.com)

Several supplements have been found to be helpful in correcting GERD naturally without inducing the common side effects of conventional medications. It is important to understand that these supplements are not just milder, more-natural forms of conventional therapies, which is so often the case with natural medicines.

They also act differently in the gastrointestinal (GI) tract because they have an altogether different mode of action. Because these agents support the function of the stomach rather than fight it, they promote healing from GERD rather than its prolongation.

Raw organic apple cider vinegar (1 to 2 teaspoons daily) is extremely effective in reducing the incidence of GERD. At first glance, the use of this supplement appears counterintuitive since vinegar is a weak acid (5 percent acidity).

Supplementation with a weak acid in a hyperacidic situation is, by definition, homeopathic. Adding a small amount of acid back into the system (in the form of vinegar) can strengthen the tone of the lower esophageal sphincter (LES).


Conventional treatment aims to suppress and neutralize acid in the stomach. The usual end result of this antipathic approach is to force the body to produce the opposite effect: Namely, the stomach fights to produce more acid. Suppressing stomach acid also appears to weaken the LES.

The homeopathic approach delivers a tiny amount of the offending agent (acid) back to the body. This small stimulus somehow acts through physiologic sensors and feedback loops to enable the body to down-regulate acid production, tighten the LES, and stimulate peristalsis.

Adding a small amount of acid back into the system (in the form of apple cider vinegar) strengthens the tone of the LES, probably via the acid receptors in the lower esophagus.

Supplementing diet with a variety of probiotics and a diet rich in prebiotics may reinforce biological symbiosis (see H. pylori in Part 2) and fortify the digestive process.

Exercise

Doing proper exercises is extremely important to ensuring recovery from GERD. These exercises are primarily oriented toward strengthening and reinforcing the LES.

Conventional treatments weaken the LES, but if the LES is stressed through the proper procedures, it can recover function and end the cycle of GERD. The following exercises are recommended to strengthen both the LES and diaphragm and thus ensure the long-term recovery from GERD.

Since the diaphragm surrounds and augments the LES and it is under voluntary control, it is the focus of most of these exercises. Strengthening the diaphragm involves the voluntary, conscious technique of diaphragmatic breathing.

Diaphragmatic breathing means expanding and forcing out the abdomen while inhaling and then doing the opposite, sucking in the abdomen and forcing the air out while exhaling.

Certain yoga methods utilize this type of breathing (named Bhastrika, or bellows breath) to the same end. Both inhalation and exhalation should be actively and forcefully controlled to alternately flex and relax the diaphragm. Care should be taken not to hyperventilate.

These techniques are counterintuitive and opposite to the way in which most people naturally breathe. Most people breathe unconsciously, utilizing the muscles of the chest wall and allowing the diaphragm to remain inactive until it is atrophied.

Conscious, forced diaphragmatic breathing reinforces the activity of the LES and also stimulates mechanical emptying of the stomach and peristalsis of the intestines. Other benefits include improved biliary (gall bladder) activity, stimulation of bowel function, and augmentation of the gastrocolic reflex, which promotes timely bowel movements.

Other important exercises that help strengthen the diaphragm include inversion postures. These can be accomplished either on an inversion table or through certain carefully executed yoga positions, including the plough, the shoulder stand, and the headstand.

These exercises should only be performed with proper supervision and training. They should always be utilized in conjunction with deep abdominal-diaphragmatic breathing. These postures force the diaphragm and the LES to contract more tightly under pressure and against added postural stress. The results of these exercises impart greater strength and integrity to the LES in normal everyday conditions, preventing GERD.

These exercises contradict conventional recommendations since they foster the development of increased muscle tone and greater sphincter control, which lead to decreased likelihood of developing GERD. These exercises and dietary modifications can also be used prophylactically to prevent the development of GI dysfunction.

Homeopathy

Homeopathy can be very effective in achieving full recovery and in preventing recurrences of GERD. Proper evaluation and repertorization of each individual case is important. Classical homeopathy requires individualization of treatment and attention to rare, peculiar, and constitutional details of each individual. Thorough evaluation should be performed by individuals well trained in classical homeopathy.

Generic homeopathy and combination remedies have very limited application to this condition. The best results are obtained if the remedy is selected individually to match to the specific details of each case.

Conclusion

Modifications of lifestyle include exercises, dietary guidelines, and supplements that, when used in combination with classical homeopathic treatment, can restore normal gastrointestinal functioning and relieve the symptoms of GERD.

These techniques are inexpensive, simple, and effective. Adherence to these guidelines not only relieves symptoms of GERD but also prevents recurrences and helps maintain a healthy gastrointestinal tract. 

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.




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