What is GERD?

Gastroesophageal Reflux Disease (GERD) is a condition where the stomach contents regurgitate into the esophagus after taking a meal, causing a burning sensation or a sour taste. The pH of the stomach is very acidic in contrast of the pH of the esophagus which is more alkaline. The regurgitation of acidic content from the stomach to the esophagus damages the lining of the esophagus and can cause serious conditions if untreated. Continuous exposure of the lower esophagus to an acidic pH can cause Barrett Esophagus a pre-cancerous condition that can later develop into stomach cancer. GERD has also been associated to colon cancer. It is therefore important to treat GERD as soon as possible.

Up to 40% of people are estimated to regularly experience heartburn, the main symptom of GERD.

Symptoms include:

  • Difficulty swallowing
  • Heartburn
  • Regurgitation of a sour brash
  • Blood in vomit
  • Black stool from GI tract bleeding
  • Chronic symptoms can be punctuated by attacks of severe chest pain that can be mistaken for a myocardial infarction

What Causes GERD?

The lower esophageal sphincter (LES) acts as a partition between the esophagus and the stomach. Normally the LES is closed except to allow the passage of food while eating. However, a weak LES or hiatal hernia or large amount of food intake, can cause the reflux of acidic stomach contents into the esophagus causing heartburn. The following factors may contribute to GERD:

  • Benzodiazepines and Barbiturates
  • Sleep medication: Ambien, Lunestra, Sonata
  • Bisphosphonates
  • Hypothyroidism
  • Pregnancy
  • Autoimmune disease
  • Alcohol or tobacco use
  • Nasogastric tube
  • Hiatal hernia

Conventional Treatment of GERD and Side Effects

Conventional treatments use proton pump inhibitors aiming to decrease the amount of acids secreted by the stomach by blocking the ability of the stomach to produce acid. However, acids play an important role in digestion: Acids breakdown food and make nutrients available for absorption by the small intestine. Long-term use of these drugs impairs digestion and causes nutritional deficiencies. Acids are also the first line of defense against pathogenic bacteria such as H. Pylori that may enter the body through food. In addition, there are suspicions that these drugs may cause cancer of the stomach and colorectal cancer.

Conventional drugs used for GERD:

  1. Antacids- act to suppress the gastric acid by buffering the gastric and esophageal contents providing a rapid and short-term relief of symptoms in 25% of patients. Must be dosed frequently throughout the day for relief.
  2. Alginates- an anti-reflux agent, form a viscous protective barrier on the top of the gastric contents, which prevents contact with the esophagus.
  3. Histamine H2- Receptor Antagonists (H2RA)- inhibit the secretion of acid by competitively and reversibly blocking the parietal cell H2- receptors. They have a slower onset of action compared to the antacids, but suppress 70% of the gastric acid release for 4-8 hours. This medication has a pharmacological tolerance that develops in 7-14 days which inhibits it from being a long-term solution for GERD. They are dosed twice daily.
  4. Sucralfate- acts as a barrier to gastric acid and pepsin by binding to damaged epithelium, epidermal and fibroblast growth factors. Its efficacy is similar to the H2RA with a reported healing rate of 17-67%.
  5. Prokinetics- such as bethanecol, metoclopramide, domperidone and cisapride stimulate gastric motility by acting’s as a dopamine receptor agonist in the gut, or on serotonin receptors, increasing the release of acetylchoine. They have a similar efficacy to H2RAs, but are limited by their side effects.
  6. Proton Pump Inhibitors- act on the gastric acid pump. They are considered a highly effective therapy for GERD and its complications. They produce significantly faster and more complete relief of heartburn symptoms than H2RAs, and heal erosive GERD with higher rates after 4-8 weeks of treatment. They are dosed once daily.

How Does Hawaii Naturopathic Retreat Center Treat GERD?

Naturopathic medicine aims to eliminate any factors that may be affecting the functioning of the lower esophageal sphincter (LES) such as hiatal hernia, low acid pH, poor diet and food sensitivity. Our goal is to optimize digestion and food breakdown by increasing the stomach acid with Betain HCL.