Causes, prevention and treatment for GERD / ACIDITY / ACID REFLUX
MORE COMMON THAN YOU THINK - PART XI
Have you ever heard of GERD or Gastroesophageal reflux disease? What you have possibly heard about is acidity; that is closely related to GERD. Well that is why GERD is "More common than you think". GERD affects about 8-12% of the Indian population as per the Journal of The Association of Physicians of India while acidity is far more common. In the western countries, the prevalence is expected to be about 20%. The treatment of GERD or acidity is also relative simple in most cases and can also be prevented using some home remedies.
What causes acidity? What is GERD?
Whenever one eats food, digestive enzymes are secreted by the body for digestion. The food, through a tube connecting the mouth and the stomach called esophagus, enters the stomach for digestion. There is a valve known as the lower esophageal sphincter (LES), that opens and allows this flow. Once the food has entered the stomach, this valve closes, thereby not allowing the food and "acids" produced for digestion to flow back to the mouth. If this valve malfunctions, the acids flow back through esophagus to the mouth which results in acidity or acid reflux or gastroesophagus reflux (GER). When the acid refluxes progress and are frequent (twice a week), it is known as GERD.
One of the major reasons for the valve to malfunction is the weakening of the muscles i.e. LES that could result in improper closing of the esophagus or opening of the valve at the wrong time. One of the reason for this can be hiatal hernia (the stomach bulges into the chest through the diaphragm).
What puts us at risk of GERD or frequent acidity attacks?
Even without hiatal hernia, many factors might make us prone to GERD. They are:
Being overweight or obese
Certain medical conditions like rheumatoid arthritis or lupus
Delayed emptying of the stomach
Eating too soon before bed
Certain medications including aspirin
Certain foods and drinks like chocolates, fried foods, coffee or alcohol.
What are the symptoms of GERD?
The most common symptom for GERD or acidity is heartburn. It can be often confused with heart ailments or heart attacks. Apart from this, other symptoms could be:
A hard time swallowing
A lump in the throat
Specifically at night, these symptoms can be further complicated by
A lingering cough
Asthma could get worse
How is GERD diagnosed?
Upper GI series
This is a preliminary test that a physician will conduct, more to rule out other ailments. It is a special type of an X Ray of the esophagus and stomach. It does not give a detailed result but helps in confirming the further course of action.
An endoscope (a tube with light and camera) is put in the esophagus to examine it for any inflammation or irritation. If further analysis is needed, a biopsy is conducted i.e. a small tissue sample is taken from the esophagus.
Esophageal manometry and impedance study
This test checks for low pressure in your esophagus. It can also show defects in how your esophageal muscles contract.
The physicians can conduct pH tests to check the acidity levels in the body during various activities like eating, sleeping and other times during the day to have a definite diagnosis and further course of treatment.
How can one prevent acidity? What are the possible treatments for GERD or acidity?
Acidity can be prevented by making simple changes to the lifestyle. Some things that might help are:
Avoid foods that trigger acidity
Typically these foods could be chocolate, peppermint, caffeine, alcoholic beverages, citrus fruits, tomato products and pepper
Eat smaller servings
Having smaller servings every 2-3 hours helps in better digestion and lesser acids being released thereby avoid the reflux. Also, eating 2-3 hours before going bed helps in easing acidity at night.
Eat slowly. Chew properly
The digestion of food begins in the mouth. So eating slowly and chewing the food thoroughly aids digestion, leaving a lesser needs for acids. With lesser acids, the chances of reflexes are further reduced.
Smoking results in the weakening of LES. Hence, if one has severe bouts of acidity frequently, one should stop smoking immediately.
Sleeping on a thicker pillow
If the head is elevated while sleeping, the reflux of acids becomes difficult owing to simple gravitational force. Far more acids will be required for the reflux trigger. This may avoid the reflux completely.
Lose excess weight
Obesity is known to be a big reason for acidity. Reducing weight can go a long way in avoiding acid refluxes.
Wear loose clothes
If the clothes worn are too tight around the waist, they might interfere with the functioning of the LES and thereby cause GERD. Hence, it is best to avoid tight clothes.
Treatment of acidity or GERD is usually easy. Following could be the possible course of treatment.
Over the counter antacids are a well known, instant relief mechanism for acidity. These antacids neutralise the acids in the esophagus and stops heartburn almost instantly.
But, if one needs to have these antacids very often (i.e. suffers from GERD), there might be severe health concerns arising out them like excess magnesium (that could result in kidney disorders) or Diarrhea or many more.
H2 blockers block the acid secretion in the stomach thereby avoiding acid refluxes. These are typically used for chronic GERD and not for acidity per se. Long usage of these medicines can have a negative impact on the digestive tract.
These drugs block the formation of a protein needed to make stomach acids. Again, without the acids, the chances of acid refluxes are lowered but long term impacts on digestive tract are a real possibility.
Rarely, doctors prescribe these medicines. They help empty the stomach faster thereby reducing the need for acids. They might also help in other gut health issues like bloating and nausea. But continued usage is never recommended as it can have severe side effects.
If all the medications fail, the last resort to solve chronic GERD is surgery. There are different types of surgeries that can help with GERD, some invasive some newer, more innovative and non-invasive. Some common surgeries are Fundoplication, TIF, Stretta and LINX.
What are further complications if one does not take care of acidity or GERD?
Apart from the regular heartburns and uneasiness, GERD could have a severe long terms impact.
With continues damage to the lining of the esophagus, open sores are formed. With more acids, these can be painful and cause internal bleeding.
Stomach acid damages the lower part of the esophagus and causes scar tissue to form. This scar tissue builds up until it narrows the inside of the esophagus and makes it hard to swallow food.
Esophagus lining damage and further exposure to the stomach acids causes the lining to get thicker and turn red. This condition is linked to a higher chance of esophageal cancer.
If the reflux reaches the back of the throat, it can cause irritation and pain. From there it can get into the lung. This could further lead to having a hoarse voice, postnasal drip, chest congestion and cough. Further worsening might result in asthma and bronchitis.
Ayurvedic view and treatment of GERD
Ayurveda treats digestion as the most important function of they body. Most ailments are directly or indirectly related digestion. Any ayurveda practitioner is bound to diagnose first, the gut health even for ailments that might seem unrelated. GERD or acidity is a direct implication of gut health. GERD is typically caused when the doshas are vitiated, typically the pitta dosha. One of the issues that ayurveda points at is virudh aahar i.e. having foods of incompatible nature (foods that have a very different digestive process). At Chyavan Rishi Ayur Siddha, our gut health expert and the ayurvedic medicine for acidity, GERD, constipation is Chyavan Pachan. With potent herbs, having this gold dust an hour before meals helps digest the food without needing excessive acids and hence helps reduces acid refluxes. Instant relief for acidity on one end and serving as an ayurvedic medicine for GERD at the other, Chyavan Pachan can do it all for you, all without any side effects or long term damage to the body.
If you would like to read up on the other blogs in this series called 'More common than you think', here are quick links for Urinary Tract Infection, Mental wellness, Tuberculosis, Constipation, Arthritis, Erectile dysfunction, Periodontitis / Pyorrhea, Anaemia, Kidney stones, Asthma, Bloating.