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GERD, Heartburn and Acid Reflux: Causes, Symptoms and Treatment

While many people experience occasional heartburn or indigestion it is estimated that nearly 20% percent of the U.S. population suffer from Gastro-Esophageal Reflux Disease or G.E.R.D. This condition is also referred to as Gastro-Oesophageal Reflux Disease (GORD) or Gastric Reflux Disease (GRD). GERD is serious chronic condition with frequent symptoms including: heartburn, dyspepsia, regurgitation, chest sensations or pain, acid laryngitis and dysphagia (difficulty swallowing). Man with indigestionHeartburn results when stomach acid flows back (refluxes) into the lower esophagus, causing pain or tissue damage. It's important to realize that heartburn, reflux and even GERD itself are really a collection of symptoms and not the underlying problem. A symptom is merely how the body expresses a problem so we can do something about it.

Too Much Stomach Acid is Not the Culprit

Curiously, your body's ability to produce stomach acid decreases with age yet the incidence of reflux increases with age1. This is evidence that too much stomach acid, as the drug companies would like you to believe, has in fact nothing to do with the reflux problem. In fact, research shows that too much stomach acid, known as hyperchlorhydria, is actually quite rare. Excessive stomach acid is usually linked to bacterial infection or a very uncommon medical condition called with Zollinger-Ellison Syndrome.

If you have frequent heartburn, GER or GERD too much acid is highly unlikely to be the cause of your reflux problem. It is estimated by medical researchers that over 90% of people who suffer from reflux or GERD have normal or below normal levels of stomach acid1. As we age our acid levels decline dramatically. At age 50 the stomach releases only 15% of the acid it produced at age 25. Even more alarming is that 35% of people over age 65 produce no stomach acid at all. This one fact explains why calcium deficiencies are so commonly linked with health problems of older patients as stomach acid is essential for the proper calcium absorption.

5 Causes of RefluxThe Five Main Causes of Reflux

So if it's not too much acid, what are the causes of reflux? There are five primary causes of reflux described in more detail below. They are:

  1. Incompetent Lower Esophageal Sphincter (LES)
  2. Impaired Digestion
  3. Hiatus Hernia
  4. Bacterial Infection or Fungal Overgrowth
  5. Lifestyle and Dietary Habits

1. An Incompetent Lower Esophageal Sphincter (LES)

The stomach generates strong acids and enzymes to aid in food digestion. This digestive mixture is called gastric acid. The inner lining of the stomach has several mechanisms to resist the effect of gastric acid on itself, but the lining of the esophagus does not. The esophagus is normally protected from these acids by a one-way valve mechanism at its junction with the stomach called the lower esophageal sphincter (LES). The LES allows the food chunks (bolus) to pass into the stomach but prevents food, drink, stomach acid and digestive enzymes (chyme) from flowing back up into the esophagus. The LES is aided in this task by the diaphragm. An incompetent LES fails to prevent back flow from occurring. An LES may be incompetent because it:

  • does not maintain sufficient closing pressure.
  • has uncoordinated openings (relaxations)
  • does not flush refluxed gastric juice back to stomach

Reflux Pathology ChartInsufficient Closing Pressure

Insufficient closing pressure can be the result of damage to the LES tissues themselves. This is one reason why long term GERD sufferers gradually get worse as reflux damages the tissues further. In the most severe case cases this leads to Barrett's esophagus and even esophageal cancer. Weak closing pressure can also result if the muscles surrounding the LES are weak. There are exercises that can strengthen the musculature and help stop the vicious cycle.

Uncoordinated Transient LES Relaxations (TLESRs)

As a by-product of digestion, gases build up with the stomach. These gases increase pressure within the stomach. In order to lower the pressure, the LES will momentarily open and shut to release the gases. This is what occurs when we burp and is called Transient LES Relaxations (TLESRs). If this process is uncoordinated stomach contents will reflux back into the esophagus.

The Vicious CycleImpaired Expulsion of Refluxed Acid from the Esophagus Back into the Stomach

Even in individuals with a competent LES and properly function TLESRs, stomach acid occasionally reaches the esophagus. Saliva and peristalsis are the body’s defense against this. Peristalsis is a wave-like rhythmic contraction of muscles that propels food, drink, and saliva through the digestive tract. If peristalsis is impaired, the stomach acid will not be cleared from the esophagus and pushed back into the stomach. The stomach acid will remain in the esophagus, damaging the lining causing pain and inflammation. This cycle becomes self reinforcing. Thankfully, a few helpful herbs can encourage the process of peristalsis and help flush gastric acid back where it belongs.

2. Impaired Digestion

Impaired digestion refers to the stomachs inability to break down solid food clumps (bolus) into small particle floating in a soupy liquid (chyme) before exiting the stomach through the parietal sphincter. The stomach normally manufactures enough stomach acid and digestive enzymes to perform this process. However this capability generally declines with age, illness or chronic overuse of acid suppression medications. People who suffer from food allergies or food intolerances such as gluten and dairy often experience acid reflux in response to their inability to properly digest the specific food(s) they are intolerant to. Any of these scenarios lead to regular bouts of indigestion as the food sits in the stomach ad infinitum waiting for the pyloric sphincter to open and release the stomachs contents to the upper intestines. Fortunately, a few simple remedies can put your digestion back on track.

3. Hiatus Hernia

Hiatus HerniaA hiatal hernia is a condition in which the upper portion of the stomach protrudes into the chest cavity through an opening of the diaphragm called the esophageal hiatus. This opening usually is large enough to accommodate the esophagus alone. With weakening and enlargement however, the opening can allow upward passage or even entrapment of the upper stomach above the diaphragm.

Some people develop a hiatal hernia after sustaining an injury to that area of the body; others are born with a weakness or an especially large hiatus. Some experts suspect that increased pressure in the abdomen from coughing, straining during bowel movements, pregnancy and delivery, or substantial weight gain may contribute to the development of a hiatal hernia. With a hiatus hernia, it is significantly more difficult to clear the esophagus of refluxed acid. In effect, the stomach acid sits in the pouch created by a hiatus hernia.

Studies indicate that 32% of people over 50 and 89% of people over 90 have a hiatal hernia. However, even children can develop this condition.

Some doctors apply a simple breath test to determine if the patient has a hiatal hernia. Although this test is not infallible, most healthy individuals can hold their breath for at least 40 seconds whereas those with a hiatal hernia cannot. Fortunately, there are some simple postural exercises which in many cases can temporarily correct the position of the bulging hernia tissues and provide at least temporary relief. If applied frequently and over time, these techniques combined with the other steps outlined in the guide, may cause a hiatul hernia to disappear completely.

4. Bacterial and Fungal Infections

Helicobacter Pylori

Helicobacter PyloriHelicobacter pylori is a helically shaped bacteria that has the unique ability to counteract and thrive in the highly acidic environment of the stomach. It wreaks its damage by infecting the mucosal lining of the stomach, upper intestines and lower esophagus. Helicobacter pylori is associated with many gastrointestinal diseases including GERD, ulcers and gastritis. Helicobacter pylori (H pylori) infection is the main cause of gastritis, gastroduodenal ulcer disease, and gastric cancer. It is believed that between 70 - 90% of all ulcers are caused by H. pylori. This nasty parasite is even linked to heart problems. Indicators that may point to possible an h pylori infection include; stinky breath that does not go away with brushing or mouthwash, stomach pain, nausea and vomiting. However, some 70% of hosts may have no obvious signs or symptoms of infection and the culprit can only be discovered through blood, stool or internal tests administered by a doctor. Thankfully there are natural remedies that can put helicobacter pylori out of business. Using a natural and side effect free remedy such as the one described in the Reflux Defense System is also a reliable way to identify and ultimately eradicate the helicobacter pylori bacterium.

Candida AlbicansCandida

Candida is a type of yeast which is nearly always present to some level in the gastrointestinal system. However when the population of candida microbes rises beyond healthy levels due to an immune deficiency or antibiotics for example, they will cause trouble. Candida is implicated in many types of gastrointestinal disorders such as GERD, urinary tract infections, food allergies and many other ailments. Several safe and natural supplements are known to keep candida levels in check when combined with an appropriately balanced carbohydrate diet.

5. The Role of Lifestyle and Diet

Diet is perhaps the most obvious lifestyle choice that can result in GERD. Many of us have experienced heartburn after eating certain foods; particularly rich, fried or sugary foods are common culprits. However, how and when you eat is almost as important as what you eat. Eating meals which are too large for the volume of stomach, eating too quickly or under stress and not allowing food to digest, or not chewing the food properly can all lead to reflux problems. Eating right before bedtime is almost always a bad idea as food refluxes back up the esophagus without the force of gravity to assist its downward passage. The RDS offers a lot more specifics on what to avoid so to not trigger another reflux episode. Even if you do things that are likely to trigger reflux there are remedies which when taken proactively can counteract the trouble brewing in your stomach.

Many people don't realize that poor posture can also be a major contributor to GERD or frequent bouts of reflux. If a person is stooped or hunched over the ribcage puts direct pressure on the stomach. If you are seated for long periods during the day you are far more likely to develop bad posture. Fortunately poor posture also can be corrected through certain exercises which strengthen postural muscles in the back, shoulders and abdomen. For similar reasons, pregnant women or people who are overweight may experience excess pressure on the abdomen, causing the contents of the stomach to reflux back up the esophagus.

Symptoms of Reflux

The major symptoms of reflux are:

  • Heartburn - the most common symptom characterized by a burning sensation that feels as though it is rising from the stomach or lower chest. In many cases, the burning sensation typically begins behind the breastbone, and it may travel up to the throat. In severe cases heartburn can spread to the neck, jaw, arms and back.
  • Chest pain - This may include chest pressure, dull chest discomfort, or severe burning pain that radiates across the mid chest.
  • Excessive salvation - An increase in saliva production  may be the body's response to dealing with acid in the esophagus, as saliva helps to neutralize acid.
  • Burning sensation in the throat - This symptom generally causes a person to feel burning high in the neck close to the mouth, but it can happen in the lower region of the neck as well. It is common for the painful burning sensation to worsen when the person swallows. This particular symptom is often brought on by irritation that occurs when stomach contents have been refluxed up the esophagus into the throat.
  • Painful swallowing - This symptom usually follows the burning sensation in the throat.
  • Acid taste in the mouth/regurgitation - With this symptom a person tastes a strong sour or bitter flavor in their mouth. This usually occurs when acid has been refluxed up the esophagus into the back of the throat. Sometimes, along with the bitter taste, a person may also have food contents refluxed back into their mouth, which is better known as regurgitation.
  • Sore throat, bad breath, and dental erosion - These symptoms typically occur as a result of a person suffering from acid being refluxed up into the throat and mouth.
  • Trouble swallowing - Difficulty swallowing (dysphagia) is a symptom that occurs when food cannot pass normally from the mouth to the esophagus and to the stomach. Most people who experience dysphagia feel as if food is stuck in their throat, a choking sensation, pressure in their chest, or a burning sensation after eating.
  • Nausea and/or vomiting - When unexplained nausea and/or vomiting occurs, reflux is usually one of the first conditions doctors suspect.
  • Chronic coughing - A persistent dry cough can be a symptom of acid reflux that may occur if acid is irritating the windpipe or when acid is refluxed into the lungs, which is known as aspiration. Persistent coughing can cause hoarseness or asthma-like symptoms such as wheezing.
  • Severe chest pain - Sometimes severe chest pain can develop that feels like a heart attack. Though severe chest pain related to acid reflux is non-life threatening, if you experience what you feel is a heart attack, do not just assume it is acid reflux and seek medical attention immediately!
  • Asthma - Stomach acid that refluxes back into the esophagus is often absorbed into the lung. This acid damages the lining of the lungs and may lead to an asthmatic condition.

Conclusion

It is important to develop an understanding of the underlying causes of your reflux condition. The diagnostic tool can aid you in this process. Once you've established the causes you can start to map out a strategy for treatment. Hopefully something that does not involve imbibing copious acid suppression pills over an extended period. The Reflux Defense System will provide you a comprehensive strategy for resolving your condition naturally.

 

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