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Sunday, July 11, 2010

Gastroesophageal Reflux Disease GERD

by Georgianna Donadio, MSc, DC, PhD

GERD, Gastroesophageal Reflux Disease, is one of the top 5 most prevalent gastrointestinal conditions in adults. Considering that digestive complaints comprise the number one emergency room complaint, that is a lot of tummy aches! GERD is typified by heartburn, nausea and regurgitation and is most common when a GERD sufferer lies down at night.

The cause of GERD is the failure of the lower esophageal sphincter or LES mechanism, meaning it does not close properly to keep stomach acid from regurgitating into the upper esophageal region. When acid finds its way there (we've all burped up stomach acid and it hurts!) burning, sometimes nausea and even vomiting can occur. Unfortunately, if it becomes chronic a wide number of conditions can occur, including esophageal ulcer and cancer.

Why do people get this? From a medical perspective it’s a condition caused by a mechanical failure of the LES and the diaphragm (there can be a hiatial hernia involved) to keep the pressure on the esophageal sphincter; or there is "slow stomach emptying" that can be the cause. Using antacids, Prilosec, anti-histamines, eliminating foods that can provoke the GERD (chocolate, mint, alcohol and coffee) or reducing the amount the patient eats and the times they eat are all treatments for GERD. In severe cases, surgery is often recommended.

From a Whole Person Health perspective how would a practitioner support a client with GERD? Let's look at the mechanisms involved to give us clues to the cause and effect of this condition:

> esophageal sphincter is not working properly
> diaphragm is not working properly
> acid is escaping into the upper esophageal area
> obese or significantly overweight individuals have a higher occurrence of GERD

These symptoms suggest that the innervations of nerve stimulation of the esophagus and diaphragm may be under functioning due to either structural/neurological causes or that stress, which constricts the diaphragm and decrease internal muscle function.

In the medical literature, GERD appears to be more related to structure and function than to pathology. Unfortunately, the traditional treatment for GERD is Prilosec, which by suppressing the stomach acid also reducing the body's immune function as stomach acid is a front line immune defense against bacteria and viruses entering the body. This medication comes with a caution for many unpleasant side effects, including cancer, which is a result of the decreased immune function of the stomach acid which kills micro-organisms that can make us sick or even kill us.

How would a Whole Health Practitioner facilitate their client's recovery from GERD?

> educate the patient about HOW GERD occurs and invite them to identify what could be the causes for their dysfunctional digestive system. If you ask most individuals what they think is wrong; 9 times out of 10 they have the answer.

If they understand the role their stress plays in this condition they can do something about it and take greater control over their health.

> provide information about how to relax the diaphragm both manually and thru breathing exercises to assist is reducing the GERD symptoms

> assist the person in identifying how various known foods and over eating of these foods can contribute to the problem

> providing information about calcium as a natural anti-acid

> identify how yoga postures can make a marked difference in GERD symptoms

> offer information about acupuncture, chiropractic and osteopathic as options to treating the neurological component of GERD rather than only relying on drugs

> explain how losing weight can greatly enhance recovery

> share exercise information that can help strengthen their diaphragm

> most importantly, let them know they are in charge of their body and they can take control over their symptoms

Even if a person is taking medication, there are many things they can do to improve and even eliminate GERD. I have seen this happen almost miraculously once a person is fully engaged with clear, demystified health information and is empowered to take control, feel better, be healthier and happier.

With all good wishes,
G
© by NIWH 2010 all rights reserved

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