(Gastro-Esophageal Reflux Disease)
aka Acid Reflux, Heartburn
What’s the difference between all three?
- GERD encompasses both acid reflux and heartburn, and occurs
when the sour gastric acid ascends up the esophagus as far as
the mouth. Heartburn specifically refers to the sensation of
retro-sternal burning that spreads upward to the throat.
- GERD can present with other symptoms like stomach pain, abdominal
distention, nausea, and a vague hunger, but can also occur alone.
- The acid from chronic GERD can scar the esophagus leading
to difficulty swallowing or regurgitation, cause a sore throat
and hoarseness, and if it enters the lungs can lead to bronchitis
or asthma. Long-term: Barrett’s Esophagus, cancer.
What caused this condition?
- Diet: foods that are overly hot in nature like chile and spices,
alcohol, coffee and chocolate; foods that are overly acidic
in nature like citrus fruits, tomatoes, uncooked peppers, radishes,
onions and garlic. Excessive use of cold, raw foods, medications
like antibiotics, and overly strict dieting can all damage digestive
- Lifestyle: eating at odd hours or on the go, overeating, and,
of course, stress. Stress can stagnate Qi and attack the Stomach
causing it to “rebel upwards.” Qi Stagnation can
also cause constipation backing up the intestinal system leading
to more rebellious Qi. And one of the great causes of Qi Stagnation
is unexpressed, unresolved emotions that get stored in the gut.
- WHAT you eat, WHY you eat, WHEN you eat, and HOW you eat!
- Lower Esophageal Sphincter dysfunction: Food stagnation, high-fat
meals, lying down post-meal, weak muscle control; decreased
clearance of refluxate from esophagus; delayed ST emptying
- Your internal pattern:
- Liver Qi Stagnation Invading the Stomach:
A clear relationship to your emotional state and stress, hypochondriac
and epigastric tenderness, bloating, alternating constipation
and diarrhea, loss of appetite, frequent sighing or burping,
irritability, depression, anxiety, tension headaches, PMS, cold
fingers and toes, and shoulder and neck tension.
- Stomach and Liver Heat: This may evolve
from Liver Qi Stagnation, but may be aggravated by the excessive
consumption of heating foods where the GERD is most noticeable
just after eating. You may experience it in the middle of the
night around 1-2am with sour reflux and burping, a burning sensation,
dry mouth and thirst, irritability and easily angered.
- Phlegm-Damp Accumulation: This can result
from long-term Spleen Qi Deficiency producing a pathological
by-product called Dampness that impairs healthy circulation
and can further congeal to produce Phlegm. In the end, the normal
downward direction of Stomach Qi is disrupted. The symptoms
are similar to those above plus a decreased sensation of taste,
a tendency to loose stools, tiredness and heavy limbs, poor
concentration, a tendency to be over-weight, mucus, dizziness
and headaches, and a musty body odor.
- Food Stagnation: This can occur due to frequent
over-eating and irregular eating especially when coupled with
a sedentary lifestyle. Symptoms include: the GERD is worse after
a large meal and is relieved by vomiting or burping up undigested
food particles, bad breath is common, along with constipation
or diarrhea that relieves the pain.
- Spleen-Stomach Qi/Yang Deficiency: Long-term
digestive weakness inhibiting the proper movement of food in
the GI tract. Symptoms include: intermittent, worse with hard
to digest or raw foods, bending or any increase in abdominal
pressure; waking during the night with heartburn is common;
abdominal pain which is better with warmth and
pressure; bloating post-meal, drooling, sour belching, poor
appetite, fatigue, loose stools, and cold intolerance.
- Stomach and Liver Yin Deficiency: Long-term
excess heat (from stress, overly heating foods, etc.) in the
Stomach can damage the Yin. Symptoms include: chronic GERD,
acidity and heartburn worse with stress or in the evening, may
wake 1-4am with reflux which can be relieved by eating; dull
pain, loss of appetite or vague hunger, dry mouth and throat,
and dry stools or constipation.over-eating and irregular eating
especially when coupled with a sedentary lifestyle. Symptoms
include: the GERD is worse after a large meal and is relieved
by vomiting or burping up undigested food particles, bad breath
is common, along with constipation or diarrhea that relieves
What can I do about it?
- Foods: Aloe vera juice, raw potato juice mixed with water
3x/day, 1 Tbsp apple cider vinegar in water with food, digestive
enzymes pre-meal without HCl acid, stop eating 3 hours before
sleep, lay on your left side to keep your stomach below your
esophagus. Be cautious with estrogen use, Aspirin/Advil. Rx
drugs: Zantac, Nexium, Prevacid, Protonix, Pepcid, and Tagamet
all inhibit stomach acid production. Deglycyrrhizinated Licorice
- Liver Qi Stagnation/Food Stagnation: smaller
portions, ginger tea, digestive enzymes pre-meal, exercise,
eat dinner earlier; veggies and complex carbs, decrease fats
and heavier proteins, reduce or learn to better cope with stress.
- Stomach and Liver Heat: bitter, cool, pungent
foods; raw foods like fruits and veggies, decrease proteins
to primarily fish; avoid spicy or overly spiced and complicated
meals, fried greasy foods, and COFFEE and ALCOHOL.
- Phlegm-Damp Accumulation: decrease carbs,
except rice barley and millet; decrease sugars and sweets, fats
and oils, and raw foods. Ginger and other warming acrid spices
like garlic, mustard, horseradish, and pepper are helpful. Plus
the food suggestions below for Qi Deficiency.
- Spleen-Stomach Qi/Yang Deficiency: lightly
cook all veggies, avoiding raw foods; soups and stews, broths;
chew your food more thoroughly; simpler combinations of foods;
smaller portions and more frequent meals. For Yang Deficiency:
same as Qi Deficiency, but more warming foods are indicated;
avoid cold raw foods. Cinnamon, Ginger, Cloves and Garlic are
- Stomach and Liver Yin Deficiency: nourishing
roots, soups, and stews; seeds and beans can moisten; rich-colored
veggies; Flax seed oil! Avoid overly spiced foods, coffee, and
other stimulants like caffeine.
- Acupuncture and Chinese Medicinal Herbs: Your second and third
lines of defense. Sometimes, modifying your daily food intake
is not enough, and you need some extra assistance. Working together,
we can create a specific treatment plan to meet your individual
needs. This can include Acupuncture, a Chinese Medicinal Herbal
Formula, and Nutritional and Lifestyle Counseling.
- Cautions about over-the-counter antacids: These can be effective
at giving you symptomatic relief, but pose some long-term problems.
The first is that they are not actually addressing the root
cause of the imbalance. And the second is the concern about
the side effects related to the metal content which include
constipation, diarrhea, belching, gas and nausea. For example:
calcium and aluminum-based drugs can lead to constipation, and
magnesium can act as a laxative, sodium bicarbonate can cause
gas and bloating, and calcium carbonate can have a stomach acid
rebound effect. Antacids can also adversely affecting your electrolyte
imbalance, inhibit nutrient absorption and proper digestion,
and are useless for gas and bloating.
© Jordan Hoffman, L.Ac., Dipl. OM, 2007. All
The information presented here is not medical
advice, is not intended as medical advice, and is intended to
provide only general, non-specific information related to Chinese
Medicine and Acupuncture and is not intended to cover all the
issues related to the topic discussed. You should consult a licensed
health practitioner before using any of this information.
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