Chinese Medicine and GERD

Gastro-Esophageal Reflux Disease, or GERD, can be a very difficult symptom to deal with on a daily basis.  It burns, it aches, it keeps us up at night, and it causes us to want to snack so that the discomfort may momentarily pass.  It is one of the conditions that most of us will experience in our lives, and which most of us will attempt to treat on our own with the wide variety of over the counter ant-acids that are now available at grocery stores.  Most of the drugs which once required a Medical Doctor’s prescription can now be bought by the case and gallon at Costco.  On any given trip to the store, I will see people analyzing and comparing ingredients, trying to discern their many differences.  Which pill is right for me? Which type of heart burn do I have? Is there an alternative to taking these pills everyday and if I keep taking them will something bad happen to my stomach?

These are all the questions I see mixed into the facial expressions of shoppers as they navigate the aisles at the drug department.  I wanted to write this blog entry about the different types of ant-acids out on the market and what options there might be to come off of them.  I will also address the potential side effects of long term use of over the counter medications.

Some people feel heartburn, a burning sensation beneath the sternum, immediately after eating a meal.  Our stomachs have a small opening at the top which is kept shut by something called our pyloric sphincter.  This structure helps keeps stomach hydrochloric acid, HCL, from regurgitating back up into our esophagus.  While our stomach has intricate systems in place to protect itself from the powerful effects of HCL, our esophagus has no such protection, and thus become corroded and burned by the high acidity. If the pyloric sphincter becomes relaxed and allows acid to leak out to the esophagus we feel pain. This problem could be due to over eating, lying down to rest after a meal, or consuming certain foods like coffee, chocolate, or wine.  These foods, along with certain others, should be avoided by those who suffer from chronic heart burn. They can aggravate the problem through both their acidity and their effect on our stomach’s containment of HCL.

Ginger Root

For those people who suffer discomfort immediately after eating a meal, Pepcid AC might be the preferred antacid as it quickly neutralizes the PH of our stomach. Old favorites like Tums and Rolaids, are made up of Sodium Bicarbonate (Baking Soda) and also work by neutralizing acidity in the stomach, providing a rapid change in the PH levels. When the acid levels are reduced than the burning should decrease, although, some damage may already have been done and it may take some time for the inflamed tissues to recover. This gnawing pain causes some people to want to snack to reduce it, which only increases acid production in the stomach, starting the chemical cycle over.

If you suffer from constant over production of stomach acid, even at times when your stomach is empty, you may end up developing more serious problems such as gastric ulcers.  If your problem has advanced to this stage you may be recommended to take Prevacid 24hr. Prevacid is an over the counter drug which is in the class called Proton Pump Inhibitors or PPIs.  This type of drug works by completely stopping the production of acid in your stomach. Good news for stopping the pain but one might wonder how a person is supposed to digest food, especially protein, if this production is limited or shut down completely. Prilosec, containing Esomeprazol, the active ingredient in Nexium’s “little purple pill”, is another over the counter PPI drug which can be used to treat chronic over production of HCL in the stomach.  It is important to note that this class of medication, PPI’s, is not the type which provides immediate relief.  These drugs take time to build up in the system and must be taken regularly if one wishes to see healing of the damaged tissues of the stomach and esophagus. Simply using these PPI medications on an as needed basis, as one would use Tums or Prevacid, will not give you results.

The long term effects of taking antacids or proton pump inhibitors are generally the same as any medication. The body become accustomed to their presence and may actually increase the amount of acid the stomach produces to reach the desired PH for digestion of proteins.  You may have to take more of the medication to get the same results and if you miss a dose the pain could now be significantly worse than it was at the start of the problem.  Additionally, there is the problem of tampering with the stomach’s natural self-protective measures.  It is the natural rise in acidity that triggers the stomach to release chemicals which protect its lining from the acids, stimulate the mechanical digestion of food, and signal the lower digestive tract, gallbladder and pancreas, that food is coming.  Every time our bodies release a chemical messenger there is another part of the body waiting for the message to signal the next process to begin. Using medications to stop or reverse these natural chemical processes can cause problems further down the digestive line.  Lastly, it is the stomach acid which represents our best line of defense against foreign bacteria which enter our bodies with food.  Without adequate acidity these bacteria will survive and pass to the intestines where some believe they cause chronic bacterial infections such as Candida Albicans which can cause another cascade of negative effects on our health.

Turmeric powder and root

Chinese medicine has a long lineage of treating high acidity with herbal medicine to reduce the production of acid and increase the tone of the stomach’s sphincters. It does this without shutting down acid production so that digestion may still occur. Essentially strengthening the digestion to get an improvement rather than down regulating the stomach’s function to reduce pain.  In Japan, some of the population has historically relied on tea made from turmeric, to calm the over production of stomach acid. In China, one can find tablets made from orange peel and ginger for aiding in the gastric reflux after a night of over-eating. Acupuncture works best when treating patients who suffer these digestive problems only when experiencing high periods of stress or anxiety.  Acupuncture works extremely well at reducing all the effects of stress on the body and studies of acupuncture for digestive disorders are becoming more and more common in the medical research literature.

You have many options in dealing with chronic stomach pain including medication when necessary to control pain. Sometimes over the counter medicines are needed to bring the problem under control or to deal with an acute discomfort, as many of us will be experiencing at the family feasts of Thanksgiving and Christmas in the coming months.  Chinese Medicine will be there to shift the patterns in your life and personality that cause this problem to re-occur and you should ask us how we can help you make these changes now, before the turkey and stuffing, the sweet potatoes and pecan pie, and do not forget, all that family.

Should I be getting Acupuncture or taking Chinese herbal medicine for my condition?

In China, Acupuncture is used for a great variety of conditions that focus on reducing both the pain and stress responses in our bodies. Acupuncture excels at resetting the chemical and hormone mechanisms which cause our bodies to feel tight, painful, anxious and sluggish in their functional abilities. It can help us sleep more deeply, increase circulation in injured areas, and increase the efficiency and movement of our digestive systems. Acupuncture produces immediate feelings of calm and well-being. Patients leave relaxed, with reduced pain, and sleep deeply the night after treatment. Acupuncture is a convenient and effective way to deal with tension and pain in the body and the many myriad of disorders that can arise from chronic stress and anxiety.

Chinese herbal medicine uses formulas of medicinals that are combined in groups of four to twelve in an attempt to tailor the medicine to the particular needs of the individual. This concept in completely separate from western herbalism which uses single plant products to affect a single symptom. Examples: Valerian root sedates a restless person or Chamomile makes one drowsy. The Chinese medical approach is rather different and attempts to address the problem from its root cause not its manifestation on the surface. A second key difference is the the quality of production, craftsmanship, and care which go into cultivating Chinese medicinal plants. One can easily buy a “natural” product at Whole Foods but they have no idea where/how it was grown. Who tested it for pesticides, heavy metals, and who ensured plant authenticity.

It is important for all of us to question the products we buy and the purity of their ingredients. Would you want to know you are taking a safe product that actually contained the ingredients it claimed? Especially when said products often are imported from other countries? One should always buy these products from a professional in the field, not just a person with an Acupuncturist license, but someone who has actually committed themselves to the life of study in the field of Chinese herbal medicine. Remember, plants are medicine and all medicinal products contain the risk of side effects. You would not go and buy pharmaceuticals without being told so by a qualified practitioner of medicine and so I encourage patients to approach plant medicinals in the same way, with a prescription.

It must be noted that ALL internal medicine disorders are treated in China with herbal medicine and not necessarily acupuncture. Internal medicine is a broad category of diseases that includes some of the main medical fields that we know of in the west. Think Endocrine, Respiratory, Gynecological, Immunological, Urinary, Cardiology, Pediatric and the field Fertility medicine when you think of Chinese Medicinals. Often our conditions require daily administration of medicine and that is most effectively accomplished with internally administered medicinals. These formulas offer the benefit of daily care without the need for semi-weekly visits to the clinic and thought often not ideal in taste, they are the preferred means of treating chronic internal diseases of the body in China.