Gastroesophageal reflux disease, also known as GERD, is one of the most common reasons for someone to see a GI specialist. What I’d like to talk about during Gerd Awareness Week is – What is GERD? What causes it? How can people begin a treatment regimen at home?

First and foremost, reflux, also known as gastroesophageal reflux disease, is a functional disorder of the esophagus or throat. There are many functional bowel disorders – ranging from irritable bowel disease to dysphasia or painful swallowing to reflux. Many times the workup for these is normal, showing no pathology or disease, despite the significant symptoms of reflux disease.

The major symptoms are all around the esophagus or throat. Typical symptoms include a burning, sour taste in the back of the mouth, reactions with different types of food, a sensation of a fullness in the throat when swallowing, and sometimes foods will get stuck or feel like they do not go down all the way.

Symptoms that present lower in the stomach are less likely to be diagnosed as GERD and generally fall into the realm of other functional bowel disorders. Typically, the evaluation for this disorder includes seeing a specialist and getting a scope down the throat to rule out things such as throat ulcerations and gastritis. These are often ruled out, and the diagnosis is simple reflux. But, what is it? What causes it?

One of the most common causes of reflux is a reaction to foods. There are many foods that have chemicals, emulsifiers, food preservatives, processed oils, sugars, and other processed or refined substances that cause a delayed or immediate reaction to the lining or mucosa of the esophagus. So, simply changing the diet and eliminating the most irritating foods is one of the primary ways to treat reflux. About 80% of people will notice a significant improvement, simply by doing an elimination diet.

For a full elimination diet, you can visit our website. The typical entry-level elimination diet usually involves removing processed foods, grains, milk, soy, eggs, and sugars. That will take care of about 60 to 70% of people with reflux disease. Another elimination diet is called the six-food elimination diet, uniquely developed for treatment of esophagitis, which can also be used in this case.

An important factor to think about in reflux disease is decreased stomach acid, not increased stomach acid. I know this is counterintuitive to our thinking, but as people age, they actually make less digestive enzymes and stomach acid. The result is that food will sit in their stomach for long periods of time. Typically, all the food should be out of your stomach within 45 to 50 minutes and no later than 90 minutes after eating. The result of low digestive enzymes and low stomach acid is that food will sit in the stomach and reflux up into the esophagus, softening it in the process.

This tends to be worse at night when people sleep, but can occur at any time of day. So, simple maneuvers such as using apple cider vinegar, some kind of digestive bitter, or even small amounts of betaine hydrochloride, which acts like a stomach acid, can help these patients. When people take acid blockers, such as Prilosec or Pepcid, what they’re doing is decreasing the acid that’s refluxed into the esophagus. Symptoms have decreased, but the issue is still there.

Some people also have primary issues with the lining of their esophagus. This can be caused by stress, poor sleep, food reactivities, or using demulcents, which are substances that coat the esophagus, like aloe or licorice. Using nutrients, such as glutamine, zinc, and carnosine, can help the esophagus heal and address this problem. 

Now, the big elephant in the room with reflux disease is actually about our mindset when we are eating. Twenty-five percent of digestive enzymes are released from your stomach just by looking at and smelling what you eat. In today’s rush-rush society, we don’t take the time to sit down and actually enjoy our meals. We eat our meals quickly, while feeling rushed and stressed. We don’t chew our food properly, and then we swallow it, and expect our body to take care of the rest. To better aid digestion, chew each bite of food between 20 and 30 times in order to allow your stomach to properly digest it. Being stressed while you eat also reduces digestive enzymes, which can affect how you digest food.

Sit down and rest yourself, allowing enjoyment over your meal. Have a moment to contemplate the food before giving thanks, or take some slow, deep breaths. Whatever resonates with you to prepare your body to go from stress, stress, stress to rest and digest, do that! Unfortunately, in our culture, we tend to create habits and patterns of behavior that cause reflux, and this is one of the reasons why we’re seeing an epidemic of GERD in our country. 

Hopefully, this short treatise is helpful and has given you some ideas on how to deal with reflux! For more information, please check out the variety of educational materials, reading lists, blogs and social media on our practice website.

Take care and be well.