Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease (GERD) occurs when there is abnormal passage of acidic stomach contents into the esophagus causing symptoms or complications. It is one of the primary causes of ” heartburn” and GERD is a common phenomenon. It is estimated that 15-20% of people in the US have heartburn once weekly and that 7% suffer from these symptoms daily.

Symptoms of GERD may include retrosternal burning, acid regurgitation, nausea, vomiting, chest pain laryngitis and cough. People report that stress exacerbates GERD and this has been confirmed in clinical trials. Factors associated with decreased tone of the lower esophageal sphincter and the development of GERD include alcohol, chocolate, coffee, cow’s milk, orange juice, spicy foods, smoking, tea and tomato juice. Medications including aminophylline, anticholinergics, beta blockers, calcium channel blockers and nitrates can also contribute to symptoms.

Treatment of GERD includes lifestyle changes. People should consider quitting smoking and losing weight if obese. If nighttime symptoms are present, consider elevating the head of the bed by 4-6 inches. Avoid large meals and consuming large quantities of liquids with meals. Practice stress management and relaxation techniques. Botanical medicines that help include deglycrrhizinated licorice before meals, slippery elm three to four times daily and the use of chamomile, marshmallow and valerian. For severe cases, physicians have long resorted to prescribing proton pump inhibitors which decrease acid secretion in the stomach. This is fine for SHORT TERM use only. Aggressive long term acid suppression can decrease absorption of Vitamin B12, can cause iron malabsorption and osteoporosis with hip fracture.

If you have been on one of these medications long term considering tapering with concomitant use of the botanicals listed. For additional information, contact me in the office or via email.

Thank you!

~Dr. Giannotto

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