August 23, 2017

New mechanism of acid reflux damage discovered by researchers

GERD, acid reflux, and functional medicineAccording to a new study published 3 days ago in The Journal of the American Medical Association, researchers found that the damage of the esophagus in gastroesophageal reflux disease (GERD) to be cytokine mediated due to inflammation and not caused directly by the acid in the stomach.

For almost a century, it has been assumed that damage to the lining of the esophagus is caused by the hydrochloric acid of the stomach. According to researchers at UT Southwestern Medical Center and the Dallas VA Medical Center, this damage to the esophageal lining is occurring through an inflammatory response by cytokines.
This new information will probably not change the traditional approach to treating GERD in the near future but it may shift to targeting the cytokines and inflammation in the future which is really causing the damage to the esophagus.

This research builds on previous work in mice demonstrating that it takes several weeks from the time stomach acid is introduced into the esophagus before damage occurs. If the damage from HCL, it should develop immediately.
It’s interesting because alternative healthcare providers have been addressing this inflammation by supporting their patients with natural anti-inflammatory botanicals like deglycyrrhizinated licorice (DGL) to help with dyspepsia and symptoms associated with GERD, which has been recognized for its anti-ulcer, anti-inflammatory and healing effects on the esophageal lining (when using a chewable) and gastric mucosa. DGL is a mucilaginous herb that coats and soothes inflamed gastric and intestinal tissue.

Pharmaceutical interventions may provide symptom management but they do not correct many of the underlying factors and have side effects. Lifestyle changes and nutritional support are usually sufficient to address acid reflux. Patients should consider eat smaller portions at meals. In addition, avoid laying down after meals and avoid eating before bed. Also, alcohol and specific foods can trigger symptoms.

We need to address the underlying causes of these symptoms such as a weak lower esophageal sphincter, impaired digestion (ie. hypochlorhyrdria, enzyme insufficiency), food sensitivities, hiatal hernia, bacterial or fungal imbalance, and lifestyle (ie. stress, poor diet, poor sleep habits)

Although these medications may help with the symptoms, proton pump inhibitors may not be the solution. Recent previous studies have linked PPIs to chronic kidney disease as cardiovascular disease and an increase risk of a heart attack. PPIs can also lead to other problems such as small intestinal bacterial overgrowth (SIBO).

Nutritional supplements may be needed to improve your digestive function such as probiotics and glutamine. Deglycyrrhiizinated licorice (DGL) is well established as an anti-ulcer and mucosal healing botanical and is soothing and protecting to the gastric mucosa and mucous membranes lining the digestive tract.

Helicoacter pylori is a major cause of gastritis. Mastic gum, methylmethionesulfonium, zinc-carnosine and vitamin C address both eradication of H. pylori and the healing and protection of inflamed mucosal tissue.

An alternative approach is typically more effective than what is provided by proton pump inhibitors and does not have side effects or other complications that can be associated with them, such mineral deficiencies, bacterial infections, and dysbiosis .

By Michael Jurgelewicz, DC, DACBN, DCBCN

Source: Kerry B. Dunbar, Agoston T. Agoston, Robert D. Odze, Xiaofang Huo, Thai H. Pham, Daisha J. Cipher, Donald O. Castell, Robert M. Genta, Rhonda F. Souza, Stuart J. Spechler. Association of Acute Gastroesophageal Reflux Disease With Esophageal Histologic Changes. JAMA, 2016; 315 (19): 2104 DOI: 10.1001/jama.2016.5657

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