While most of us are familiar with acid reflux, gastroesophageal reflux disease, or GERD, is not as widely recognized. Though the two conditions are related, there are important differences, and the right diagnosis is crucial to finding the most appropriate treatment options. Dr. Linell King and the team at Naples Vitality in Naples, FL have experience identifying and addressing these and other chronic health issues using an integrative approach.
What Is GERD?
In simple terms, this condition happens when stomach acid enters the esophagus. While this also occurs with acid reflux, reflux disease is a long-term condition and is therefore considered to be more serious. It’s also quite common: the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the American College of Gastroenterology both estimate that about 20% of the U.S. population is affected.
What Are the Symptoms of GERD in Adults?
Most Common Symptoms
Because the symptoms can overlap with those of many other gastrointestinal and digestive disorders, misdiagnosis often occurs. Patients most commonly experience the following symptoms, especially after a meal or while in a lying position:
- Chest pain
- Trouble swallowing
Most of us get heartburn on occasion, but with GERD, the symptom persists and is typically felt several times per week. That type of frequency should be taken seriously and warrants urgent attention.
While the chest pain caused by gastroesophageal reflux disease may mimic the symptoms of a heart attack, it’s important to distinguish between the two. Chest pain associated with a heart attack is also often accompanied by pain in the jaw, neck, or arm as well as shortness of breath.
Some individuals with reflux disease also notice frequent burping, abdominal bloating, or indigestion. Others report having food or acid come back up into their mouths, leaving a bitter taste and a feeling that something may be stuck in their throat.
Less frequently, patients may suffer from a sore throat or a cough that doesn’t go away. The condition has also been known to trigger asthma.
How Is It Diagnosed?
A health care provider can usually make a diagnosis based on a physical exam and medical history, and this should include a thorough discussion of all of your symptoms as well as any suspected dietary triggers. Your doctor may order an endoscopy to confirm the diagnosis. During this procedure, a thin tube is used to examine your esophagus and stomach. A camera is used to identify any inflammation that may be indicative of the disease.
In some situations, a special type of x-ray is performed while having the patient swallow a liquid called barium. This allows the doctor or radiologist to detect problems in your food pipe or the rest of your upper gastrointestinal system. Most of the time, however, these diagnostic tests are unnecessary.
What Causes GERD?
At the bottom of our esophagus lies a valve, also known as the lower esophageal sphincter or LES. Under normal circumstances, the LES should close once the food we’ve eaten gets into the stomach. In GERD patients, however, this valve stays open, and this allows stomach acid to wash back up through the esophagus and into our mouths. There are several conditions that can contribute to this:
This can be caused by vigorous or intense forms of exercise, such as weightlifting, plyometrics, or sprinting. Abdominal pressure is also common during pregnancy and is thought to be due, in part, to fluctuations in the levels of certain hormones, such as estrogen. Those who are overweight or obese are also at much greater risk, and the condition appears to be much more prevalent among that particular population.
A hiatal hernia is considered particularly problematic. This type of hernia occurs when the stomach pushes up through the diaphragm, which is the muscle responsible for keeping acid out of the esophagus.
Some foods increase acid production in the stomach and weaken or relax the lower esophageal sphincter. Examples include spicy foods, citrus, tomato products, chocolate, fried foods, and coffee or other sources of caffeine. For some, dairy may exacerbate symptoms, as can fatty foods and carbonated beverages such as soda. Heavy meals can cause stomach distension, and that is also thought to be a contributing factor.
Certain types of medications are known to weaken the lower esophageal sphincter, cause heartburn, and increase the risk of gastroesophageal reflux disease. These medications include some antibiotics, a group of painkillers called non-steroidal anti-inflammatory drugs or NSAIDs (ibuprofen, aspirin), and a class of anxiety drugs and anti-depressants known as selective serotonin reuptake inhibitors (SSRIs). These include Zoloft and Paxil, among others.
During a consultation, we will go over with you any prescription and over-the-counter medications you may be taking. Many of our patients have found that they’re able to reduce and, in some cases, eliminate these drugs after incorporating some of the dietary and lifestyle interventions that we have found to be most helpful. All of this will be covered during your initial visit.
How Is It Treated?
One of the limitations of conventional medicine is its heavy reliance on pharmaceutical medication to address health issues. Though these drugs are sometimes necessary, they also cause side effects and merely mask the symptoms of disease. It was his frustration with this approach that inspired Dr. King to seek a different path: one that emphasizes prevention and natural healing.
The Conventional Approach
While patients may initially be tempted to use over-the-counter medications such as antacids to relieve symptoms, those benefits are only temporary. Similarly, the standard course of treatment in conventional medicine involves the use of proton pump inhibitors (PPIs). Long-term use of these drugs has been linked to serious adverse effects such as an increased risk of stroke, infections, nutrient deficiencies, bone fractures, pneumonia, and kidney issues.
Personal responsibility and empowerment is our core philosophy. We’ll provide you with the tools you need to uncover the true causes of your health challenges and we’ll be there to guide you through the process. Your treatment plan will be based on the seriousness of your symptoms and your overall health but will include the following considerations:
At Naples Vitality, we treat reflux disease and all other digestive issues by first looking for the root cause. Often, there are underlying food sensitivities or intolerances that need to be addressed. To make that assessment, we might ask you to keep a food diary. Once these issues are identified, we may recommend an elimination diet. Foods will then be reintroduced, one at a time, and reactions noted.
To prevent bloating, abdominal pressure, and stomach distension, it is advisable to consume smaller meals throughout the day. This allows for better digestion. Though reflux issues are usually assumed to be caused by excess stomach acid, practitioners of integrative medicine know that many times it is actually low stomach acid that allows for undigested food particles to re-enter the esophagus. An enzyme deficiency may also contribute to this issue. Both causes can be treated through diet and lifestyle modification as well as with nutritional supplements.
Since excess body fat puts pressure on the stomach and increases reflux, patients struggling with weight management issues will be encouraged to modify their diets. We’ve helped clients successfully implement a wide variety of nutritional strategies, including paleo, ketogenic, vegetarian, and vegan. There is no one-size-fits-all approach to healthy eating, and the meal plan we recommend will be tailored to your individual needs.
Once dietary triggers are removed, we will focus on healing the esophagus using natural remedies. Gastroesophageal reflux disease can irritate and erode the lining of the esophagus, a situation that can become painful. A soft diet emphasizing fruits, vegetables, and easily digested proteins has been shown to repair some of that damage, and evidence supports the use of certain dietary supplements to soothe the esophageal tissue.
Lifestyle changes may include altering one’s exercise routine to focus more on low-impact modalities, such as walking, yoga, swimming, and bodyweight strength training exercises. Patients should also refrain from eating for at least a couple of hours before engaging in any form of physical activity. Heavy meals should be avoided as well.
Both smoking and alcohol use have been shown to worsen the symptoms of gastroesophageal reflux disease by relaxing the lower esophageal sphincter, allowing acid to wash back up into the food pipe. Cutting back or eliminating these habits can make a big difference and we can help with that as well.
Other lifestyle modifications that may be helpful include elevating your bed by at least a few inches using risers or blocks. Foam wedges are another option and serve the same purpose. Avoiding food and drink several hours before bed and wearing roomier clothing may also help.
Scientific research has demonstrated that stress and anxiety can exacerbate existing reflux and other gastrointestinal issues. As an integrative health practice, it is our view that mental and emotional wellness can be just as consequential in the development and promotion of chronic disease as any physical cause. For this reason, we offer a Mindset Re-evaluation program to help patients incorporate proven stress-busting practices that focus on breathing, meditation, and relaxation.
Is It Serious?
Initially, the symptoms of gastroesophageal reflux disease may be limited to mild discomfort. Ongoing symptoms, however, should not be ignored or assumed to be the result of standard acid reflux. The biggest concern is a condition called Barrett’s esophagus. Although rare, this can lead to the development of esophageal cancer. This occurs in only about five percent of patients.
Other complications include an inflammatory condition called esophagitis and scarring of the esophagus, which can cause it to become narrow and interfere with swallowing. Ulcers can also form and become painful, and breathing issues may occur if the acid impacts lung function.
It is important to point out that these complications are uncommon, and even more so when the underlying cause is detected and addressed. This is why it is so critical to have your symptoms evaluated by a qualified healthcare professional.
Getting Help for Your Gastrointestinal Issues
The long-term implications of reflux disease go far beyond the discomfort of frequent heartburn. Left untreated, this condition can lead to serious complications. Dr. Linell King combines the best of conventional and alternative medicine to design the most effective treatment plan for all of your chronic health issues.
Have you been let down or disappointed in the past with an antiquated and inadequate healthcare model? Call Naples Vitality in Naples, Florida today at (239) 307-0036 or visit us online to register for one of our upcoming events and learn more about the programs and services we offer. Don’t suffer needlessly. Let us share with your our unique, innovative approach to natural healing, longevity, and optimal wellness.