Heartburn aka Gastroesophageal Reflux Disease (GERD))

Heartburn or GERD (gastroesophageal reflux disease) is defined as a motility disorder characterized by heartburn due to the reflux of gastric contents into the esophagus.

 

It is one of the most prevalent GI (gastrointestinal) disorders, with heartburn being experienced by 7% of the population on a daily basis, 20% on a monthly basis and 60% intermittently.  In addition, it affects more than 70% of pregnant women.

 

The causes of heartburn or GERD are:

  • Incompetent lower esophageal sphincter (LES)
  • Medications that lower LES pressure such as anti-cholinergics, beta-adrenergic blockers, calcium channel blockers or theophylline
  • Foods that lower LES pressure such as yellow onions, chocolate or peppermint
  • Excessive use of alcohol, coffee or tobacco
  • Pregnancy
  • Obesity

 

The most commonly experienced signs and symptoms for heartburn or GERD include:

  • Heartburn with/without the regurgitation of gastric contents into the mouth
  • Pain or discomfort during the ingestion of food
  • Sour taste in mouth
  • Dental erosion
  • Chronic cough
  • Chest pain
  • Belching, abdominal fullness or abdominal bloating

 

Always be aware the following complications may arise:

  • Esophagitis: causes dynophagia (pain during swallowing) and possible hemorrhage (bleeding)
  • Esophageal stricture(s): causes a gradually progressive dysphagia (difficulty swallowing) of solid foods
  • Esophageal ulcer: causes pain in the xiphoid or high substernal region (below the throat at the mid-chest).  These ulcers heal slowly, tend to recur and usually leave a stricture once healed.
  • Barrett's metaplasia

 

The following diagnostic assessments are usually used to diagnose heartburn or GERD:

  • Upper GI endoscopy with/without biopsy: to document the type and extent of tissue damage and to rule out potentially malignant conditions
  • Upper GI x-ray imaging series with barium swallow
  • Esophageal manometry: to determine the pressure at the lower esophageal sphincter
  • Esophageal pH monitoring

 

From a Naturopathic standpoint, Dr. Moira Kwok ND will obtain a very thorough medical history in order to put all of your "puzzle pieces" together to form a whole picture of everything that is going on from a health perspective.  From this holistic approach to treatment, she will put together an individualized treatment plan based on a combination of dietary and lifestyle recommendations, supplements, botanicals, acupuncture and/or IV therapy that is based on your specific case.  

 

References

  • Beers MH & Berkow R (Editors).  1999.  The Merck Manual of Diagnosis and Therapy (17th Ed.).  Merck Research Laboratories: Whitehouse Station, NJ.
  • Ferri FF.  2007.  Ferri’s Clinical Advisor: Instant Diagnosis and Treatment.  Mosby Elsevier: Philadelphia, PA.
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