Gastro Oesophageal Reflux Disease (GORD)
Do you suffer with reflux? There is nothing worse than that burning feeling of acid washing up into the back of your throat. There are a number of diet and lifestyle contributors to this condition that aren’t necessarily due to a disease process. Simply going on an antacid is not the solution. Long term untreated reflux is a serious cause for concern as complications may arise so ensure you seek professional help and get it under control. Let’s talk about some of the causes below:
Aetiology and Pathophysiology
GORD involves chronic exposure of the oesophageal mucosa to gastric and duodenal contents leading to irritation and inflammation of the oesophagus. Aetiology may include reduced lower oesophageal sphincter tone (LOS), hiatus hernia, intra-abdominal pressure and delayed gastric emptying. Alcohol, coffee, chocolate and dietary fats may contribute to poor lower oesophageal sphincter tone. Pregnancy and obesity may contribute to intra-abdominal pressure (Colledge, Walker & Ralston 2010, pp.863-865; Hechtman 2012, pp.197-8; Moayyedi & Talley 2006, p.2086).
Symptoms may include heart burn, regurgitation exacerbated by lying down, stress, dysphagia, odynophagia, cough, hoarseness and chest pain. GORD can complicate into pre-malignant Barrett’s Oesophagus. Proton pump inhibitors (PPI’s) are a common allopathic treatment for GORD. GORD may cause reflux oesophagitis or be classed as non-erosive on endoscopy (Colledge, Walker & Ralston 2010, pp.863-865; Hechtman 2012, pp.197-8; Moayyedi & Talley 2006, p.2086).
Reflux is caused by hypochlorhydria as digestion is slower resulting in the presence of food in the stomach for a longer period of time which stimulates the regurgitation of hydrochloric acid up into the oesophagus. Hypochlorhydria is associated with a combination of factors including ageing, stress, poor parasympathetic nervous system activity, antacids, medications, high intake of refined carbohydrates, over eating, alcohol consumption, zinc and thiamine deficiency (Hechtman 2012, pp.198; Moayyedi & Talley 2006, pp.2086-7; Weatherby 2004, p.108).
Antacids or Proton Pump Inhibitors reduce the production of hydrochloric acid (HCL) to minimise damage to the oesophageal mucosa and should not be used as long term medication as this may lead to hypochlorhydria, nutrient deficiencies and electrolylte imbalances (NPS Medicine Wise, Nexium Tablets 2015). The naturopathic understanding of GORD differs to the medical understanding in that suppression of HCL production does not address the underlying causative pathophysiology and thus provides symptomatic relief rather than cure. The primary treatment aim is to improve LOS tone and improve digestive secretions. Bloating after eating is a sign of hypochlorhydria as undigested foods ferment and produce gas. Hypochlorhydria predisposes to dysbiosis, pancreatic insufficiency and intestinal hyper-permeability (Weatherby 2004, pp.112, 122).
Reflux can also be a sign of a bacterial infection known as helicobacter pylori, a very common infection which may be asymptomatic at times and may lead to stomach ulcers. A simple breath test with your GP can rule this out.
If you are suffering with reflux, see your naturopath today for a holistic health plan. Make sure you understand what is driving it for you and address the cause.
Dietary considerations in GORD – foods that irritate the mucosa or relax LOS
Large meals high in carbohydrates
(Hechtman 2012, pp.198; Moayyedi & Talley 2006, p.2086).
Colledge, N, Walker, B & Ralston, S 2010, Davidson’s Principles & Practice of Medicine, 21st Edn, Elsevier, China
Hechtman, L 2012, Clinical Naturopathic Medicine, Elsevier, Australia
Moayyedi, P & Talley, NJ 2006, ‘Gastro-oesophageal reflux disease’, The Lancet, vol. 637, no. 9528, pp. 2086-2100, viewed 1st September 2015, http://eds.b.ebscohost.com.ezproxy.endeavour.edu.au/eds/pdfviewer/pdfviewer?vid=4&sid=d05cfa05-dd03-4db0-beb8-1fd042fe771e%40sessionmgr115&hid=108
Weatherby, D 2004, Signs and Symptoms Analysis from a Functional Perspective, 2nd edn, Bear Mountain Publishing, USA
Jean is a fully qualified naturopath with clinics in Sydney CBD and Glen Innes NSW, a telehealth service offering phone and video conferencing consults to rural and remote areas of Australia and services country towns such as Tamworth, Armidale and Inverell.
Get in touch today for a holistic health plan and get on track with your health!