Gastro-esophageal Reflux Disease (GERD) is an increasingly common complaint that affects up to 40% of the American population. It is caused by stomach secretions passing above the valve at the top of the stomach into the lower esophagus. These secretions are highly acidic and irritate the esophagus eliciting upper abdominal and/or chest pain. If left untreated, the chronically irritated esophagus (Barrett’s esophagitis) can become cancerous in some individuals.

Current medical treatment focuses on decreasing the acidity of the stomach secretions in an attempt to limit esophageal irritation. This is accomplished with a variety of acid-blocking medications such as Nexium, Prevacid, and Prilosec. However, the cause of GERD is almost never too much acid, but rather acid that is in the wrong place: the esophagus. GERD medications never address why acid is refluxing. In fact, the stomach is supposed to be acidic—a requirement for the proper digestion of foods. By ignoring the actual cause of GERD and by treating the symptoms rather than the causes, conventional treatment results in lower gastrointestinal problems over time. This is due to improperly digested foods finding their way into the intestine where billions of bacteria are waiting with fork and knife to feast on the food you intended for yourself. The result is increased bacterial fermentation that will cause bloating and potentially damage the selectively permeable nature of the intestine (Leaky Gut Syndrome). Additionally, all of these drugs can have severe side-effects.

Effectively managing GERD requires addressing the reasons why acid is refluxing and focuses on two areas: 1) Diet, and 2) The Control of the Lower Esophageal Sphincter. Neither of these causes typically results in GERD alone, but rather works in concert to create the conditions necessary for reflux to develop. The ultimate goal is to prevent stomach secretions from entering the lower esophagus and this two-part treatment is almost always a “slam dunk” in eliminating GERD.

Even conventional doctors acknowledge that some foods will worsen reflux—the most offensive being chocolate, coffee and alcohol; however, food allergies or food sensitivities are an often missed cause of GERD. Food sensitivities occur when your immune system recognizes an ingested food as being foreign. This is a delayed reaction rather than the immediate reactions associated with “true” allergies such as when your throat closes after eating peanuts. Identifying delayed allergic reactions are accomplished with a blood test that measure IgG antibodies. I’ve used this test for almost twenty years with exceptional results. Once the offensive foods are identified, they are eliminated from your diet for 12 weeks, and then they are re-introduced one food at a time in an attempt to find any foods to which you are still reacting.

Most of us are aware, or at least have heard, that stress can contribute to gastrointestinal problems that include ulcers, GERD and irritable bowel syndrome. But did you ever ask yourself why? The reason requires some understanding of how the brain controls the lower esophageal sphincter (LES).

The LES is the valve at the top of the stomach, whose job it is to prevent stomach contents from refluxing up into the esophagus. GERD is not caused by a deficiency of acid-blocking drugs, but rather the improper function of the LES. Drugs do nothing to improve the function of this valve. The brain controls the LES by balancing the two parts of the autonomic nervous system: the parasympathetic system and the sympathetic system.

The parasympathetic portion is associated with relaxation, proper digestion via digestive secretions, and maintaining closure of the LES. The sympathetic portion is associated with stress. Known also as the “flight or fight” response, this portion is increased with stress, either perceived or real (such as a bear chasing you!). Activation of the sympathetic nervous system impairs digestive function and loosens the LES. So the answer to the second part of treating GERD: increase your parasympathetic activity! Pretty much anything that relaxes you will achieve this (with the exception of tobacco and alcohol! FYI: both contribute to reflux by relaxing the LES). Meditation, yoga, and exercise are all good at increasing the parasympathetic system, but my favorite is acupuncture. Acupuncture—especially of the ears, the only place in the human body innervated by parasympathetic nerves—is very good at “re-programming” the central nervous system to facilitate the parasympathetics while decreasing the sympathetics. I almost always include acupuncture as part of my integrative approach to the treatment of GERD.

Most GERD is caused by an improper diet and a malfunctioning lower esophageal sphincter. Effective management of this potentially serious condition requires addressing these underlying factors. Acid-blocking medications only mask symptoms, ultimately cause additional gastrointestinal illnesses, and can result in serious, even life-threatening side-effects. I recommend undergoing proper treatment of GERD before resorting to medications.