By Dr. Monica Meng Xu (ND)
GERD, also known as acid reflux, is a chronic condition that involves malfunction of the valve (LES) between the esopsgus and the stomach. Stomach acid can travel back up the esophagus and bring about a burning sensation that is commonly described as heartburn, as well as acidic taste in the mouth.
Proton pump inhibitors (PPIs) such as Pantoprazole are often prescribed in conventional medical treatment. PPIs reduce the production of acid in the stomach so when reflux does happen it is less irritating and allows the esophagus to heal.
Naturopathic medicine can help to address the root cause of the problem and rebalance the digestive system without the use of pharmceutical drugs. Here is an example:
“Ken” is in his 60s and had been suffering from acid reflux for over 20 years. The symptoms had worsened in the last 4 years. Even though he had been taking Pantoprazole but his acid reflux didn't get any better. Ken reported that the acidic taste was usually wort in the morning on empty stomach, but the reflux was worse in the evening. He also had bad breath and decreased energy due to poor sleep.
During the abdominal exam, I found hyperactive bowel sounds upon auscultation. He was also tender to palpation at subxyphoid region. These indicated hyperactivity of the gut and local tissue inflammation at the location where esophagus joins duodenum.
He told me that his typical diet was made up of spaghetti and bread, both high processed food, as well as high protein items such as BBQ beef, grilled pork, and cheese. He stopped having carbonated drinks recently as it seemed to have helped with the reflux.
Based on his diet, energy level, and bad breath, I suspected that he may suffer from small intestine bowel bacteria overgrowth (SIBO) so we decided to take the SIBO breath test. For more information about SIBO and the SIBO test, please see this article.
Our treatment goal was to sooth the esophageal mucosal membrane, and to identify the reasons triggering the reflux so we can address the root cause. I also recommended a diet and lifestyle change that will promote better digestive health and overall wellbeing.
I prescibed him a deglycerhizinated form of licorice and stomach acid support supplements such as Betaine HCl and apple cider vinegar to promote his natural stomach acid secretions.
The diet and lifestyle changes I suggested include:
- A modified Paleo diet, 3-5 days a week.
- Remove dairy and processed carbohydrate from diet
- Whole food ingredients
- Limit alcohol to once a week.
- Sleep hygeine—no electronic usage 30 minutes prior to bedtime. No electronic equipments near bed.
3 weeks later Ken came back for a follow-up visit and he reported that his GERD symptoms had improved drastically, to a point that he deciced to stop taking Pantoprazole.
With the new diet, he also reported that his digestion had improved, with less loose stools, less subxyphoid pain and bloating.
His SIBO test result indicated an extensive bacteria overgrowth. Even though his digestion seemed to have improved, the bacteria overgrowth is a situation that must be addressed in order to bring his digestive system back to balance. The SIBO could be the reason for his GERD, as the gaseous byproducts from bacteria resides in the stomach or duodenum could create pressure that resulted in incomplete closure of esophageal sphinctures. As the sphincture was unable to fully close, irritation of mucosal membrane could occur from leakage of gastric acid.
I prescribed him a broad spectrum antimicrobial and antifungal formular consisted of a properitary blend of berberine rich herbal extracts and essential oil extracts. It can eliminate the gram-positive and negative bacteria and yeasts in the digestive tract. I also gave him digestive enzymes that help to break down complex carbohydrates, animal and plant proteins, as well as fats from the diet.
3 weeks later he came in for another follow-up. He told me that his acid reflux had not come back, even after he stopped the licorice support. Bad breath has been improving and become less bothersome espcially in social settings.
SIBO could take as little as 8 to 12 weeks to heal, depending on severity and how long patient had those symptoms. Maintaining a healthy diet and replenishing the good bacteria (probiotics) are keys to bring back a healthy balance in the digestive tract.
Overall, Ken has better energy and endurance when he exercise, and he had decided to stick with his new diet regime.
As you can see in Ken’s case, naturopathic medicine can safely and effective address the root causes of many digestive conditions. For more complicated cases such as IBS, SIBO, or food intolerances, there are functional medicine tests available at IMI to help reach an accurate diagnosis. If you suffer from acid reflex or other digestive ailments, you should consider seeing a qualified natuopathic medicine practitioner.
About Dr. Monica Xu
Dr. Monica Xu (ND) is a US trained and licensed primary care naturopathic physician, who applies functional medicine in her practice and utilizes lab tests to identify the root causes of symptoms.