Reflux, heartburn, indigestion, gastro-oesophageal reflux, GORD: these are all names for the painful sensation that occurs when the contents of the stomach back-flows into the oesophagus. Reflux is one of the most common digestive complains that Australian’s suffer from. The acidity of the stomach contents causes a burning like pain and can lead to inflammation and erosion of the oesophagus. The pain is normally located just behind the breastbone, in the oesophagus and can radiates to the throat, neck and jaw if severe. Some people don’t experience pain, but a daily discomfort such as pressure or gas build up in the upper abdominal area. Burping and bloating can also occur.
Unlike the stomach, the lining of the oesophagus is not designed to withstand acid, so reflux of the acidic contents can damage the lower end of the oesophagus. This can lead to the formation of ulcers and erosion, causing more discomfort and pain. As these ulcers heal they can result in a narrowing of the oesophagus, which can cause difficult, painful swallowing and regurgitation of food. There is also an increased risk of developing Barrett’s oesophagus, a condition where the cells lining the oesophagus undergo changes and become pre-malignant. This is why symptoms of reflux should not be taken lightly, and it is essential to manage your reflux symptoms and we can do this using natural medicines without the need to rely on medications.
It is estimated that between 10-20% of the western population suffer from GORD and most of these people will be prescribed daily medications that either lower stomach acid production or work as an antacid to neutralize acidity and therefore reduce pain. However these are not great long term solutions, as they are not addressing the cause of reflux. Luckily there are many dietary, nutritional and herbal strategies that can be put in place to help you manage reflux for the long term.
There are a variety of reasons as to why someone would develop reflux, and these can form the basis of naturopathic treatment. For many, their lower oesophageal sphincter can be incompetent, meaning that the area is too relaxed and can allow the regurgitation of acids and/or food contents back up into the oesophagus. This will only be picked up after an endoscopy but it is a component that I address with my reflux patient’s as I find it to have a huge impact on preventing reflux long term.
Slow stomach emptying can be a cause as it increases the amount of time that food contents are kept in the stomach, therefore increasing the likelihood of reflux. Insufficient saliva levels can further cause the oesophagus to be too relaxed. There is a high incidence of food intolerances or allergies which further complicates the issue, and this is something I like to test with my reflux patients. Avoiding a food that you are intolerant too (often dairy, wheat or yeast) is the easiest long term way that you can manage your reflux.
Some may also be diagnosed with a hiatus hernia which reduces the function of the oesophageal sphincter to effectively close off the stomach contents. Lastly, being overweight or obese increases the strain on the oesophagus and is a huge trigger for reflux. These are all causes of reflux that we investigate and work on to help you to control your reflux, without the need for medication.
Here are a few diet and lifestyle factors to be aware of-
- Alcohol- increases acid secretions, reduces lower oesophageal sphincter pressure, slows gastric emptying and triggers pain. Avoid alcohol to limit your symptoms
- Coffee- increases acid secretions and reduces lower oesophageal pressure.
- Fatty foods- reduce lower oesophageal pressure and can slow gastric emptying. It may be necessary to avoid healthy fats such as nuts, avocado and oily fish in the beginning of treatment while the oesophagus is healing.
- Spicy foods, tomato, citrus, peppermint, chocolate – all trigger pain
- Food intolerances can also be a trigger and needs to be tested
- Eat slowly. Consume small, but more regular meals. Chew really well.
- Avoid fluid consumption with meals. This dilutes stomach acid levels which delays gastric emptying. Drink nothing 20 minutes before and 30 mins after meals.
- Ensure dinner is at least 3 hours before bedtime.
- If you are above your healthy weight, then weight loss is very effective for reducing reflux
These lifestyle and dietary factors discussed above can go a long way to helping you manage your reflux. However, please remember that we have a whole array of well researched herbal and nutritional medicines that we can use to reduce your reflux. These work to help balance stomach acid production, improve the tone and function of the oesophageal sphincter and repair any damage and inflammation caused by the acid reflux. Please call and make an appointment to see us today.