What is GERD?

Currently, GERD (Gastro-Esophageal Reflux Disorder) is one of the commonly observed conditions in youths due to various factors, such as faulty diet and lifestyle, excessive smoking or alcohol consumption, stress, etc. Gastroesophageal means a condition relating to the stomach and esophagus. Reflux means backflow.

GERD (Gastro-esophageal reflux disorder) is a very common chronic condition of the digestive system seen in young and older people, where there is reflux (backward flow) of acid and food contents from the stomach to the esophagus (food pipe). It is termed gastro-oesophageal since the condition is related to the esophagus and stomach.

This constant backward flow of acid if not treated on time irritates the lining of the esophagus leading to erosive reflux oesophagitis.

Researchers have found a correlation between stress, anxiety, and GERD. Hence this condition is categorized under psychosomatic (psycho-mind, soma-body) diseases.

Normally, when we eat or drink anything, the lower end of the food pipe (lower esophageal sphincter) opens and allows the food to pass into the stomach. Once the process is done, it closes and prevents the backflow of food and stomach juices (acid) to the esophagus. 

However, when the lower esophageal sphincter (band-like muscular gateway) weakens or relaxes abnormally, there is a backflow of stomach content to the esophagus or food pipe, and this backflow is known as gastroesophageal reflux. The reflux of acid may irritate the mucosa of the esophagus and may cause symptoms, such as heartburn, acidity, sour or bitter taste, chest pain, coughing, etc. 

Everyone experiences such symptoms at some point in their life, but, if the symptoms persist and start causing discomfort in day-to-day life, it may be termed as Gastroesophageal reflux disease. It is also known as Acid reflux disease. In many patients, GERD can be managed by dietary and lifestyle changes, but some patients may require stronger medications or surgery.

Homeopathic Treatment For GERD:

Homeopathy aims at treating the root cause of GERD. Homeopathic medicines have the capacity to restore the abnormal functioning of the oesophageal sphincter. The medicines also help in balancing the metabolism and correcting digestive errors. A combination of well-taken homeopathic case history with diet and lifestyle changes helps in offering a sustainable recovery to the patients.

How can homeopathy help with GERD?

• The prescription of homeopathic medicine for GERD is based on the current state of the disease, symptoms of GERD, lifestyle, dietary habits, and emotional state of the patient. Hence, it acts on a deeper level and corrects the imbalance in the system. 
• Homeopathy treats the disease at the root and tries to correct the functioning of the digestive system. In turn, it regulates acid secretion and digestion. 
• Initially, homeopathic medicines provide you relief from symptoms, such as heartburn, acidity, chest pain, sour taste, etc.
• In mild to moderate cases of GERD, it may help to strengthen the muscles of the lower esophageal sphincter and prevent the backflow of stomach content. 
• If you are taking antacids for a long, period homeopathy may help to reduce the dependency on antacids or other conventional medicines.
• Homeopathic treatment for GERD is completely safe and non-habit-forming. Results in homeopathy for GERD are long-lasting. However, severe cases may require surgical intervention or other treatment. 

Scope and duration of homeopathic treatment

Homeopathy can be opted as the first line of treatment in early-detected cases with mild to moderate symptoms. This helps in early resolution of the disease with fewer chances of relapse. Homeopathy can also be a supportive form of treatment for patients with chronic GERD who are on long-term conventional treatment.

The duration of the treatment varies from one patient to another. Associated diseases usually prolong the duration of treatment. However, the time taken for recovery is less in mild to moderate cases compared to severe ones.

Homeopathy medicine for GERD not only promotes healing, treats the existing symptoms, and helps to recover from the disease but also helps to prevent the recurrence of Gastroesophageal reflux and addresses the tendency to have reflux symptoms. The disease's further progress and the symptomatology reduction can be accomplished significantly with Homeopathy. Additionally, since the disease is tackled at the root level, it is possible to halt the further progression and deterioration of the condition, so that one is less likely to face any complications in the coming years of life.

It is believed that Gastroesophageal reflux in some patients can be related to mind and emotions. The constant anxiety, stress, worry, and psychological issues can lead to an increase in acid secretion, modify oesophageal motility, and intensify the pain. So when deciding the Homeopathic medicines not only the physical symptoms but the psychological aspects of the patients are also understood, which might add to symptoms occurrence and their persistence, so the medicines are prescribed accordingly considering the physical as well as mental generals of the patients. Homeopathy treatment for GERD helps to balance the digestive function, helps to strengthen the integrity of the oesophageal sphincter, reduces the stress levels helps in overall well-being, and minimizes the likelihood of future flare-ups.

Duration of treatment:

As per our experience in treating patients of GERD at Life Force, most of the patients respond to the treatment in the initial six to eight weeks, but the total duration of treatment may vary depending on various factors listed here.

• The extent of the disease
• Cause behind GERD
• Duration of the suffering
• Other underlying medical conditions
• Current and past medication
• Lifestyle and dietary habits of the patient

What are the chances of recovery from GERD with homeopathy?

Excellent result: Excellent results can be observed in mild, moderate, and early-detected & treated cases of GERD

Good results: Good results can be observed by using homeopathy in moderate to severe cases. Also, in 3-7-year-old cases, one may find good results by using homeopathy. 

Not-so-good result: Very severe cases, very old cases (> 15 years), and cases with poor lifestyles may not respond well to homeopathy. 

Commonly prescribed homeopathic medicines for GERD:

Some of the commonly prescribed homeopathic medicines for GERD are Natrum Phosphorica, Iris Versicolor, Robinia, Nux Vomica, Phosphorus, Lycopodium, Carbo Veg, etc.  For instance, Nux vomica might be suggested for people who experience acid reflux, the sensation of fullness in abdomen gases and bloating, and nausea, especially after indulging or eating oily spicy food varieties. Different medicines like Pulsatilla and Carbo Vegetabilis might be recommended for people with symptoms like burping, belching, and a craving for natural air or cold beverages.

What Happens In GERD? (Pathogenesis)     

When we eat, food or liquid goes from the food pipe (esophagus) to the stomach through the junction at the lower end of the esophagus and the stomach. This muscular gateway or junction is called the lower esophageal sphincter. Normally, this sphincter remains closed to prevent the reflux of stomach content into the esophagus. 

However, when, due to some reason, this sphincter becomes relaxed or weak, it may not function properly and allow the content of the stomach and acid to flow back to the esophagus.  This causes irritation and inflammation of the mucosa of the esophagus and causes symptoms, such as heartburn, acidity, sour or bitter taste, chest pain, etc. Many individuals experience this reflux and this may stop after the slightest dietary modifications or lifestyle changes. The persistence of these symptoms may lead to gastroesophageal reflux disease or GERD.

Dietary habits or factors, certain faulty lifestyle habits, and stress are common factors responsible for the occurrence of GERD in individuals who are prone to develop it. In some patients, a condition called hiatus hernia (Bulging of the upper part of the stomach up into the diaphragm) may cause pressure on the lower esophageal sphincter and make it weak leading to GERD. Obesity and pregnancy can worsen GERD. 

Prevalence Of GERD:

GERD is one of the most commonly diagnosed digestive disorders worldwide. About 18- 20% of people suffer from this condition. Females are more affected than males (2:1) and the risk increases with age.

In India, about 10- 30% of people suffer from this condition. It is most commonly noted in the Southern population.

Children and babies are also affected. Physiological GERD affects almost 70- 80% of infants and occurs due to over-feeding, wrong positioning of the baby during breastfeeding, and putting the baby to sleep immediately after breastfeeding. This usually resolves with increasing age.

Causes Of GERD:

Multiple factors are responsible for the onset of GERD. Some of the common factors responsible for GERD are listed below.

1) Abnormal functioning of lower esophageal sphincter:

Abnormally weak contractions or relaxation of the lower esophageal sphincter leads to GERD. Certain structural abnormalities, certain types of foods, medications, and beverages may lead to abnormal functioning of LES.  

2) Hiatus Hernia

Hiatus hernia bulges the upper part of the stomach up into the diaphragm. This bulging causes pressure on and may cause abnormal relaxation or weakness in the lower esophageal sphincter leading to GERD.

3) Delayed stomach emptying: 

Due to some reasons, food may remain for a longer time in the stomach causing distension of the stomach for a longer time than usual. This may put pressure on the lower esophageal sphincter leading to GERD.  

4) Stress

Many patients report that emotional or physical stress may trigger or aggravate GERD.

5) Pregnancy

During pregnancy, hormonal changes may slow down the functioning of the digestive system. Thus, the food is pushed down slowly from the esophagus to the stomach causing relaxation of the lower esophageal sphincter.  In addition to this, as the uterus grows in size, it puts pressure on the stomach and diaphragm leading to reflux. 

6) Connective tissue disorder (like scleroderma) may weaken the activity of the lower esophageal sphincter. 

7) Faulty diet: 

• Eating an excess of spicy food, pungent food, or fatty food
• Having an excess of coffee or aerated drinks
• Eating citrus fruits
• Excess use of garlic or onion in the diet
• Using chocolates or peppermints 

8) Faulty eating habits

• Eating large meals at a time
• Eating late at night
• A long gap between two meals
• Lying down immediately after eating
• A poor posture after eating

9) Faulty lifestyle

• Excess smoking
• Excess use of alcohol 
• Lack of sleep
• Lack of exercise

10) Obesity: Excess weight may put pressure on the abdomen and diaphragm leading to abnormal relaxation of the lower esophageal sphincter and reflux. 

11) Medication and drugs: 

Medications, such as calcium channel blockers, painkillers, antihistamines, sedatives, antidepressants, bronchodilators, some antibiotics, iron supplements, hormone therapy (progesterone), etc. may trigger the onset of GERD.

12) Other medical conditions: Scleroderma, Diabetes, Asthma, COPD, Celiac diseases, etc. may cause reflux and lead to GERD. 

Symptoms Of GERD:

Commonly presenting symptoms of GERD are listed here.

• Heartburn: Burning sensation in the chest and behind the sternum (retrosternal region)
• Burning in the chest after meals
• Reflux: Regurgitation of food or sour water
• Heartburn or reflux is more severe at night or on lying down
• Sour, acidic, or bitter taste in the mouth
• The sensation of something stuck up in the throat or the sensation of a lump in the throat
• Nausea
• Chest pain
• Persistent sore throat
• Chronic cough
• Hoarseness of the voice
• Difficulty in swallowing
• A bad breath
• In children: Regurgitation of food, vomiting, persistent cough, etc.

Complications Of GERD

A poorly managed or untreated GERD can cause severe complications as listed below.

1. Esophageal stricture or narrowing of the esophagus: Continuous irritation and inflammation of esophageal mucosa due to acid reflux may lead to scarring of the tissues of the esophagus leading to permanent damage to the esophagus. This causes difficulty in swallowing.
2. Erosion of the esophagus: Continuous exposure to acid may lead to esophageal erosion. 
3. Esophageal ulceration: Stomach acid may cause an open sore or ulcer to esophageal mucosa due to continuous erosion. This may lead to pain and bleeding from the ulcer.
4. Barrett’s esophagus: Due to persistent reflux in a few patients, the normal lining of the esophagus is replaced by abnormal tissues. This condition is known as Barrett’s esophagus, which is a precancerous condition. 

Diagnosis Of GERD:

Diagnosis is made with the help of clinical evaluation, which includes a detailed study of the symptoms, past medical history, and physical examination. After the clinical evaluation, the diagnosis of GERD can be confirmed by using some tests and other conditions can be ruled out. Here are some of the tests for diagnosing GERD.

1. Endoscopy (upper gastrointestinal endoscopy)
2. Biopsy of esophageal mucosa
3. Barium swallow X-ray
4. 24-hour pH monitoring
5. Esophageal manometry: Esophageal manometry is done to measure the rhythmic muscle contractions of the esophagus.

Supportive Treatment (Diet, Lifestyle, and Exercises) For GERD:

Changes in lifestyle and changes in dietary and eating habits help in controlling symptoms of GERD significantly.

1. Avoid foods that may trigger GERD
   • Avoid very spicy, pungent, or fatty food. 
   • Avoid excess use of onion garlic, mint, coffee, and chocolate in your diet
2. Avoid other triggers:
   • Limit your alcohol intake
   • Quit smoking
3. Change your eating habits 
   • Eat small meals at regular intervals.
   • Eat food slowly and chew properly.
   • Eat food at least 2-3 hours before your bedtime.
   • Avoid lying down immediately after having your meals.
   • Avoid late-night meals.
   • Take proper sleep for 7 hours.
4. Lifestyle changes: 
   • Elevate the head of the bed to avoid reflux.
   • Maintain an upright posture while standing or sitting.
   • Perform exercises regularly.
   • Manage your stress: Try meditation, yoga, and other relaxation techniques.
   • Manage your weight to avoid obesity.
5. Stay hydrated:
   • Dehydration can intensify the GERD symptoms, so make sure to have enough water to help balance the proper digestion and prevent dehydration. People who are residing in cold countries if it is not possible to drink more water, can increase their liquid intake in the form of soups, broths, herbal teas, coconut water, smoothies, milk, and fruit juices.  In this way, one can increase liquid intake and at the same time, can enjoy a variety of flavors and nutritional benefits.
6. Maintain food dairy:
   • Keep track of foods that trigger the GERD symptoms, identifying the specific foods or drinks that trigger your GERD can help manage your GERD, by targeting the dietary adjustments.
7. Avoid tight clothing:
   • Make sure to opt for loose-fitting clothes since tight clothing or using tight belts and waistbands can put additional pressure on the stomach and can worsen the symptoms of GERD.
8. Alkaline foods and drinks:
   • Start incorporating the use of alkaline foods and drinks, since alkaline foods help to reduce the irritation and inflammation of the esophagus. Additionally, alkaline foods are rich in vitamins, minerals, and fiber which help in overall gastrointestinal health. Some of the alkaline foods are apples, bananas, cherries, green leafy vegetables, carrots, etc...
9. Opt for probiotics:
   • Probiotics, beneficial bacteria are well known for their use to promote and maintain gut health. Probiotics help in digestion and nutrient absorption. Some examples of probiotics are curd/yogurt and fermented foods like idli, dosa, dhokla, and kadhi. Also, probiotic supplements are available in the market.

Conventional Treatment For GERD:

Commonly prescribed conventional treatment for GERD is as follows:

• Antacids: These neutralize the effect of acid. Most of the antacids are habit-forming.
• H2-receptor blockers: These decrease acid production for a long duration.
• Proton pump inhibitors: They block acid production and reduce inflammation.
• If medications and lifestyle changes are not helping, surgery is advised in some cases. 

Our Experience In Treating GERD At Life Force:

Dr. Shah has been treating different cases of GERD with homeopathy for the last more than 30 years. With his rich experience in treating patients from over 180 countries with homeopathic medicines, he has designed a systemic protocol for treating the causes of GERD. As per our experience at Life Force, all mild, moderate, and a few severe cases of GERD respond very well to homeopathic treatment. Mild to moderate cases with recent origin respond wonderfully to homeopathy. Antacid-dependent cases, very old cases of GERD, and cases with some structural abnormality may take time or may not respond to homeopathy. We have documented a few successful cases of treating GERD in children and infants as well. Lifestyle changes, diet habits, and regular exercises have to be augmented with homeopathic treatment to achieve good results. 

Related Disease:

• Gastritis 
• Pancreatitis
• Hepatitis
• Peptic ulcer disease
• Cholangitis
• Achalasia
• Dyspepsia