By: Dr. Marjan Hosseini, BSc., NDNaturopathic Doctor

THE GERD TALKGastroesophageal Reflux Disease

From a Talk by Dr. Marjan Hosseini, B.Sc., N.D. - Naturopathic Doctor

Dr. Marjan Hosseini is a licensed Naturopathic Doctor in Ontario. Dr. Hosseini

completed her Bachelor of Science at York University in 2009. In 2013, she

graduated from the Canadian College of Naturopathic Medicine (CCNM) in Toronto

as a Naturopathic Doctor. Naturopathic Medicine is a distinct primary health care

system that blends modern scientific knowledge with traditional/natural forms of

medicine. The Naturopathic philosophy is to stimulate the healing power of the

body and treat the underlying cause of disease.

Dr. Hosseini treats a variety of acute and chronic health concerns: hypertension,

diabetes, mental health (stress, anxiety, depression), insomnia, fatigue, arthritis,

smoking cessation and addiction, allergies (food sensitivity, allergy testing),

women’s health, fertility, headaches and migraines, gastrointestinal disorders,

weight loss/management; these are few of the many conditions Dr. Hosseini

treats. Dr. Hosseini’s services/therapies include: diet and lifestyle counseling,

botanical medicine, acupuncture, clinical nutrition (vitamins, etc), hydrotherapy,

homeopathy, naturopathic manipulation, B12 injections, and labs. Dr. Hosseini is

also certified in the Healthy and Active Metabolism Program designed for weight

loss.”

What is GERD?

• Gastroesophagealreflux disease, or GERD, is a digestive disorder that affects the lower esophageal sphincter (LES)

• Heartburn

• Acid reflux

• Gastroesophageal refers to the stomach and esophagus.

• Reflux means to flow back or return.

What is GERD? (cont’d...)

Function of the LES

• A normally functioning LES prevents food and stomach acid from backing up into the esophagus and ultimately into the trachea or "windpipe"

• The LES normally opens or relaxes (lowers its pressure) as food is moved down the esophagus by esophageal contractions

Who Is Affected?

• Many people, including pregnant women, suffer from heartburn or acid indigestion caused by GERD.

• Some people suffer from GERD due to a condition called hiatal hernia.

• Diet and lifestyle changes.

• Medication or surgery.

How Severe is GERD?

• LES dysfunction.

• Type and amount of fluid brought up from the stomach.

• The neutralizing effect of saliva.

Symptoms of GERD• Heartburn• Burning chest pain• Can last as long as 2 hours • Worse after eating• Lying down or bending over can also result in heartburn• Relief by:

– Standing upright or taking an antacid that clears acid out of the esophagus

• Heartburn pain can be mistaken for the pain associated with heart disease or a heart attack, but there are differences.– Exercise may aggravate pain resulting from heart disease, and rest

may relieve the pain– Heartburn pain is less likely to be associated with physical activity

How Common Is Heartburn and GERD?• More than 60 million American adults

experience heartburn at least once a month, and more than 15 million adults suffer daily from heartburn.

• Many pregnant women experience daily heartburn.

GERD in Babies?

• Recent studies show that GERD in infants and children is more common than previously recognized and may produce recurrent vomiting, coughing, and other respiratory problems.

Causes of GERD in Children

• Most of the time, reflux in babies is due to a poorly coordinated gastrointestinal tract.

• Many infants with the condition are otherwise healthy.

• In older children, the causes of GERD are often the same as those seen in adults.

• Certain factors also may contribute to GERD, including obesity, overeating, eating spicy or fried foods, drinking caffeine, carbonation, and specific medications.

• Hereditary

Treatment

• Lifestyle and dietary changes.• Treatment aims at decreasing the amount of reflux

or reducing damage to the lining of the esophagus from refluxed materials.

• Avoiding foods and beverages that can weaken the LES is often recommended: – Chocolate, peppermint, fatty foods, coffee, and alcoholic

beverages– Foods and beverages that can irritate a damaged esophageal

lining, such as citrus fruits and juices, tomato products, and pepper, should also be avoided if they cause symptoms

Treatment (cont’d...)

• Decreasing the size of portions at mealtime

• Eating meals at least 2 to 3 hours before bedtime

• Weight loss

• Smoking cessation

• Elevating the head of the bed on 6-inch blocks or sleeping on a specially designed wedge – Do not use pillows to prop yourself up- that only

increases pressure on the stomach.

• Over-the-counter or prescription treatments

Conventional Treatment• Over-the-counter medications are usually prescribed to help control heartburn:

• Antacids may provide quick relief

– Maalox, Mylanta, Gelusil, Gaviscon, Rolaids and Tums

– These can help neutralize acid in the esophagus and stomach and stop heartburn, but they won't heal an inflamed esophagus damaged by stomach acid.

– Overuse of some antacids can cause side effects, such as diarrhea or constipation.

• Medications to reduce acid production: these are called H-2-receptor blockers,

– Cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR) or ranitidine (Zantac).

– H-2-receptor blockers don't act as quickly as antacids do, but they provide longer relief and may decrease acid production from the stomach for up to 12 hours.

– Stronger versions of these medications are available in prescription form.

Conventional Treatment (Cont’d...)• Medications that block acid production and heal the esophagus: Proton

pump inhibitors (PPIs)

– OTC: lansoprazole (Prevacid 24 HR) and omeprazole (Prilosec, ZegeridOTC).

– PPIs are stronger blockers of acid production than are H-2-receptor blockers and allow time for damaged esophageal tissue to heal.

• Medications to increase the strength of the LES and quicken emptying of stomach contents with motility drugs that act on the upper gastrointestinal (GI) tract. These drugs include bethanechol (Urecholine) and metoclopramide (Reglan).

• Surgery and other procedures used if medications don't help: most GERD can be controlled through medications. In situations where medications aren't helpful or you wish to avoid long-term medication use, your doctor may recommend surgery.

Conventional Treatment:Side Effects

• Antacids can help neutralize acid in the esophagus and stomach and stop heartburn.

• Temporary or partial relief.

• Long-term use can result in side effects:

– Diarrhea, altered calcium metabolism and buildup of magnesium in the body.

– If antacids are needed for more than 2 weeks, a doctor should be consulted.

Naturopathic Treatment

• Herbal remedies:

– Licorice, slippery elm, chamomile, marshmallow.

– Serious side effects.

– May interfere with medications.

Naturopathic Treatment (Cont’d...)

• Relaxation therapies:

– Techniques to calm stress and anxiety.

– Progressive muscle relaxation or guided imagery.

Progressive Muscle Relaxation

Naturopathi Treatment (Cont’d...)

• Acupuncture:

– Inserting thin needles into specific points on your body.

– Limited evidence suggests it may help people with heartburn.

Conclusion...

• Heartburn and GERD are extremely common but very treatable.

• Simply masking the symptom with a medication is not only temporary but can result, long term, in more serious diseases.

• Naturopathic Doctors (NDs) have excellent success in this area and are more than happy to assist you, your friends, and family.

Special Offer: Receive a complimentary informational Health Check

session with Dr. Marjan Hosseini and a discount of 25% on an initial

consultation.

For an appointment with Dr. Marjan Hosseini, B.Sc., N.D. –Naturopathic

Doctor, call 416.445.2075 or email ellesmere@corecare.ca.