The WORD on GERD
The increased incidence of GERD, or gastroesophageal reflux disease, has caused more and more people to seek medications to eliminate their reflux. Approximately 15 million people are using proton pump inhibitors, or PPIs, making these drugs one of the most commonly prescribed medications on the market. Clearly, GERD is a huge issue for many people and you may be one of them. If you are relying on a PPI to relieve your symptoms, then you need to be aware of the long term effects that may be damaging to your health. In addition, understanding the underlying cause of reflux is essential to work with your body to remedy the cause rather than simply suppressing the symptoms with a pill.
In most medical schools, health care providers have been taught that GERD results from too much acid being produced that backs up into the esophagus through the esophageal sphincter. In addition, this acid may move downward into the digestive tract causing burning, pain, ulcerations, and even bleeding. This can be very serious and should not be ignored. However, we now know that GERD is almost always caused by TOO LITTLE, not too much stomach acid.
Think of it like this…your body is insanely intelligent. When you eat, your food goes into your mouth and down your esophagus. It passes through a valve at the end of your esophagus called the esophageal sphincter. Your body excretes hydrochloric acid and uses digestive enzymes to break down the food so it can pass further down into the digestive tract. However, when there is an insufficient amount of acid, the body protects itself by holding the food higher and longer just below the esophagus as the body tries to muster up enough acid so the food can be broken down into a more usable form. Now when food sits there too long, it begins to putrefy (a nice word for “rot!”). This process can be caused by a diet of processed foods that are difficult to break down, insufficient hydrochloric acid to digest the food, or a combination of both. Remember, we must have digestive enzymes and hydrochloric acid to break down food properly. Processed foods have NONE of these enzymes or acids. Fruits and vegetables have digestive enzymes “built in.” A diet lacking in whole foods also contributes to a lack of minerals needed to produce sufficient amounts of hydrochloric acid.
So these two things are true: GERD IS caused by acid refluxing up into the esophagus and PPIs REALLY DO work to alleviate the symptoms. But health should not be about symptom relief by “hiding” the symptoms but by treating the underlying cause in order to eliminate the symptoms. So blocking the acid should not be a long term solution. In fact, blocking the acid caused by undigested food is likely contributing to your health issues. Studies show that people on PPIs quickly become deficient in magnesium and other major nutrients, are more prone to opportunistic infections such as C. difficile or MRSA, and are more prone to fractures and pneumonia. Nutrient deficiencies can contribute to a myriad of other issues as the various nutrients are involved in so many processes in the body, including overall immunity. These side effects can be subtle and may not even be recognized by the real cause, which is nutritional deficiencies resulting from PPI usage. PPIs cannot be stopped abruptly, however, especially if they have been used daily for a long time. “Rebound reflux” may result and produce worse reflux than when it first began.
The focus of resolving GERD and weaning off of PPIs should be providing your body with the ingredients needed to improve digestion. That includes eating those foods that are more easily digested and adding supplements to help with the digestion process. The following protocol can improve your digestion issues, heal your gut, eliminate your need for PPIs, and improve your overall health:
1.Eat real food including fresh fruits and vegetables. Include twice as many veggies as fruit, as fruit still has a lot of sugar. These foods contain digestive enzymes, whereas processed foods have none of these enzymes. Also avoid sugar, flour, and industrial seed oils (soybean, cottonseed, sunflower, safflower, corn, and canola oils).
2. Drink plenty of water, but avoid juices, sodas, alcohol, and other sugary beverages. Diet drinks are no better as aspartame is very dangerous to your health. Avoid more than 4 ounces of water with meals as this will dilute stomach acid even further.
3. Add aloe juice and/or chlorophyll. Anyone with GERD typically has gastric irritation that needs to be healed. Aloe and chlorophyll are great products to heal the inflammation, support digestion, and improve nutrient absorption. For aloe, my favorite brand is Aloelife Aloe Juice in cherry berry flavor. You need 2 tbsp twice daily and can increase to 3 times daily if additional healing is needed. For chlorophyll, I love Standard Process Chlorophyll Complex 2 gelcaps three times daily.
4. Add probiotics to improve your gut flora. Probiotics are “good bacteria” necessary to keep “bad bacteria” in balance. You can also add this by eating fermented foods like sauerkraut (like 1 tbsp 3 times daily). Gut flora becomes out of balance with poor diet, use of antibiotics and other drugs, stress, and many other factors. Avoid antibiotics whenever possible.
5. Add digestive enzymes with hydrochloric acid (HCL) with meals to give your body what it needs to break down that meal. This is especially needed when weaning off the PPI. I recommend Zypan by Standard Process, two tablets with meals. It contains both enzymes and HCL. This can also be taken when you have heartburn, gas, or bloating.
6. Another helpful remedy is 1-2 teaspoons of Braggs apple cider vinegar in 4-6 ounces of water twice daily. If you feel any burning, omit this and continue with aloe juice and diet changes.
7. Greatly limit or eliminate gluten, dairy, and sugar. These foods can be difficult to digest or cause gut inflammation and should be avoided generally, but especially while trying to wean off PPIs.
8. Once you have established improved gut health with the suggestions above, then talk with your doctor about reducing your PPI to one pill every other day for one week. If symptoms do not return and in consultation with your doctor, you may reduce your PPI to every two days for another week. Again, if symptoms do not return, you may reduce to every third day. Continue to reduce frequency until you no longer need it.
It is important that you work with your health care provider to ensure that you are improving your health, not just alleviating symptoms. Schedule an appointment if you need further assistance with weaning off your PPI.