There is mounting evidence that drug treatment for GERD does not come without potentially serious risk. Such studies suggest that these drugs increase the risk of osteoporosis, depression, serious digestive tract infection, flu, irritable bowel disease and nutrient deficiencies such as vitamin B12 as well as important minerals. Although research has demonstrated these potential consequences, it does not take a multi-million dollar study to be able to reason that medications that interfere with acid secretion in the stomach will also interrupt nutrient absorption while making it easier for harmful organisms such as C. difficile to grow and cause havoc in our digestive tracts.

GERD occurs when the digestive juices back up into the esophagus, which results in an irritation to the fragile lining of the esophagus. The chronic irritation to the esophagus potentially results in a pre-cancerous condition called Barrett’s esophagus and then, left unchecked, to esophageal cancer. This process of progression sounds horrible and, drug companies would have you believe, imminent if left untreated.  Research, however, does not support this seemingly rational and unquestionable connection. In fact, a recent review of the data suggests that the connection between GERD and Barrett’s esophagus is so weak that the reviewing scientists felt that the widespread practice of screening patients with GERD, using endoscopy, was not warranted. Other researchers found that patients who were suffering with nighttime symptoms, as well as obese patients, were at a higher likelihood of having GERD progress to Barrett’s and ultimately to cancer. These patients may be the ones who require endoscopy as a screening tool.

What causes GERD?

A common characteristic of GERD is what is known as a relaxed lower esophageal sphincter (LES Valve). This sphincter acts as a door between the esophagus and the stomach. In a healthy person, the door slams tightly shut after food enters the stomach; however, in someone with GERD, this door may not shut snuggly, which can lead to reflux of stomach contents and ultimately irritation of the esophagus. The better question is, “what causes this doorway to remain slightly ajar?”  There are number of reasons for this:

1. Portion size – People who eat large quantities of food can cause the stomach to expand well beyond the normal stretched size. Regular exposure to this degree of stretch can cause a deformity in the doorframe so that a gap remains, even when the door is shut. Portion size of food can have an immediate and a more long-term effect. If you eat a large meal right now, the stretching of the stomach can immediately cause symptoms; long-term exposure to such large portion sizes can result in a deformity in the doorframe even when the stomach is empty. Both of these situations can be remedied by eating smaller quantities.
2. Mint – Mint has a relaxing effect on the esophageal sphincter, you may want to avoid using mint candies and gum if you suffer with GERD.
3. Deep fried food – These foods slow the movement of food from the stomach to the intestines, this increases the likelihood of contents moving into the esophagus.
4. Late night eating – This increases the likelihood that food will be in the stomach while your body is in a horizontal position.
5. Medications – There are many medications that can cause problems with GERD: Calcium channel blockers, beta blockers (metoprolol, Toprol XL, etc.), NSAIDs (Ibuprophen, Naproxen, Advil, Aleve) , aspirin, nitrates, anti-depressant medications, bisphophonates (Fosamax, Actonel, Boniva, etc.) and progesterone.
6. Excess weight, especially central obesity.
7. Food allergies and sensitivities. Although this is an underappreciated cause of reflux disease, it is important to note and it may be worthwhile to look for offending foods and precede with eliminating these foods from the diet.  These food sensitivities can be worsened by acid suppression through the use of medications like Nexium, Prevacid, Tums, etc.
8. Stress is a major cause of GERD. When you are stressed, the digestive tract does not function properly. This can result in a poorly functioning LES valve and more reflux.
9. Other factors – There are other factors that have been linked to GERD such as: Smoking, spicy food, citrus, tomato products, caffeine, alcohol and chocolate.

Isn’t GERD Caused by Too Much Acid in the Stomach?

Although there is a condition, called Zollinger-Ellison Syndrome, where the stomach produces excess acid, this condition is quite rare. In fact, many doctors have discovered that 9 out of 10 people, who suffer with reflux, actually do not produce enough acid to trigger the closure of the LES valve. In addition, when stomach juices do not reach a particular acid level, the food contents sit stagnant and the food begins to putrefy and rot. As the food sits, it ferments and causes excess gas to form. This bubbling action can further worsen reflux by pushing the contents of the stomach into the esophagus.

So what do we do about it?

1. Have a careful assessment of medications and request your doctor remove or alter any medication listed above that may be linked to reflux. Please note, most doctors and pharmacists do not know about the link between these medications and reflux.
2. Learn about and implement a food elimination diet to try and pinpoint certain food triggers. Wheat, gluten and dairy are common culprits.
3. Replace acid in the stomach. It is a little known fact that a lack of acid in the stomach may be responsible for the reflux. This goes contrary to the conventional belief about what causes GERD; excess acid and poor sphincter tone. See our article about Betaine HCl Therapy for GERD. Taking an enzyme along with the Betaine HCl could result in further improvements.
4. Take an Enzyme – Plant enzymes work throughout the entire digestive tract to break down the food that we consume. Through the use of enzymes, we can decrease the time it takes to move the contents of the stomach from the stomach to the intestines. A potent enzyme that we commonly recommend is OrthoDigestzyme V. What makes these enzymes so powerful is the fact that they work through a broad range of acid levels. If the pH within your digestive tract is off, these enzymes will still work. This will often improve transit times and decrease gas and bloating.
5. DGL Ultra – This is a chewable form of licorice that helps to coat, soothe and stimulate healing in the esophagus and stomach. Chew 1 tablet before each meal and at bedtime.
6. Acid Assist – For symptomatic relief and/or in serious cases of GERD, Acid Assist is a chewable tablet that forms buffered foam on top of the stomach acid. This allows normal digestion to occur beneath the foam while preventing acid from jumping into the esophagus. This is to be used as needed to control symptoms while you are working to rebalance the body.

• The first line of defense against infection
• Stimulating the production of the stomach’s protective lining
• Stimulating the proper closure of the doorways between the stomach and the esophagus.

Contrary to popular belief, many people have too little acid in their stomach which prevents them from being able to properly digest their food. In addition, this low stomach acid results in a number of conditions including: acid reflux disease (heartburn/GERD), food allergies, ulcers, infection and nutrient deficiency syndromes.

So how do we know if there is enough acid in the stomach? Well, there is not a simple answer. The gold standard test is to swallow an electronic capsule that tests the pH of the acid in the stomach. Unfortunately, this test is rarely done due to its cost and complexity. Generally, people rely on their symptoms as a means of assessing possible acid deficiency and then follow this assessment with a trial of betaine HCl supplementation. Seniors and people who have suffered with a lot of stress in their lives may be at risk of having low stomach acid.

Betain HCl is an encapsulated form of hydrochloric acid, the acid that is found in the stomach. By taking stomach acid with each meal, you are adding the acid back to the stomach and allowing initial digestion to occur again. Here is how you test yourself.

Just before your next meal take one 500 mg capsule of betaine HCl . If you notice improved digestion then continue with this dose. If you notice no improvement and you feel no warmth or irritation in the stomach then increase the dose to two capsules before each meal on the following day. Again, look for improvements in your symptoms. If nothing is noticed and you feel no stomach warmth or irritation then proceed to increase the dose to 3 capsules before each main meal and then to four if needed. If you notice a warmth or irritation in the stomach then cut the dose back by one capsule and continue with this dose.

When you are trying this method, keep some Tums or other antacid on hand to neutralize some of the acid in case you overshoot your mark.

Once you find the dose that works well for you then you can continue to take the betaine HCl as long as needed. Some practitioners recommend stopping the acid after a couple of months to see if the stomach is able to begin producing more acid on its own. They believe that the capsules reset the pH thermostat in the stomach and once the betaine is stopped then the body kicks up acid production in a positive way.

Today’s story is going to focus on the last statement. Did you know that it is estimated that there are more bacteria in the digestive system then there are cells in your body? Most people just don’t realize how important the bacteria in our gut are. They help digest food, they produce essential vitamins and they act as a defense against harmful organisms that are trying to creep their way into our blood.

There is more to the story though, not all bacteria that reside in the gut are good. In fact, the biological soup that exists within our digestive system is a constant proverbial battle between good and evil. The good bacteria are constantly producing certain compounds that prevent the bad guys from being able to take residence and wreak havoc. The good bacteria are like superheroes in comic books, when they are strong and allowed to grow they are nearly unbeatable. There is a problem, however, many things that we do and are exposed to in everyday life can act as kryptonite to the superhero bacteria that reside in our gut. Some examples include:

1. Stress
2. Chlorine in water
3. High sugar intake
4. Antibiotic use

Now let’s move north and discuss the mouth. As I mentioned earlier, the mouth is teaming with bacteria just like the gut (although there are fewer strains and quantities). Just like the gut, the mouth should be full of superhero bacteria that make the oral environment unwelcoming to harmful bacteria. Unfortunately, these superhero bacteria are even more susceptible to weakening and it is very easy for harmful organisms to grow and cause plaque, cavities and ultimately gum disease. Recent research suggests that these super-villain bacteria can actually cause chronic inflammation in the body that could lead to heart disease, rheumatoid arthritis, autoimmune conditions and joint degeneration. You can see that proper oral hygiene can play a very important role in protecting the whole body from disease.

When the good bacteria in the gut weaken, we simply recommend supplementing with a probiotic supplement that helps to recolonize the gut with more superhero bacteria. One such formula is called iFlora by Sedona Labs. These probiotics can work wonders for people with all sorts of digestive problems. That is all fine and dandy but unfortunately there was no supplement to replace the good bacteria of the mouth, until now…

Over a year ago I learned of an oral probiotic that was under development that contained bacteria that are known to colonize and protect the tissues of the mouth. This supplement, when given by lozenge, would recolonize the mouth with healthy bacteria that beat up and kick out the super-villain organisms that cause so many problems in the mouth and body. I have been waiting anxiously for this formula to come to market and finally it arrived.

Research to date shows that these probiotic supplements can:

1. Decrease the number of harmful bacteria in the mouth
2. Decrease the number of cavities
3. Reverse the symptoms of gingivitis
4. Reduce the amount of plaque
5. Decrease the number and severity of mouth ulcers (canker sores)
6. Improve bad breath
6. Possibly decrease the risk of upper respiratory infection

Of course, this formula, called Advanced Oral Hygiene does not replace brushing and flossing. Instead this formula acts as one more potent defense against bacteria that lead to disease in the body. Simply dissolve one mint lozenge in the mouth at least twice a day after your brushing and flossing. If you have significant problems then you may want to dose more often throughout the day.