Gastro-Esophageal Reflux Disease (GERD)

Paul A. Goldberg MPH, DC, DACBN, DCBCN
Founder and Consultant to The Goldberg Tener Clinic
Chronic Disease Reversal

Gastro-Esophageal Reflux Disease (GERD) is a long name for a common condition affecting over twenty million people in the United States. The manner an individual is affected by GERD differs from person to person but in general there is a burning sensation, related to irritation by stomach acid commonly referred to as “heartburn”, though the condition is not directly related to the heart.

Stomach acid is often blamed and treated medically as if it were a villain to be attacked and banished. This is very far from the truth. Stomach acid is indeed a highly valued and needed component for good health and in many ways should be considered liquid gold!

Stomach acid is comprised of Hydrochloric acid (HCL) which is produced and secreted by specialized cells in the stomach called parietal cells. HCL has critical functions including:

1. HCL begins the digestion of proteins on their ultimate pathway to become amino acids. Amino acids perform a myriad of essential functions including becoming structural components of connective tissues e.g. skin, muscles, ligament and tendons, constructing hormones and red blood cells, making cells for organs, creating neurotransmitters and other vital tasks. Without the production of HCL from parietal cells, proteins cannot be efficiently broken down into their constituent polypeptides and amino acids. This results in impaired metabolic function. Adding to the problem, if dietary proteins are not broken down, they will be acted upon by bacteria residing in the gut, leading to putrefaction and its byproducts e.g. ammonia, indican, cadaverine and putrescine. The byproducts of bacterial putrefaction are highly toxic, contributing to the development of impaired digestion, allergies, foul smelling methane gas, irritation of the intestinal lining and increased chances of developing a wide range of health issues including autoimmune disorders.
2. HCL is used to administer an acid bath to food entering the stomach thereby eliminating invading bacteria, viruses and parasites and preventing them from entering the small intestine to create illness. Insufficient stomach acid due to poor health and/or the use of acid reducing medications is a common cause of SIBO (Bacterial Overgrowth of the Small Intestine). 
3. HCL makes minerals in our food such as calcium and magnesium more soluble so they can be more effectively utilized by the body.
4. HCL, upon entering the duodenum (small intestine), triggers the release of sodium bicarbonate neutralizing the acid and activating pancreatic enzymes including amylase for the digestion of carbohydrates. Without HCL (acid), bicarbonate would not be released leading to turmoil in the digestive tract and a severe lack of digestive enzymes for the breakdown of food.

The Hazards of Acid Reducing Drugs

The acid reflux associated with GERD causes irritation of both the stomach and/or the lower esophagus and in severe cases can lead to gastric bleeding, ulcers and strictures. It is for these reasons that physicians commonly administer antacids, PPI’s (proton pump inhibitors) and H2 Blockers. Antacids neutralize the acid and H2 blockers (e.g.) pepcid, zantac, ranitidine) and PPI’s (e.g. prilosec / omeprazole, nexium, prevacid, protonix) inhibit acid secretion. In both cases, the availability of acid is reduced. This can lead to a wide range of health issues as detailed above resulting from the incomplete breakdown of proteins, minerals not being made soluble and bacteria / parasites not being inhibited/destroyed due to the absence of HCL. The multitude of resulting health issues that can then evolve is enormous e.g. SIBO, allergies, autoimmune disorders, rheumatological / joint issues, eczema, psoriasis and other chronic skin issues, headaches, chronic fatigue etc. and, according to some studies, bone fractures, myocardial infarction and dementia.

In the video shown below, Scott, a recent patient that came to see us with chronic acid reflux (GERD), discusses the complications (neurological symptoms) he experienced after his medical physician prescribed Omeprezole (Prilosec) to treat his symptoms. Today, Scott no longer experiences reflux and is no longer taking Omeprazole.

While pharmaceuticals, whether over the counter or prescription, are the most common ways GERD is addressed, surgical options are employed in some cases as well.

In none of these scenarios is the cause of the problem addressed and therefore resolution of the problem is unlikely to occur with complications often resulting from these medical interventions.

What Causes GERD?

The first task to address regarding each patient with GERD is why is it occurring? This is a far more effective and rational approach than to immediately “treat” GERD with drugs, usually on an ongoing basis, leaving the patient open to a lifetime of disabling treatments and side effects. Identification and addressing the cause(s) and improving the patient’s overall health is always the best route to take initially and in most cases the problem, with the right detective work completed and health building measures taken, can be resolved.

Common contributing causal factors in GERD include:

• Overeating
• Emotional stress (worry and anxiety)
• Abnormal gastrointestinal bacteria
• Environmental exposures/toxicities
• Poor dietary
• Food and inhalant allergies
• Pharmaceutical agents
• The use of coffee
• The use of tobacco
• Alcohol usage
• Obesity
• Lack of stomach acid
• Sleep deprivation

It should also be pointed out that excess stomach acid is rarely the cause of GERD. When stomach acid comes into contact with tissues not protected by goblet cells that secrete mucus and protect the lining of the tissues from acid, damage can occur. The stomach, however, has a large number of goblet cells and as long as acid remains in the stomach and the first portion of the duodenum (where it is neutralized by bicarbonate) problems are unlikely to manifest. When the acid is displaced, however, usually due to one or more of the causal items listed above, then damage to tissues, particularly in the esophagus, can and do occur.

We also find in many patients that it is not an excess of stomach acid causing the patient’s problems, but a lack of stomach acid, which in turn causes indigestion and the misplacement of what HCL is present to come into contact with the esophageal tissues. Low stomach acid becomes more prevalent as we get older. We often find patients who have been on antacids, PPI’s or H2 blockers for years, suffering from a multitude of issues not only from the GERD but from the effects of prescribed drugs which inhibit the amount of HCL the patient is able to produce. Identifying the causal issues and restoring good health to the GI tract allows normalcy to return and with causes gone so are the symptoms.

Below is an interview with a recent patient from our clinic that suffered from chronic reflux, irritable bowel, high blood sugar and high cholesterol. His case illustrates the good outcomes that are possible when taking a causal based approach to the problem. The patient is no longer taking acid reducing drugs.

Identifying causal factors in GERD and applying the appropriate health building measures takes work on the part of both the doctor and the patient. By doing so, however, what can turn into an ongoing nightmare of drugs and side effects can frequently be avoided.

Stomach acid is an important component of good health. Interfering with the normal physiology of the GI tract with drugs to treat problems that are better addressed by causal identification and health building measures, often turns into a lifelong nightmare for patients that does not have to occur.

Causes Identified…Causes Addressed…Health Restored

Related Articles by the Goldberg Tener Clinic

1. Understanding and Resolving Digestive Issues
2. Crohn’s Disease and Ulcerative Colitis: Health Restoration as Opposed to Disease Treatment
3. Irritable Bowel Syndrome: A Meaningless Diagnosis
4. Bacterial Overgrowth of the Small Intestine (SIBO)
5. Eosinophilic Esophagitis, Gastritis and Colitis
6. Problems with Ant-Acids
7. Serious Considerations Regarding Colonoscopy
8. The Perils of Laxatives, Enemas and Colonics

Chronic Disease Reversal Case Studies

1. Autoimmune / Allergic Disorders
2. Digestive Disorders
3. Rheumatoid Disorders
4. Hormonal and Weight Disorders
5. Diabetes
6. Chronic Skin Conditions
7. Cardiovascular Disease
8. Chronic Headaches
9. Thyroid Disorders
10. Fibromyalgia
11. Chronic Fatigue
12. Goldberg Tener Clinic Kids