Gastroesophageal Reflux Disease (GERD)
Between 20 and 44% of people worldwide who live in developed, Western countries have GERD. Many medical professionals think that consuming contemporary, highly processed food is directly responsible for the dangerously high prevalence of GERD. Up to 40% of Americans go through GERD-related symptoms at least once every month. About 10–20 percent of people have symptoms practically every day. And to make matters worse, up to 15% of GERD sufferers may end up with Barrett's esophagus syndrome. Barrett's esophagus syndrome is brought on by severe esophageal tissue damage and scarring. Studies reveal that the frequency of GERD is significantly higher in Western nations than in Asian nations, which is not surprising. Therefore, the prevalence is less than 5%.
According to a current study, the reason why so many people acquire GERD is probably not merely that they ignored their acid reflux symptoms. Acid reflux has been regarded as the initial stage of GERD for almost 80 years. Today, researchers are focusing on another contributing factor: chronically elevated inflammation, which they believe to be the true cause of GERD. Inflammation does more than just cause esophageal tissue damage. Numerous other types of intestinal problems are also connected to it.
Even though this discovery is significant and is altering the way we view GERD, perhaps we shouldn't be too shocked. After all, the majority of diseases have their roots in inflammation.
GERD: What Is It?
The most frequent esophageal health issues include heartburn, GERD, and belching (also known as eructation), which are all linked to situations of gastric reflux. Gastroesophageal reflux disease is referred to as GERD. It affects the esophagus and is frequently referred to as heartburn. Up to 1 in 5 adults in America have GERD. In severe situations, it may result in esophageal ulcers that bleed. Additionally, it may result in the severe condition known as Barrett's esophagus. The development of esophageal cancer has occasionally been linked to Barrett's esophagus.
"Symptoms of mucosal injury generated by the aberrant reflux of stomach contents into the esophagus or beyond, into the oral cavity (including larynx) or lungs," is how experts define gastroesophageal reflux disease (GERD). The two types of GERD are erosive reflux disease (ERD) and non-erosive reflux disease (NERD) (ERD). These groups are based on the presence or absence of esophageal mucosal injury.
Typically, symptoms of GERD or acid reflux are not brought on by excessive stomach acid. Instead, the acid is in the incorrect location. Less acid may be produced than in healthy individuals. The esophageal sphincter, a portion of the esophagus, controls stomach acid in healthy humans. Stomach acid can enter the esophagus when this "valve" malfunctions (often because it "relaxes" too much or loses its strength). Chest pains, burning feelings, and difficulty swallowing are the most typical GERD or acid reflux symptoms that occur from this.
The following are the most typical signs of GERD:
1. chest pain
2. Burning or uncomfortable pain in the chest or throat
3. Wheezing, asthmatic symptoms, a persistent cough, and breathing problems (particularly when exercising, sleeping, or when you're ill)
4. swallowing issues
5. a sour aftertaste
6. Belching is a sometimes painful condition brought on by gas that has become stifled in the upper digestive tract.
7. excessive slobbering
8. tooth decay
GERD symptoms are categorized by gastroenterologists as either typical or atypical. After eating, most symptoms are at their peak. Particularly problematic meals are those that are larger, fattier, and made up of processed or acidic foods. Acid regurgitation and heartburn are typical symptoms. Epigastric pain, dyspepsia, nausea, bloating, and belching are examples of unusual symptoms. The throat and esophagus may also experience pain or malfunction as a result of numerous GERD secondary symptoms. Asthma and coughing are two examples. Because the cough reflex and esophagus are both controlled by the same nerves, these secondary symptoms appear to be more common in people who have an esophageal injury. Over time, these interconnected nerves may swell and suffer injury. Exposure to esophageal acid and mucosal injury might set off reflexes that make someone gasp for air, have difficulty breathing, or have other respiratory problems.
In some circumstances, untreated GERD might also result in major health issues. Barrett's esophagus, an elevated risk of esophageal cancer, deteriorating asthma, esophageal ulcers, and severe tissue scarring are complications. Persistent GERD symptoms can have a negative impact on a person's quality of life, as well as their physical and emotional health, according to experts. Many people with GERD report having poorer mental health. Their ability to respond to drugs appears to be affected by their decreased mental health.
Acid Reflux vs. GERD:
Acid reflux is brought on by stomach acid leaking up into the esophagus. Chest aches, heartburn, a terrible taste in the mouth, stomach bloating, gassiness, and difficulty swallowing are typical acid reflux symptoms.
Numerous risk factors are shared by both GERD and acid reflux, including pregnancy, a history of Hiatal hernias, obesity, consuming a poor diet, advanced age, and an imbalance of stomach acid.
You have an increased risk of getting GERD if you experience heartburn and acid reflux frequently or severely.
Natural treatments for acid reflux can lessen GERD symptoms as well. These include altering your eating habits, staying away from certain foods that are problematic, getting a healthier weight, taking beneficial supplements, and eating smaller, more nutritious meals.
Does GERD inevitably result from acid reflux, and if not, what does?
Burning in the chest and other symptoms of acid reflux that led to GERD have long been attributed by scientists and medical professionals to stomach acid rising from the stomach and entering the esophagus. GERD has been identified using 24-hour pH monitoring testing of the esophagus. Along with measuring symptoms, these tests calculate the overall amount of time that acid has been in contact with the esophagus. According to the theory, acid reflux erodes the esophageal tissue for a very long time before GERD, the more serious ailment, appears.
However, studies in animals have questioned the conventional wisdom that reflux esophagitis arises when esophageal surface epithelial cells are subjected to deadly chemical harm from refluxed acid, according to a 2016 study published in the Journal of the American Medical Association. Even though acid reflux, or the regurgitation of acid into the esophagus, probably contributes to the symptoms of GERD, recent research indicates that the actual underlying causes of GERD are linked to aberrant inflammatory reactions. By secreting proteins like cytokines, which harm esophageal tissue cells, the digestive tract, which includes the esophagus, becomes inflamed.
There is evidence that some GERD patients have high levels of acid production or even little acid reflux. In rare instances, it might be the other way around; patients with low acid levels can nevertheless have GERD. In one study, over 900 patients were examined to determine the origin of their GERD symptoms. Only 12% of symptoms in patients with extremely low total acid levels were related to acid reflux, according to research. Compared to GERD patients with greater acid levels, the majority of those with low acid levels were female and younger.
GERD Risk Factors & Causes:
Researchers who participated in the aforementioned JAMA study discovered that many acid reflux patients who stop taking their prescribed proton pump inhibitors, or PPIs, experience alterations in their esophagus. These alterations are brought on by increased inflammation rather than just scars or burns as one might anticipate from stomach acid. All patients reported signs of esophagitis two weeks after ceasing their PPI prescription, and many patients experienced an increase in esophageal acid exposure and a decrease in mucosal resistance (caused by inflammation). Basal cell and papillary hyperplasia, T-lymphocyte inflammation, and stopping PPI use were all linked. This shows that there was more going on than just esophageal erosion brought on by stomach acid.
What kinds of factors initially create inflammation?
The following are risk factors for developing severe inflammation that might harm the esophagus:
unhealthily diet
Leaky gut syndrome, or poor gut health
food sensitivities or allergies
chronic Stress, either physical or emotional
a sedentary way of life
taking drugs, drinking too much, or smoking
taking drugs that inhibit the immune system
exposure to chemicals, environmental toxicity, and drug toxicity
Other potential causes and aggravating elements of GERD symptoms include:
Abdominal hernias: This occurs as a result of heartburn caused by a piece of the stomach pushing through the diaphragm and into the thoracic cavity. Approximately 20% of adults are thought to have Hiatal hernias, though not everyone experiences symptoms.
Persistent stress: Stress is thought to be a major factor in GERD. Additionally, it's connected to generally increased inflammation levels.
Pregnancy: Pregnant women are more likely to experience GERD and acid reflux because their growing bellies might press against their stomachs, causing discomfort.
Taking particular medicines: NSAID pain relievers, aspirin, steroids, birth control pills or other hormone replacement therapy, nicotine, and various antibiotic treatment regimens are some of them.
Being overweight and being obese
In my own experience, the first time I had acid reflux and heartburn was when I was told I had an h pylori infection. I had heartburn because I was reacting to almost all food and because my stomach acid was low, which made it difficult for me to properly digest my food. As a result, the food would reflux into my esophagus, causing a burning sensation that was so strong I almost had to sleep standing up.
Therefore, if you have the symptoms before, the first thing to do is to get tested for H pylori infection or to perform a GI map stool, and then you should work with a naturopath to restore your gut.
RESOURCES:
https://www.nature.com/nrneurol/
2022. NP. Malika Katrouche. All Rights Reserved.
