GERDs – A Negative Side Effect of the Holidays?

With the holiday season upon us there are many opportunities to ingest foods we may not typically eat or perhaps not so many of them all at once. This can cause some common symptoms of ‘GERDs”, GastroEsophageal Reflux Disease, otherwise known as heartburn or indigestion. It is not a disease per se but a phenomenon known also as acid reflux, whereby food and acid splash up into the esophagus, causing heartburn, chest pains, and belching. A person with severe symptoms may regurgitate stomach acid into the throat and the mouth. Sometimes the acid reflux leads to angina-like chest pains and spasms; the symptoms may be so intense that they are mistaken for a heart attack. Over long periods of time, the constant irritation of the esophagus can lead to inflammation, scarring, ulceration, hemorrhaging, and even esophageal cancer. I have had patients  complain of asthma like symptoms and/or lung scarring resulting from chronic reflux.

This condition is typically treated with either over the counter antacids or proton pump inhibitor medications,  “PPIs”.  A new commentary published in the November, 2009 issue of Otolaryngology – Head and Neck Survery. Research is revealing that acid is not the only contributor to reflux diseases and that PPIs are not always an effective treatment.

PPIs come with a slew of negative side effects that include inhibited calcium absorption that can lead to hip fractures, alteration of the gastric pH levels that can negatively affect vitamin B12 and iron assimilation, and increased propensity to develop certain types of diarrhea and pneumonia. For these reasons, researchers are urging doctors to carefully monitor patients prescribed these drugs. In the past 20 years, there has been a four-fold increase in the number of people in Western countries seeking medical help for their reflux symptoms. As a result, there has been a corresponding increase in the volume of PPIs being administered despite the fact that they may often be causing more harm than good. The study authors are encouraging doctors to weigh the pros and cons and carefully consider whether PPIs are necessary before prescribing them so freely. They implore doctors to consider venturing towards a more holistic approach in which dietary modifications and lifestyle changes are prescribed rather than drugs.

When people come to see me and say, “I have acid reflux. What can be done?” I then ask, “How many and what drugs are you on?” and “What are you eating?”….Many drugs can contribute to the symptoms of reflux and frequently foods themselves though perfectly healthy in most people can cause the problem as well.  I work with people to identify the specific foods that may be effecting them as either food allergies or intolerances. Occasionally patients have a deficiency of digestive enzymes for certain foods and also have imbalanced gut flora that can create digestive pressure on the gastrointestinal tract all the way up the tube!

If you want to eliminate acid reflux, start eating more food that has living enzymes. Eat organic, fresh, raw fruits and vegetables. Go back to the basics. Eat a raw organic apple a day. Eat a fresh salad with lunch and dinner consisting of raw organic vegetables. This will add living enzymes. This is a good start and why so many folks feel so much better eating a raw foods diet, not that that is good in the long run for everyone.

Now let me give you some additional suggestions to help with acid reflux:

1. Raw apple cider vinegar. Take one tablespoon right before you eat each meal. This should eliminate any acid reflux if it from reduced gastric secretions.

2. Avoid carbonated beverages of all kinds

3. Eliminate foods that weaken the esophageal sphincter (at the bottom of the esophagus before entering the stomach)…alcohol, mint, chocolate

4. Do not overeat or lie down within 3 hours of eating a meal.

5. Identify food allergens and intolerances and eliminate them from your diet

I employ a number of herbs and nutrients to help heal the irritation this condition causes as well as get to the root cause of this annoying problem. An individualized approach is always most effective at getting things back on track digestively. Happy Holidays !

Celiac Disease

So What is Celiac Disease?

Celiac disease is an immune-mediated permanent intolerance to gluten found in wheat, rye and barley. Traditionally considered uncommon, the disease was simply thought of as a gastrointestinal disorder recognized, if at all, in early childhood with the introduction of cereals into the diet. With our growing awareness of the various manifestations of this disease we now understand it to be a relatively common disease affecting approximately 1% of the general U.S. population. Celiac disease is a multi-system disorder and presentation may occur at any age in both sexes under a wide variety of clinical circumstances:

Classic Celiac Disease

Gastrointestinal (GI) Symptoms – Pain;D iarrhea/Constipation; Steatorrhea(fatty, frothy, or foul smelling stools); flatulence; Vomiting; Distention and Weight Loss. Manifestations of malabsorption may include; anemia from iron, folate and B12 deficiencies; coagulopathy from vitamin K deficiency and hypocalcemia from vitamin D deficiency.

Celiac Disease with Atypical Symptoms

Some manifestations may predominate with little or no GI symptoms. A key example is dermatitis herpetiformis characterized by itchy, blistering lesions on the extensor surfaces of the extremities and trunk. Other examples include; iron deficiency anemia that is unresponsive to treatment with oral iron; persistent aphthous ulcers, arthritis, delayed puberty and infertility to name a few. Children may present with behavioral problems including depression, irritability and impaired scholastic performance.

Silent Celiac Disease

Individuals are asymptomatic but have positive blood test and intestinal villous atrophy on biopsy. Diagnosis in these cases most often comes from a routine screening of high risk individuals or biopsy performed for another reason say during a colonoscopy. High risk individuals include for example:

First – and second-degree relatives of individuals with celiac disease.

People with Type 1 diabetes mellitus or other autoimmune disorder.

Down syndrome and other genetic disorder.

Individuals with selective IgA deficiency.

Latent Celiac Disease

Asymptomatic individuals with positive blood tests but no villous atrophy on biopsy. Over time these patients develop symptoms and/ or histological changes. Many of these people may have a long history of imbalanced gut flora, dysbiosis as it is called, and this could be a result or even a potential cause of the problem to begin with some speculate.

There are various blood tests that can be used to screen for this condition which involve investigating for Celiac Antibody Profiles through Serum or whole Blood. If these are inconclusive, “simply” eliminating gluten containing grains in all forms from the diet can be very convincing if it is problematic.