Calihan: Cooling Heartburn with Therapeutic Solutions

I have been writing about the GI system and it’s importance to our health the past several weeks. Now I want to talk about one of the most common gastrointestinal ailments that we see,  GERD (gastroesophageal reflux disease).

Commonly known as “heartburn”, this complaint brings millions of people to their physicians each year, and there is a multimillion dollar pharmaceutical industry that has developed around the treatment of this condition. We have all seen the many dozens of TV ads touting the efficacy of the “purple pill” as the guy in the ad continues to eat his chili dogs!

Certainly, there are serious and significant conditions of the stomach and esophagus that need to be evaluated and if present, appropriately treated when people have persistent heartburn symptoms.

But many, perhaps most, of the people with these complaints, could, and probably should, be treated with lifestyle changes and the use of products that do not have the potential downstream negative consequences of so many of the currently available drugs that are used.

One of the most common reasons for people to experience heartburn is a mechanical one; there is too much pressure on the stomach and this contributes to the reflux of the stomach contents upwards; back into the esophagus from where it just came, causing the sensation of burning in the mid chest and sometimes even up into the mouth. Obesity is the most frequent contributor to this phenomenon, particularly abdominal obesity, by causing pressure on the stomach.

Overeating can also contribute to this, which causes its own sort of pressure on the stomach and causing the stomach contents to reflux backwards.

Another very significant factor contributing to heartburn, and to many GI symptoms, is stress. Excessive stress is pervasive in our culture, and learning to deal effectively with our stress should be a foundational part of any treatment of GERD

So a lifestyle change that teaches us better stress management skills, lessens the amount we eat and helps with weight loss is a great place to start when looking at treating this condition. And yes, until those changes can result in a lessening of symptoms, a person may need to have symptomatic relief, and there are a number of products and nutrients that can help treat the symptoms, from antacids to specific amino acids to targeted nutrients.

One of the important things to bear in mind when considering the treatment of GERD with the prescription or OTC “acid blocker” medications such as those advertised s frequently, is the long-term consequences of those medications.

The H2 blockers (like Nexium and others) work by lowering the amount of acid that is formed and released into the stomach, making the acidity of the material that refluxes back lower, and thereby alleviating the symptoms such as burning. But, I would argue, there is a need for the stomach to be an acidic environment; this is how digestions begins. When the acid is routinely suppressed, there are consequences that should not be overlooked. Some important nutrients, such as B12 and calcium, can not be properly absorbed when there is a lack of acid; and this is just one example. And when the digestive process is altered like this, what other steps are also compromised?

Other therapeutic solutions have arguably less potentially severe consequences. And although they might require more effort because lifestyle changes, diet change and changing habits is never easy, there is likely to be less collateral damage.

As is true for many things, we need to think through the consequences of the actions we take. There are times where the more aggressive prescription solution to this problem is appropriate. But many times a less severe intervention would be preferable, and less potentially damaging in the long run.


Dr. Martha Calihan

Dr. Martha Calihan has practiced Family Medicine for more than 20 years, during which time her interests and her practice have gradually evolved into a holistic, integrative approach to medicine. She is licensed to practice acupuncture and is also trained in both Mind-Body Medicine and Functional Medicine. She is the founder of the Five Stones Healing Arts & Wellness Center in Leesburg.

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