What is GERD
GERD is the short form of Gastroesophageal Reflux Disease. It is also known as Acid Reflux. GERD or Acid Reflux is a chronic digestive disorder that involves the esophagus and stomach. Gastro means the stomach while the esophagus refers to the tube that carries food from your mouth to the stomach. The term reflux means to flow back. Let’s check out how to cure GERD in this article.
Are you dealing with frequent heartburn after a meal? Or are you experiencing a bitter, sour, or foul taste in your mouth?
If this happens occasionally then no need to worry. Occasional heartburn is common in most people due to overeating or sometimes eating a particular type of food. But if you are having it chronically then you may be suffering from GERD or Acid Reflux.
When we eat, food passes from the esophagus into the stomach. The stomach coats the food with the gastric juices to help break the food down further. But sometimes in a disease condition, the gastric juices or food flows back abnormally from the stomach into the esophagus. This condition of troublesome symptoms and complications that result from the reflux of stomach contents into the esophagus is called GERD.
According to the medical definition, GERD is a condition that develops when acidic gastric juice and the food from the stomach abnormally flows back into the esophagus causing a burning sensation in the chest along with other complications.
This article covers information about the causes, symptoms, treatments, and some ayurvedic as well as home remedies of GERD.
What causes GERD
Gastroesophageal reflux disease is mainly caused due to disorder of the lower esophageal sphincter (LES). LES is a circular band of muscle at the junction of the esophagus and the stomach. This sphincter normally remains closed to keep stomach content from flowing back into the esophagus.
When food reaches the end of the esophagus, LES opens and allows food to pass into the stomach. After that, it closes again to prevent stomach content from flowing back into the esophagus.
But, if the function of the LES weakens and it relaxes and tightens abnormally, it allows the stomach content to flow backward into the esophagus. This backwash irritates and inflamed your esophageal mucosal lining that causes acid reflux.
However, several other factors may contribute to its development. Some other factors that can cause GERD include Hiatal hernias, impaired esophageal clearance, and delayed gastric emptying.
Types of GERD
GERD is classified into two groups. The basis of this classification is that the presence or absence of esophageal mucosal damage seen on endoscopy. These are:
- Non-erosive reflux disease (NERD): No esophageal mucosal damage
- Erosive reflux disease (ERD) or Erosive esophagitis (EE): having esophageal mucosal damage
Symptoms of GERD
The most common symptom is regular heartburn, a painful and burning sensation in the middle of your chest, behind your breastbone, and in the middle of your abdomen.
Other typical symptoms include
- Water brash
- Abdominal pain or discomfort
- Indigestion (Dyspepsia)
Some symptoms arise from the respiratory tract which includes
- Chronic cough
- Sore throat
Treatment for GERD
GERD is a chronic disease that usually requires long term management. Current modern management recommends
- Lifestyle modification
- Surgical therapy (in some severe cases)
If you have mild and occasional symptoms, your doctor will probably suggest diet and lifestyle modification alone. When these practices do not give relief, then only the doctor will recommend other treatments including medications and lastly surgery.
The ancient Indian System of Medicine, Ayurveda also has several treatments for GERD. The signs and symptoms of GERD resemble the disease Amlapitta as mentioned in Ayurveda. The word Amlapitta is comprised of two words- Amla means sour and Pitta means gastric juice. In amlapitta, secretion of sour gastric juice is increased due to disease conditions.
According to ayurvedic literature, amlapitta is a chronic disorder caused by an unhealthy living style, irregular & faulty food habits, and busy stressful life. ‘Hurry’, ‘Worry’ and ‘Curry’ are the three main reasons for the complications. The line of treatment include:
- Home remedies
- Yoga and meditation
- Medical management
Modern treatment for GERD
Lifestyle and dietary changes remain first-line in the management of GERD. These include:
- Maintain a healthy body weight
- Eat smaller and frequent meals
- Avoid spicy and oily foods
- Avoid high-fat foods
- Avoid alcohol, caffeine, carbonated beverages
- Avoid citrus fruits, tomato and tomato-based products, peppermint, and onion
- Avoid junk/fast foods, bakery items, chocolates, refined flour items
- Quit smoking
- Avoid eating before exercise
- Avoid drinking fluids during meals
- Avoid lying down and going to bed soon after meals (within 2–3 hours)
- Raise the head end of the bed (for night time symptoms)
- sleep on the left side of your body after a meal
- Avoid stress and anxiety
If the troublesome symptom continues regardless of lifestyle modifications, it can be dealt with effectively in a combination of medical therapy and lifestyle modifications. The medical therapy includes the treatment with
- Antacids and Alginate
- Histamine 2 receptor antagonists (H2RAs)
- Proton Pump Inhibitors (PPI)
Treatment of GERD with Antacids and Alginate
An antacid neutralizes the acid in the stomach. These are self-prescribed medicine and do not require a prescription.
The active ingredients of antacids are sodium bicarbonate (baking soda), calcium carbonate, magnesium carbonate, magnesium hydroxide, and aluminium hydroxide. These are called the generic names of the antacids. Most commercially available antacids contain two or more of the above these generic compounds.
Some commercially available antacid are:
- Acid Gone (aluminium hydroxide/magnesium carbonate)
- Gelusil, Di-Gel, Alamag, Almacone, Mylanta, Mintox (aluminium hydroxide/ magnesium hydroxide)
- Ducolax Milk of Magnesia (magnesium hydroxide)
- Caltrate, Titralac and Tums (calcium carbonate)
- Neut (pro) (sodium bicarbonate)
- Amphojel (aluminium hydroxide)
Apart from antacids, alginates are also used to prevent gastric reflux. Alginates are derived from Seawood. These compounds form a gel that floats on the stomach content and acts as a barrier to stop the acid reflux. The main active ingredient of alginate is sodium alginate. Some alginates are:
- Maalox RefluRAPID
Treatment of GERD with Histamine2 receptor antagonists (H2RAs)
H2RAs can reduce gastric acid secretion after a meal and are better than antacids. They won’t give you quick relief as antacids, but they can work for up to 12 hours and to some extent can heal esophageal mucosal damage. Some H2RAs include
Some H2RAs are:
Treatment of GERD with Proton Pump Inhibitors (PPI)
Proton Pump Inhibitors are considered to be the foremost helpful medical therapy for GERD, due to their intense and consistent acid suppression. This can also heal your esophageal mucosal damage. Currently available PPI’s include:
Surgical therapy is the treatment option if the complications worsen and persist for longer despite lifestyle modifications and medications.
However, surgery is not usually recommended due to its higher risk of complications. If other option fails then only your doctor will go for surgery. Laparoscopic anti-reflux surgery is considered to be cost-effective compared to long term PPI therapy.
Ayurvedic treatment for GERD
As the saying goes “Prevention is better than cure” Ayurveda insists to avoid all the causative factors of GERD. You may reduce and control the frequency of the symptoms by modifying your lifestyle and food habits. Some don’ts and do’s for prevention include:
- Avoid too oily, spicy, salty, and sour taste food
- Avoid overeating, untimely eating, and eating in a hurry
- Avoid processed and canned foods
- Avoid smoking, drinking alcohol and caffeine
- Avoid overcooked, fried and junk food
- Avoid fasting, take smaller frequent meals
- Don’t drink excess water during the meal
- Don’t lie down immediately after the meal
- Avoid chocolate, mint, garlic, and onion
- Avoid painkiller drugs
- Avoid anger, jealousy, and hatred
- Avoid mental stress and anxiety
- Follow regular meal times
- Avoid problematic foods that worsen your symptoms
- Drink warm water. Coldwater increases the acid secretion in your stomach.
- Take light food and plenty of water and fluids
- Eat food containing minerals and vitamins
- Do regular exercise
- Practice yoga, pranayama, and meditation regularly
- Take adequate sleep and rest
- Keep the head end of your bed elevated
- Drink peppermint tea with meals to avoid overeating
Ayurvedic Home Remedies for GERD
Prolonged use of modern drugs may cause side effects, sometimes making the treatment riskier than the disease itself. So you can try some simple home remedies to get relief from the symptoms. Some quite easy and effective home remedies are:
- A glass of warm water mixed with lemon juice and honey regularly in the morning is helpful to reduce the symptoms of heartburn.
- 100-500 ml of tender coconut water twice daily is an excellent remedy. Coconut water provides instant relief from heartburn. It has a cooling effect and soothes your stomach providing essential vitamins and minerals.
- Try 2 tablespoon aloe vera gel with a pinch of baking soda. It has an immediate soothing effect.
- You can try 1tea spoon Amla powder (Indian gooseberry) with 1tea spoon honey. Amla counterbalances the gastric juices and heals the esophageal damages.
- Pomegranate juice (approx 10ml) twice a day is also beneficial. You can take the fruit too.
- Take a banana daily in your diet; it acts as a natural antacid. Banana is rich in potassium which helps to neutralize stomach acid.
- Try drinking 1 cup of papaya juice with 1 teaspoon sugar and 2 pinches cardamom. Or, take a slice or two of papaya daily after food. It is found to soothe the stomach and helps in better digestion (Pregnant women should avoid papaya. It may cause miscarriage)
- Take 1tsp apple cider vinegar before each meal.
- For instant relief of heartburn, you can try a mixture of lemon juice (10 drops), organic sugar (1/2tsp), and baking soda (1/2tsp) in 1 glass of water. Drink the mixture immediately after adding the baking soda.
- Take 5-6 Tulasi leaves (basil), crush them and boil in 250 ml of water on a medium flame for 10-15 minutes, filter and take the filtrate (tea)
Wholesome and Unwholesome foods
Ayurvedic literature also mentioned some wholesome and unwholesome foods for GERD. These include:
- Vegetables like white pumpkin, bitter gourd, matured ash gourd, parwal, carrot, cabbage, inflorescence of the plantain, cucumber, leafy vegetables except for methi, cucumber.
- Old rice, wheat, barley, green gram, sugarcane
- Fruits like gooseberry, dry grapes, black grapes, sweet lime, pomegranate, fig, dry fig, black raisin.
- Garlic, chili
- Arahar dal
- Urad dal,
- Sesame seed,
- Milk of goat
Yoga and Meditation
The most effective and natural cures for GERD is Yoga and Meditation. It helps to improve your digestion process. Ayurveda advised some yoga asana and pranayama to prevent as well as to cure GERD (amlapitta)
Yogasana: Bajrasana, Pavanamuktasana, Ushtrasana, Paschimotasana, Suryanamaskara, Shalabhasana, Shashankasana and Shavasana.
Pranayama: Anuloma-Vilom, kapalbhati, Bhramari, Sheetali, Sheetakari
These yoga asanas and pranayama improve your gastrointestinal tract and also removes the toxin from your body. These asanas also help to relax your mind, improves the physiology of the body, and well being of the individual.
Ayurvedic Medical Therapy
Ayurveda has many time-tested formulations and treatments to tackle GERD (amlapitta). Some important single (containing only one drug) drugs are:
- Amalaki (Indian gooseberry)
- Sunthi (dry ginger)
Some important compound formulations (containing a mixture of drugs) are:
- Kamdudha rasa,
- Sutasekhar rasa,
- Prawal pishti,
- Prawal panchamrita,
- Dhatri lauha,
- Shankha bhasma,
- Swarnamaksika bhasma,
- Avvipattikar churna,
- Amalaki rasayana,
- Shatavari ghrita
- Dadimadi ghrita.
When your symptoms cannot be well managed with oral medications ‘Panchakarma procedures’ are applied. These are some traditional techniques to cleanse and rejuvenate your body inside out by eliminating various toxins from the body. It helps to speed up metabolism and enhance the strength of the digestion process.
For GERD panchakarma therapy like Vamana (therapeutic vomiting)) or virechana (purgation or laxative therapy) whichever is needed is administered to clean the stomach. In chronic cases, Asthapanavasti (medicated enema) is applied.
However, medical management of both modern and ayurvedic always must be done with consultation by a qualified physician.
Herbal teas are very much beneficial for GERD instead of normal tea that contains caffeine. Here is an herbal tea recipe for you…..
- ¼ teaspoon cumin seeds
- ¼ teaspoon coriander seeds
- ¼ teaspoon fennel seeds
- ¼ teaspoon rose petals (optional)
- ¼ teaspoon fresh cilantro (optional)
- 2 cup of water
Coarsely grind all the seeds together. Bring water to boil and add the grounded seeds mixture. Simmer for a few minutes. Turn off the heat, cover, and let stand for 5minutes. Strain and sweeten with honey or sugar. Drink after a meal. This herbal tea stimulates digestion and calming for acidity
- Current Trends in the Management of Gastroesophageal Reflux Disease; Dalbir S. Sandhu & Ronnie Fass; Gut and Liver 12(1), 2018.
- GERD An Ayurvedic Management: A Review Article; Gadve B. N., Ramesh Pawar; National Ournal Of Research In Ayurved Science; Vol 07, Issue 5; Sept 2019.
- Gastroesophageal Reflux Disease (GERD); Danisa and Christine; Missouri Medicine, 115(3), 2018.
- Efficacy and Safety of a Natural Remedy for the Treatment of Gastroesophageal Reflux: A Double-Blinded Randomized-Controlled Study; Umberto Alecci et al; Evid Based Complement Alternat Med, 2016.
- Gastroesophageal Reflux Disease: Treating Wisely; J. Lane Wilson, Kellner L. Pruett, N C Med J.; 77(3), 2016.
- A Review on Ayurvedic Medicines for Amlapitta (Hyperacidity); Saroch Vikas And Singh Jajbir; Anveshana Ayurveda Medical Journal; Vol. 1: Issue 2: Mar-Apr 2015.
- Diagnosis and Treatment of Gastroesophageal Reflux Disease; Raul Badillo & Dawn Francis; World J Gastrointest Pharmacol, 5(3), 2014.
- Current Trends in the Management of Gastroesophageal Reflux Disease: A Review; Sylvester Chuks Nwokediuko; International Scholar Research network, 2012
- Gastroesophageal Reflux Disease (GERD): A Review of Conventional and Alternative Treatments; Alternative medicine review: a journal of clinical therapeutic, June 2011.
- The Complete Book of Ayurvedic Home Remedies, Vasant Lad; Piatkus.
- Ayurvedic home remedies, Central Council for Research in Ayurveda and Siddha, Ministry of Health and welfare, govt. of India.