LAX LES, HIATUS HERNIA AND GERD
- What is GERD?
- Causes of GERD
- GERD due to Lax LES
- GERD due to Hiatus Hernia
- Symptoms of GERD
- Diagnosis of GERD
- Complications of GERD
- Homeopathy Treatment of GERD
- How to prevent GERD?
GERD (Gastro-Esophageal Reflux Disease) is also known as Acid Reflux or Reflux Esophagitis (RE).
When you gulp down food it passes down your throat and through your esophagus - a tube (food pipe) that transports food from your throat to your stomach. A muscular valve termed as lower esophageal sphincter (LES) dominates the opening between the esophagus and the stomach and remains firmly closed except when you swallow food. When this sphincter becomes relaxed (Lax LES) due to any reason or is weak, it fails to close. Then the acid of the stomach travels back into the esophagus. This backward movement is called GERD or Acid Reflux causing inflammation of the lining of the oesophagus and leads to heartburn, pain and various other symptoms. Acid reflux can be an excruciating illness and if left untreated it can result in damage to the inner lining of esophagus and larynx (voice box).
Dietary causes and certain faulty habits are frequently responsible for initiating GERD in individuals who are prone to develop it.
The following are several contributing factors that weaken or relax the lower esophageal sphincter, making acid reflux worse:
- Diet – Oily, fatty and fried foods, garlic and onions, tea, coffee, drinks with caffeine, acid foods such as citrus fruits and tomatoes, pungent and spicy foods, mint flavourings
- Eating habits – Eating large meals, eating just before bedtime, irregular meals, change in foods due to frequent travelling etc.
- Lifestyle – Use of alcohol or cigarettes, chewing tobacco, obesity, stressful lifestyle – physical and mental stress, stressful working schedules, frequent travelling
- Anxiety – Anxieties, worries, depression, mental stress causes GERD
- Medications – Pain killers and certain drugs cause GERD. (Homeopathy medicines never cause GERD or Gastric Irritation)
- Laborious physical activity instantly after meals
- Medical condition like Hiatus Hernia
As described above, the muscular valve (Lower Esophageal Sphincter - LES) dominates the opening between the esophagus and the stomach and remains firmly closed except when swallowing food. When this sphincter becomes relaxed (Lax LES) due to any reason or is weak, it fails to close. Then the acid of the stomach travels back into the esophagus giving rise to GERD.
Hiatus hernia is a condition when the upper part of the stomach protrudes up above the diaphragm (Diaphragm is the strong muscle that separates the organs of the chest from those of the abdomen). Normally, the diaphragm acts as an additional barrier, helping the lower esophageal sphincter keep acid from backing up into the esophagus. A hiatus hernia makes it easier for the acid to back up. Hiatus hernia can be caused by persistent coughing, vomiting, straining, or sudden physical exertion. Obesity and pregnancy can make the condition worse. Hiatus hernia is very common in people older than 50 years. Hiatus hernia is treatable with homeopathy medicines. Surgery for Hiatus Hernia can be avoided with Homeopathy treatment.
- Heartburn (Burning feeling in the chest)
- Pain in epigastric region (middle of chest)
- Regurgitation (Regurgitation is when food and liquid containing stomach acid comes back up into the throat or mouth.)
- Sour or bitter vomiting
- Sore, raw throat or hoarse voice
- Frequent bitter or sour taste of acid, especially when lying down
- Feeling of burping acid into the mouth
- Difficulty in swallowing
- Feeling that food is stuck in the throat
- Feeling of choking that may wake someone up
- Bad breath
Symptoms of GERD are usually worse after lying down and temporarily relieved to some extend by sitting.
Diagnosis of GERD is frequently done based on the symptoms. Upper GI Endoscopy and Barium Meal are the commonest investigations done to diagnose GERD.
- Upper Gastrointestinal Endoscopy: Also commonly known as OGD scopy or Oesophago-Gastro-Duodenoscopy (endoscopy of the upper digestive tract). This involves viewing the inside of the food pipe, stomach and upper part of intestine using a fibre-optic tube to look out for any inflammation, erosions, ulcers and to rule out any complications of GERD.
- Barium Meal: These are specialised x-ray of the esophagus using barium as contrast. This is done to rule out complications of GERD such as ulcers, strictures, etc. This test is not used frequently nowadays and Endoscopy remains the primary diagnostic test.
Chronic long-standing GERD may cause certain complications that have been described below:
- Esophageal Erosions: Inflammation of the esophagus, ulcers or breaks in the lining of the esophagus can occur due to repeated contact with refluxed acid from the stomach.
- Esophageal strictures: Repeated damage to the esophageal lining caused by acid reflux forms a scar tissue (stricture). These strictures can trap food and cause difficulty in swallowing.
- Barrett's esophagus: In some patients, the normal esophageal lining, or epithelium, may be replaced with abnormal epithelium. This condition is called Barrett's esophagus and it has been linked to cancer of the esophagus.
- Inflammation of the vocal cords due to refluxed acid; this may lead to hoarseness of voice. Lung (pulmonary) aspiration, asthma and chronic pulmonary disease may also be caused by GERD.
Certain diet changes, life-style modification and homeopathy medicine course is the perfect combination for any case of GERD. Homoeopathy is highly effective in managing all the symptoms of Acid Reflux and furthermore plays a vital role in preventing relapse of the condition. Homoeopathic medicines are prescribed on the basis of physical, emotional, and genetic make up that individualizes a person. This constitutional approach framing mind and body works at the root-level. Homeopathic medicines will help strengthen the lower esophageal sphincter. Chief homeopathy remedies used in treatment of GERD / Gastric Reflux or Lax LES are Argentum Nitricum, Sulphur, Phosphorus, Pulsatilla, Calcarea Carb, Lycopodium Clavatum, Natrum Muriaticum, Nux Vomica etc. However, the remedy which is selected according to personalization of the case as a whole works best and gives long term benefits. A trained and experienced homeopathy doctor can easily spot the personalized remedy and design a treatment course by studying the case history of the patient.
Homeopathic treatment of GERD is natural, safe, gentle and without any side-effects. Another impressive thing about homeopathy is that people on multiple medications can safely take Homeopathic medicines. Homeopathic drugs are non-habit forming and have no addictive characteristics.
Since homeopathy treats in totality, it leads to a long-lasting cure, rather than a temporary suppression of symptoms, and you will be able to enjoy all kinds of food to the fullest. So, food lovers, you won't have to think anymore before eating.
Symptoms of GERD can be prevented significantly by changing habits and lifestyle. The following steps, if followed, may reduce your Acid Reflux significantly.
- Don’t eat within 3 hours of bedtime. This allows your stomach to empty and acid production to decrease. If you don’t eat, your body isn’t making acid to digest the food.
- Similarly, don’t lie down right after eating at any time of day.
- Elevate the head of your bed 6 inches with blocks. Gravity helps prevent GERD.
- Don’t eat large meals. Eating a lot of food at one time increases the amount of acid needed to digest it. Eat smaller, more frequent meals throughout the day.
- Avoid oily, fatty or greasy foods, caffeine, mints or mint-flavoured foods, pungent, spicy foods, sour things, citrus and tomato-based foods. These foods decrease the competence of the LES.
- Avoid tea, coffee
- Avoid drinking alcohol. Alcohol increases the likelihood that acid from your stomach will back up.
- Stop smoking. Smoking weakens the lower esophageal sphincter and increases reflux.
- Lose excess weight. Overweight and obese people are much more likely to have bothersome reflex than people of healthy weight.
- Stand upright or sit up straight, maintain good posture. This helps food and acid pass through the stomach instead of backing up into the esophagus.
- Reduce physical and mental stress. Maintain healthy life style. Do exercise regularly.
- Avoid night watching. Take good sleep of 6 to 7 hours.
- Avoid taking over-the-counter pain relievers. These can aggravate acid reflux. Take homeopathy medicines wherever possible. Homeopathy medicines don’t cause acidity, gastric irritation or GERD.
- Please note over the counter anti acidity tablets have side effects of producing constipation and loss of appetite and abdominal bloating problems. Don’t take self medication for GERD.