Download GERD Rec simplified

GERD – integrative approach
Rick McKinney, MD UCSF
1701 Divisadero, Suite 150
San Francisco, CA 94115
Mailing Address: Box 1726
San Francisco, CA 94143-1726
Tel: 415-353-7700
Fax: 415-353-7358
Email: [email protected]
Web: http://www.ucsf.edu/ocim
Recommendations for --------April 5, 2010
When you experience heartburn regularly (at least twice a week), it is considered to
be symptomatic of gastroesophageal reflux disease or GERD. This condition is a
clear sign that you are offending your stomach by eating too much or too often, by
choosing the wrong kinds of foods, and by allowing anxiety and stress to interfere
with digestion. GERD is more than just annoying and uncomfortable. The effect of
stomach acid on the tissue in the esophagus can eventually lead to a precancerous
condition called Barrett’s esophagus, and acid reflux is often related to respiratory
problems like asthma.
Recommended Lifestyle Changes include wearing loose clothing, avoiding eating
just before bedtime, and raising the head of your bed, especially if night time
symptoms are substantial. (Six inches is enough, so a cinderblock under each leg of
the head of the bed is a simple way to do this.) Practicing a relaxation strategy of
some sort can be very helpful. Stress and anxiety frequently make GERD symptoms
worse. Exercise helps in the long run.
Nutritional approaches:

Keeping a food log may help you track the foods and beverages that make
your symptoms worse. Certain foods and beverages weaken the esophageal
sphincter including peppermint, citrus, caffeine and alcohol. Other foods
have also been implicated – tomatoes, garlic, dairy products and high-fat
meals. Wheat and other grains containing gluten (oats, barley and rye) are
problems for some people. Learn what affects you.

Stop drinking alcohol or minimize alcohol use. Keep alcohol to a
minimum if you do drink, and drink only with meals.

Lose weight. Excess weight can put pressure on your abdomen, which can
push stomach acid upward. Losing even a few pounds can help.

Reduce stimulants. Caffeinated beverages, coffee (including decaffeinated
coffee), tobacco and other stimulants can irritate the GI tract.

If the problem remains, consider eliminating or limiting dairy foods in your
diet.
Supplements

Use DGL (Deglycyrrhizinated licorice). Slowly chew two tablets or take a
half-teaspoon of the powder before or between meals and at bedtime. Taper
your dose down after your symptoms are under control.

Add a liquid calcium supplement, taken with or soon after meals. The presence of
dissolved calcium in the stomach improves the function of the lower esophageal
sphincter. DO NOT use a form with peppermint flavoring, which can worsen GERD.

If symptoms persist, go back to the health food store for either:
Marshmallow Root or Leaf extract. Take as a tea three times a day. (2-3 tsp of
root or leaf in 1 cup of hot water, taken hot or cold. If hot, steep for 15 minutes. If
cold, steep a days supply overnight.) Also available as an extract. OR
Slippery Elm powder – unusual in being FDA approved for sore throat and cough,
this agent is especially helpful also for esophageal irritation related to GERD taken
either as a supplement or as a nutritious and reportedly tasty gruel. (Said to be a bit
slimy, though.)
If with other indigestion troubles:

Bitters, taken 20 minutes before each of your larger meals each day, can make a huge
difference. Angostura Bitters are a liquor – use one Tablespoon in six ounces of club
soda; Swedish Bitters are an extract you’ll find in the health food store. Whichever
you use, the sour taste “turns on” the stomach, the gall bladder, and the pancrease,
getting them all ready to digest your meal more completely. Try using it regularly for
10 to 14 days to decide how much it helps.