Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD) is a chronic condition in which stomach contents and acid rise up into the esophagus, resulting in symptoms and/or complications. Symptoms include the taste of acid in the back of the mouth, heartburn, bad breath, chest pain, regurgitation, breathing problems, and wearing away of the teeth. Complications include esophagitis, esophageal stricture, and Barrett’s esophagus. Let us discuss all of this in-depth and know treatments, diet, and Siddha remedies as laid down in Swami Hardas Life System.

What is GERD?

Gastroesophageal reflux disease, or GERD, is a digestive disorder that affects the ring of muscle between your esophagus and your stomach. This ring is called the Lower Esophageal Sphincter (LES). If you have it, you may get heartburn or acid indigestion. Doctors think that some people may have it because of a condition called hiatal hernia. In most cases, you can ease your GERD symptoms through diet and lifestyle changes. But some people may need medication or surgery.

Gastroesophageal reflux disease Complications

Over time, chronic inflammation in your esophagus can cause:

• Narrowing of the esophagus (esophageal stricture). Damage to the lower esophagus from stomach acid causes scar tissue to form. The scar tissue narrows the food pathway, leading to problems with swallowing.
• An open sore in the esophagus (esophageal ulcer). Stomach acid can wear away tissue in the esophagus, causing an open sore to form. An esophageal ulcer can bleed, cause pain and make swallowing difficult.
• Precancerous changes to the esophagus (Barrett’s esophagus). Damage from acid can cause changes in the tissue lining the lower esophagus. These changes are associated with an increased risk of esophageal cancer.

Gastroesophageal reflux disease Risk factors

Risk factors include:

• Obesity,
• Pregnancy,
• Smoking,
• Hiatal hernia, and
• Taking certain medicines.

Medications

Medications that may cause or worsen the disease include benzodiazepines, calcium channel blockers, tricyclic antidepressants, NSAIDs, and certain asthma medicines. Acid reflux is due to poor closure of the lower esophageal sphincter, which is at the junction between the stomach and the esophagus. 

Lifestyle changes

Treatment options include lifestyle changes, medications, and sometimes surgery for those who do not improve with the first two measures. Lifestyle changes include:

• Not lying down for three hours after eating,
• Lying down on the left side,
• Raising the pillow/bedhead height,
• Losing weight,
• Avoiding foods that result in symptoms, and
• Stopping smoking. 

Medications include antacids, H₂ receptor blockers, proton pump inhibitors, and prokinetics.

In the Western world, between 10 and 20% of the population is affected by GERD. 

Gastroesophageal reflux disease Symptoms

GERD among Adults

The most common symptoms of GERD in adults are an acidic taste in the mouth, regurgitation, and heartburn. Less common symptoms include:

• Swallowing/sore throat pain,
• Increased salivation (also known as water brash),
• Nausea, 
• Chest pain,
• Coughing, and
• Globus sensation.

The acid reflux can induce asthma attack symptoms like shortness of breath, cough, and wheezing in those with underlying asthma.

Injury

GERD sometimes causes injury to the esophagus. These injuries may include one or more of the following:

• Reflux esophagitis – inflammation of esophageal epithelium which can cause ulcers near the junction of the stomach and esophagus,
• Esophageal strictures – the persistent narrowing of the esophagus caused by reflux-induced inflammation,
• Barrett’s esophagus – intestinal metaplasia (changes of the epithelial cells from squamous to intestinal columnar epithelium) of the distal esophagus, and
• Esophageal adenocarcinoma – a form of cancer.

GERD sometimes causes injury to the larynx (LPR). Other complications can include aspiration pneumonia.

GERD among Children and Babies

Respiratory problems

GERD may be difficult to detect in infants and children since they cannot describe what they are feeling and indicators must be observed. Symptoms may vary from typical adult symptoms. GERD in children may cause repeated:

• Vomiting,
• Effortless spitting up,
• Coughing,
• Wheezing,
• Inconsolable crying,
• Refusing food,
• Crying for food and then pulling off the bottle or breast only to cry for it again,
• Failure to gain adequate weight,
• Bad breath and burping are also common.

Children may have one symptom or many; no single symptom is universal in all children with GERD.

Of the estimated 4 million babies born in the US each year, up to 35% of them may have difficulties with reflux in the first few months of their lives, known as ‘spitting up’. About 90% of infants will outgrow their reflux by their first birthday.

Mouth

Acid reflux into the mouth can cause the breakdown of the enamel, especially on the inside surface of the teeth. A dry mouth, acid or burning sensation in the mouth, bad breath, and redness of the palate may occur. Other not-so-common symptoms of GERD include:

• Difficulty in swallowing,
• Water brash which is the flooding of the mouth with saliva,
• Chronic cough,
• Hoarse voice,
• Nausea, and
• Vomiting.

Tooth structure

Signs of enamel erosion are the appearance of smooth, silky-glazed, sometimes dull, enamel surfaces with the absence of perikymata, together with intact enamel along the gum margin. It will be evident in people with restorations as tooth structure typically dissolves much faster than the restorative material, causing it to seem as if it “stands above” the surrounding tooth structure.

Barrett’s esophagus

GERD may lead to Barrett’s esophagus, a type of intestinal metaplasia, which is, in turn, a precursor condition for esophageal cancer. The risk of progression from Barrett’s to dysplasia is uncertain but is estimated at about 20% of cases. 

Due to the risk of chronic heartburn progressing to Barrett’s, EGD every five years is recommended for people with chronic heartburn, or who take drugs for chronic GERD.

Gastroesophageal reflux disease Causes

Acid reflux is due to poor closure of the lower esophageal sphincter, which is at the junction between the stomach and the esophagus. Factors that can contribute to GERD:

• Hiatal hernia increases the likelihood of GERD due to mechanical and motility factors.
• Obesity: increasing body mass index is associated with more severe GERD. 

Factors that have been linked with GERD, but not conclusively:

• Obstructive sleep apnea
• Gallstones can impede the flow of bile into the duodenum, which can affect the ability to neutralize gastric acid.

In 1999, a review of existing studies found that, on average, 40% of GERD patients also had H. pylori infection. The eradication of H. pylori can lead to an increase in acid secretion, leading to the question of whether H. pylori-infected GERD patients are any different than non-infected GERD patients. 

Gastroesophageal reflux disease Diagnosis

The diagnosis of GERD is usually made when typical symptoms are present. Reflux can be present in people without symptoms and the diagnosis requires both symptoms or complications and reflux of stomach content.

Esophagogastroduodenoscopy

Other investigations may include esophagogastroduodenoscopy (EGD). Barium swallow X-rays should not be used for diagnosis. Esophageal manometry is not recommended for use in the diagnosis, being recommended only prior to surgery. 

Ambulatory esophageal pH monitoring

Ambulatory esophageal pH monitoring may be useful in those who do not improve after PPIs and is not needed in those in whom Barrett’s esophagus is seen. Investigation for H. pylori is not usually needed.

Esophageal pH monitoring

The current gold standard for diagnosis of GERD is esophageal pH monitoring. It is the most objective test to diagnose the reflux disease and allows for monitoring of GERD patients in their response to medical or surgical treatment.

One practice for diagnosis of GERD is a short-term treatment with proton-pump inhibitors, with improvement in symptoms suggesting a positive diagnosis. Short-term treatment with proton-pump inhibitors may help predict abnormal 24-hr pH monitoring results among patients with symptoms suggestive of GERD.

Endoscopy

Endoscopy, the looking down into the stomach with a fiber-optic scope, is not routinely needed if the case is typical and responds to treatment. It is recommended when people either do not respond well to treatment or have alarm symptoms, including dysphagia, anemia, blood in the stool (detected chemically), wheezing, weight loss, or voice changes. 

Some physicians advocate either once-in-a-lifetime or 5- to 10-yearly endoscopy for people with longstanding GERD, to evaluate the possible presence of dysplasia or Barrett’s esophagus.

Biopsies

Biopsies performed during gastroscopy may show:

• Edema and basal hyperplasia (nonspecific inflammatory changes),
• Lymphocytic inflammation (nonspecific),
• Neutrophilic inflammation (usually due to reflux or Helicobacter gastritis),
• Eosinophilic inflammation (usually due to reflux): The presence of intraepithelial eosinophils may suggest a diagnosis of eosinophilic esophagitis (EE) if eosinophils are present in high enough numbers, 
• Goblet cell intestinal metaplasia or Barrett’s esophagus,
• Elongation of the papillae,
• Thinning of the squamous cell layer,
• Dysplasia, and
• Carcinoma.

Severity

Severity may be documented with the Johnson-DeMeester’s scoring system: 0 – None 1 – Minimal – occasional episodes 2 – Moderate – medical therapy visits 3 – Severe – interference with daily activities.

Differential diagnoses of GERD

Other causes of chest pain such as heart disease should be ruled out before making the diagnosis. 

Another kind of acid reflux, which causes respiratory and laryngeal signs and symptoms, is called laryngopharyngeal reflux (LPR) or “extraesophageal reflux disease” (EERD). Unlike GERD, LPR rarely produces heartburn and is sometimes called silent reflux. Differential diagnoses of GERD can also include dyspepsia, peptic ulcer disease, esophageal and gastric cancer, and food allergies.

Gastroesophageal reflux disease Treatment

The treatments for GERD may include food choices, lifestyle changes, medications, and possibly surgery. Initial treatment is frequently with a proton-pump inhibitor such as omeprazole. In some cases, a person with GERD symptoms can manage them by taking over-the-counter drugs. This is often safer and less expensive than taking prescription drugs. Some guidelines recommend trying to treat symptoms with an H₂ antagonist before using a proton-pump inhibitor because of cost and safety concerns.

Medications for Gastroesophageal reflux disease

The primary medications used for GERD are proton-pump inhibitors, H₂ receptor blockers, and antacids with or without alginic acid. The use of acid suppression therapy is a common response to GERD symptoms and many people get more of this kind of treatment than their case merits. The overuse of acid suppression is a problem because of the side effects and costs.

Proton-pump inhibitors

Proton-pump inhibitors (PPIs), such as omeprazole, are the most effective, followed by H₂ receptor blockers, such as ranitidine. If a once-daily PPI is only partially effective it may be used twice a day. They should be taken one half to one hour before a meal. 

Antacids

The evidence for antacids is weaker with a benefit of about 10% (NNT=13) while a combination of an antacid and alginic acid (such as Gaviscon) may improve symptoms by 60% (NNT=4). 

Metoclopramide (a prokinetic) is not recommended either alone or in combination with other treatments due to concerns around adverse effects. The benefit of the prokinetic mosapride is modest.

Other agents

Sucralfate has similar effectiveness to H₂ receptor blockers; however, sucralfate needs to be taken multiple times a day, thus limiting its use. Baclofen, an agonist of the GABA_B receptor, while effective, has similar issues of needing frequent dosing in addition to greater adverse effects compared to other medications.

Surgery for Gastroesophageal reflux disease

The standard surgical treatment for severe GERD is the Nissen fundoplication. It is recommended only for those who do not improve with PPIs.

Uncertainty about the benefits of surgery

When comparing different fundoplication techniques, partial posterior fundoplication surgery is more effective than partial anterior fundoplication surgery, and partial fundoplication has better outcomes than total fundoplication.

In those with symptoms that do not improve with PPIs surgery known as transoral incisionless fundoplication may help. Benefits may last for up to six years.

Special populations

Gastroesophageal reflux disease during Pregnancy

GERD is a common condition that develops during pregnancy but usually resolves after delivery. The severity of symptoms tends to increase throughout the pregnancy. During pregnancy, dietary modifications and lifestyle changes may be attempted, but often have little effect.

Babies with Gastroesophageal reflux disease

Babies may see relief with smaller, more frequent feedings, more frequent burping during feedings, holding the baby in an upright position 30 minutes after feeding, keeping the baby’s head elevated while laying on the back, removing milk and soy from the mother’s diet or feeding the baby milk protein-free formula. 

The role of an Occupational Therapist with an infant with GERD includes positioning during and after feeding.  

Diet and lifestyle changes

There are several changes that doctors suggest you make in your lifestyle to help lessen your symptoms of GERD.

Avoid foods and beverages that trigger

Stay away from foods that can relax the LES, including chocolate, peppermint, fatty foods, caffeine, and alcoholic beverages. You should also avoid foods and beverages that can irritate a damaged esophageal lining if they cause symptoms, such as citrus fruits and juices, tomato products, and pepper.

Eat smaller servings

Eating smaller portions at mealtime may also help control symptoms. Also, eating meals at least 2 to 3 hours before bedtime lets the acid in your stomach go down and your stomach partially empty.

Eat slowly

Take your time at every meal. It is, however, advised to chew every morsel of food at least 32 times, which helps food to digest well.

Chew your food thoroughly

It may help you remember to do this if you set your fork down after you take a bite. Pick it up again only when you’ve completely chewed and swallowed that bite.

Stop smoking

Cigarette smoking weakens the LES. Stopping smoking is important to reduce GERD symptoms.

Elevate your head

Raising the head of your bed on 6-inch blocks or sleeping on a specially designed wedge lets gravity lessen the reflux of stomach contents into your esophagus. Don’t use pillows to prop yourself up. That only puts more pressure on the stomach.

Stay at a healthy weight

Being overweight often worsens symptoms. Many overweight people find relief when they lose weight.

Wear loose clothes

Clothes that squeeze your waist put pressure on your belly and the lower part of your esophagus.

Acupuncture

In one study, treatment with acupuncture stopped reflux in the test group better than PPIs, with results that lasted longer. We need more large studies to confirm this, but early results are promising.

Gastroesophageal reflux disease Research

A number of endoscopic devices have been tested to treat chronic heartburn.

• Endocinch puts stitches in the lower esophageal sphincter (LES) to create small pleats to help strengthen the muscle. 
• The Stretta procedure uses electrodes to apply radio-frequency energy to the LES. A 2015 systematic review and meta-analysis in response to the systematic review (no meta-analysis) conducted by SAGES did not support the claims that Stretta was an effective treatment for GERD. A 2012 systematic review found that it improves GERD symptoms.
• NDO Surgical Plicator creates a plication, or fold, of tissue near the gastroesophageal junction, and fixates the plication with a suture-based implant. The company ceased operations in mid-2008, and the device is no longer on the market.
• Transoral incisionless fundoplication, which uses a device called Esophyx, may be effective.

Ayurveda for Gastroesophageal reflux disease

Ayurveda focuses on balancing the doshas- Vata, Pitta, and Kapha. In Ayurveda Acid Reflux or GERD is a result of aggravation or imbalance in the Pitta dosha. So, we need to balance the Pitta dosha in the body.

Do’s to balance Pitta Dosha and get relief from GERD

This is the reason; it is recommended to eat foods according to your Prakriti and avoid foods that are not suited for your body and lifestyle.

So, here are some of the don’ts that you need to avoid if you have the issue of Acid Reflux or GERD:

Don’ts to balance Pitta Dosha and get relief from GERD

• If you are facing the issue of belching and acid reflux, then you can try fasting or upvasa from time to time.
• Say no to junk food and processed and fermented foods.
• Avoid using garlic, ginger, onions, tomatoes, and vinegar in cooking.
• Also avoid oily and rich gravies and sour, salty, and spicy foods.
• Take meals in a relaxed atmosphere at regular intervals of time.
• Incorporate any kind of physical activity and exercise.
• Eating meals in small proportions can help you.
• Keep your head elevated with pillows while sleeping. 
• Excessive stress and worries should be managed. 
• Using some herbs and spices in your diet such as turmeric, cumin, fennel seeds, coriander, carom seeds, basil leaves and hing (asafetida) can also help.
• Drink ginger or cumin tea once a day.
• Avoid very cold drinks such as iced drinks etc.
• Drinking water immediately after meals should be avoided.
• Eat only when hungry.
• Sipping warm water during a meal will help in the digestion and absorption of food.
• Avoid taking food items that are contradicting in nature and that is against your Prakriti.

You can follow these dos and don’ts that are according to Ayurveda principles and can help you a lot.

Siddha remedies for GERD

1. Siddha preventive measures

Everybody must practice Siddha preventive measures, whether a person is affected by Gastroesophageal reflux disease (GERD) or not, but preventive measures are the primary steps for switching on to any other Siddha remedies, and hence they are important. It helps in one’s capability, effectiveness, productivity, decision-making power, intellectuality, and removing minor health problems. There are three types of preventive measures:

• Earthing – performed for removing and earthing the negativity of our body
• Field cleaning – cleans the energy field (Aura) of our body
• Siddha brain exercise/Energizing – energizes our brain for proper functionality

Everybody’s tendency is to get attracted to the word ‘free, however, don’t neglect even these Siddha preventive measures are free. Avail of the benefits by practicing them sincerely, and regularly. For ease of understanding what Siddha preventive measures are, please watch a video for a live demonstration.

2. Siddha Shaktidata Yoga

This unique Siddha Shaktidata Yoga of Siddha Spirituality can solve the problems related to Gastroesophageal reflux disease (GERD) with Siddha remedies. There is no compulsion of training in ‘Swami Hardas Life System’ methods. This not only gives benefits to self but also it can be used for other affected persons, whether a person is in the same house, distantly available in the same city, same nation, or might be in any corner of the world, however, both the procedures have been explained here.

3. Siddha Kalyan Sadhana

Recite this Sadhana with a Sankalp “My problems of Gastroesophageal reflux disease (GERD) are solved as early as possible and I should gain health”, which should be repeated in mind 3 – 3 times after each stanza. Any person irrespective of caste, creed, religion, faith, sex, and age can recite this Sadhana for free, which should be repeated at least twice a day. To know more, please click on this link.

4. CCPE products for Gastroesophageal reflux disease

These products work on the concepts of ‘Conceptual Creative Positive Energy’ (CCPE) within the provisions of the ‘CCPE Life System’ and the theory of Quantum Technology to a certain extent. However, the products get activated only whenever touched by a human and then they become capable of solving the problem and achieving health. However, please use these products for Gastroesophageal reflux disease (GERD) as mentioned below:

CCPE Extractor: The CCPE Extractor should be gently moved over the Agya Chakra in a circular motion at least for 30 to 60 seconds, thereafter, follow the same process on the head, chest, and stomach which finishes within almost 2-4 minutes.

CCPE Booster: Keep one Booster over the Agya Chakra and another over the head, chest, and stomach for 3 minutes. You may need to have 4 Boosters, which establishes positivity. 

CCPE Booster Powder: Mix a pinch of CCPE booster powder with a few drops of coconut oil and make a paste. Apply it over the entire stomach, and leave it for about 30 minutes. Repeat the process every after 2 hours.

5. UAM or Touch Therapy for Gastroesophageal reflux disease

For quick and effective results, it is advisable to learn the unique methods of the Swami Hardas Life System. A trained person can only apply the UAM method or Touch therapy himself/herself and become capable of healing others.

A daily routine for GERD

In general, a daily routine for GERD may look like this:

• Follow the instructions of your Doctor
• Consume Sattvic diet
• Perform breathing exercises regularly
• Perform Ashtanga Yoga regularly
• Apply free touch therapy (UAM) a minimum 3 times a day, as explained above
• Perform Swayamsiddha Agnihotra daily, either self or the caretaker can perform
• In case, if someone wishes to learn advanced methods of Swami Hardas Life System, undergo unique training

Ensure to sprinkle in some fun during the day: Don’t forget to relax and laugh in between. Laughing is a great way to boost your immune system and help you.

Along with all the above activities, apply above explained free Siddha remedies minimum 3 times a day, the more is good. Just try the methods of Siddha Spirituality of Swami Hardas Life System. I am confident that you will surely find improvements within 3 days.

Training of Swami Hardas Life System

Any health, peace, and progress-related problem can be solved independently by undergoing Swami Hardas Life System training. It needs no money and medicines. Any person irrespective of religion, caste, creed, faith, sex, and age can undergo this unique training.

Conclusion

Because of the above, I am confident that you have learned about Gastroesophageal reflux disease (GERD), its meaning, symptoms, causes, complications, risk factors, diagnosis, Ayurveda diet, lifestyle, treatment, and Siddha remedies. Now, that you have become self-sufficient, hence it’s the right time to use your acquired knowledge for solving problems as per the provision available in Siddha Spirituality of Swami Hardas Life System.

However, keep learning and practicing the free Siddha remedies, which would help guide how to solve various problems regarding health, peace, and progress, without money and medicines.

After reading this article, how would you rate it? Would you please let me know your precious thoughts? 

Frequently asked questions

Before posting your query, kindly go through them:

What is GERD? Gastroesophageal reflux disease, or GERD, is a digestive disorder that affects the ring of muscle between your esophagus and your stomach. If you have it, you may get heartburn or acid indigestion. Doctors think that some people may have it because of a condition called hiatal hernia. In most cases, you can ease your GERD symptoms through diet and lifestyle changes. But some people may need medication or surgery.

 

What are the Siddha remedies for GERD? In general, a daily routine for GERD may look like this: Follow the instructions of your Doctor; Consume a Sattvic diet; Perform breathing exercises regularly; Perform Ashtanga Yoga regularly; Apply free touch therapy (UAM) a minimum 3 times a day, as explained above; Perform Swayamsiddha Agnihotra daily, either self or the caretaker can perform; and in case, if someone wishes to learn advanced methods of Swami Hardas Life System, undergo unique training. Ensure to sprinkle in some fun during the day: Don’t forget to relax and laugh in between. Laughing is a great way to boost your immune system and help you.