of the pain to the back, neck, jaw and arms. Prolonged reflux can result in erosions of the esophagus, precancerous changes (known as Barrett’s esophagus) and esophageal cancer.
Diagnosis and Treatment Given the many faces of GERD, a high index of suspicion is necessary to make an accurate diagnosis. This comes from diagnostic testing and a look at one’s medical history. There are some special studies that can assist in the diagnosis. Some of these tests include 24-hour acid monitoring via a probe in the esophagus, measurement of the pressure in the LES, and endoscopy (looking in the esophagus and stomach with a fiber optic camera). Uncontrollable GERD symptoms mandate evaluation by endoscopy. Practical measures include avoiding wearing tight clothing,
weight loss, avoiding foods that lower the LES pressure, not lying down within three hours after eating, eating smaller, more frequent meals, and chewing food thoroughly. Placing 6-9- inch blocks under the head of the bed can use gravity to keep stomach contents where they belong. Stress causes reduction in the forward flow of the GI tract; stress reduction measures can mitigate this.
Supplement Options Some supplements have been found to be useful in treating GERD. Melatonin, better known for its effect on sleep, is found at a concentration 400 times greater in the GI tract than in the brain. It tightens the LES, increases forward flow in the intestines, and modulates acid production. D-limonene found in citrus oils can increase GI movement, and it protects tissues from acid. These supplements may need up to six weeks to reach maximum efficacy. Probiotics help digestion and GI motility. Digestive enzymes improve digestion. Sometimes, it is even necessary to supplement stomach acid (in the form of betaine HCl) to improve digestion. This should be done cautiously and should be avoided in patients with active ulcer disease and/or erosions. Finally, supplements like aloe vera, slippery elm and marshmallow root can coat and soothe inflamed tissues. The goal should be normalization of the function of the
GI tract. Blocking acid production runs contrary to this. Acid blocking medications should be avoided if possible and used if the above measures are found to be ineffective. If you are already on an acid blocking agent, you should discuss your options with your healthcare provider.
Jason D. Gourlas, PA-C, practices at Vital Life Wellness Center, located at 2520 Broadway, Suite 100, in San Antonio. He has 22 years of experience in medicine, which includes primary care, emergency medicine, neurology and surgical critical care in
hospital, clinic and military settings. He is board certified through the National Commission on Certification of Physician Assistants, a member of The Institute of Functional Medicine and is seeking board certification in functional and restorative medicine with the American Academy of Anti-Aging Medicine. Gourlas also served 15 years in the United States Army. For more information about Vital Life Wellness Center, including information on free seminars, visit
www.vitallifewellness.com or call 210-595-1019.
NaturalAwakeningsSA.com August 2013 21
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