What Causes GORD & How Do PPI’s Work?
Gastro-oesophageal reflux disease (GORD) is a common condition, where acid from the stomach leaks up into the oesophagus. It can be extremely painful for sufferers.
GORD commonly occurs when the ring of muscle at the bottom of the oesophagus (the lower oesophageal sphincter) becomes weakened.
When the acid that leaks out of the stomach comes into contact with the oesophagus, it can cause a burning sensation and can lead to irritation of the oesophagus which often feels like a lump in the throat. Often there is a feeling of needing to cough frequently as a result. Sometimes individuals can also experience silent reflux. Silent reflux is where the acid causes damage during sleep.
The allopathic approach to this condition is to reduce the amount of acid produced by the stomach with the aim of reducing the damage that occurs as a consequence. Unfortunately, many people are put on acid blocking medication before the reason for the reflux has actually been explored.
PPIs reduce gastric acid production by as much as 90%. In the long-term, reducing stomach acid is not a good thing to do.
Hydrochloric acid is needed to help the body breakdown, digest and absorb nutrients, protect against infection, facilitate the conversion of pepsinogen to pepsin and the production of digestive enzymes and intrinsic factor.
This reduction in digestive capacity has wide ranging implications for health and is indeed responsible for the majority of side effects that result from the long-term use of PPIs.
Side effects of PPI use include: nausea, vomiting, diarrhoea or constipation, abdominal pain and bloating, headaches and fatigue.
The reduction in digestive capability greatly reduces the ability to absorb macro and micronutrients from food and results in wide ranging nutrient deficiencies as a result.
Key nutrient deficiencies of concern are vitamin B12 and magnesium, amongst others. Long term risks of continued use of PPIs include increased risk of pneumonia and gastric infection and increased risk of fractures. There is also concerns that long-term use may lead to increased risk of cardiovascular incidents and dementia, though further research is needed to confirm a direct link.
For this reason it is recommended that PPI use is at the lowest dose possible for the shortest period of time, unless there is a co-existing issue which warrants long-term use. Long term use is needed for conditions such as complicated oesophagitis, Barrett’s oesophagitis, previous peptic ulcer with continued H. Pylori or recurrent peptic ulcer.
Gastro-oesophageal reflux disease (GORD) is a common condition, where acid from the stomach leaks up into the oesophagus. It can be extremely painful for sufferers.
GORD commonly occurs when the ring of muscle at the bottom of the oesophagus (the lower oesophageal sphincter) becomes weakened.
When the acid that leaks out of the stomach comes into contact with the oesophagus, it can cause a burning sensation and can lead to irritation of the oesophagus which often feels like a lump in the throat. Often there is a feeling of needing to cough frequently as a result. Sometimes individuals can also experience silent reflux. Silent reflux is where the acid causes damage during sleep.
The allopathic approach to this condition is to reduce the amount of acid produced by the stomach with the aim of reducing the damage that occurs as a consequence. Unfortunately, many people are put on acid blocking medication before the reason for the reflux has actually been explored.
PPIs reduce gastric acid production by as much as 90%. In the long-term, reducing stomach acid is not a good thing to do.
Hydrochloric acid is needed to help the body breakdown, digest and absorb nutrients, protect against infection, facilitate the conversion of pepsinogen to pepsin and the production of digestive enzymes and intrinsic factor.
This reduction in digestive capacity has wide ranging implications for health and is indeed responsible for the majority of side effects that result from the long-term use of PPIs.
Side effects of PPI use include: nausea, vomiting, diarrhoea or constipation, abdominal pain and bloating, headaches and fatigue.
The reduction in digestive capability greatly reduces the ability to absorb macro and micronutrients from food and results in wide ranging nutrient deficiencies as a result.
Key nutrient deficiencies of concern are vitamin B12 and magnesium, amongst others. Long term risks of continued use of PPIs include increased risk of pneumonia and gastric infection and increased risk of fractures. There is also concerns that long-term use may lead to increased risk of cardiovascular incidents and dementia, though further research is needed to confirm a direct link.
For this reason it is recommended that PPI use is at the lowest dose possible for the shortest period of time, unless there is a co-existing issue which warrants long-term use. Long term use is needed for conditions such as complicated oesophagitis, Barrett’s oesophagitis, previous peptic ulcer with continued H. Pylori or recurrent peptic ulcer.
Strategies To Support The Digestive Process
We can not begin to help our digestive symptoms unless we have thoroughly examined the impact of stress in our life. The two things are inextricably linked.
When we are in a fight or flight situation -(which nowadays is not the sort of life-threatening scenario as running away from a saber toothed tiger, but more likely work or family related stress) our body creates stress hormones for us to be supported at that time.
These stress hormones take priority, at the detriment of digestive juices. Stress has a massive impact on our digestion. Our body doesn`t produce enough hydrochloric acid (stomach acid) and so food is under-digested. This can cause huge problems from acid reflux to severe abdominal bloating.
To support our digestion, a key part of the process is to support the balance of the autonomic nervous system (this is the nervous system that keeps us calm) to support digestion by managing stress.
Stress Management In General
One of the key reasons why so many people suffer with digestive symptoms is the sheer level of stress modern living brings. A key component of supporting digestion is in managing stress at mealtimes and supporting vagal tone. This will support the parasympathetic nervous system to allow effective digestion to occur.
Stress Management Tips
It`s so important to escape the hamster wheel of life and spend time with your own thoughts without being at the demand of others. The vagus nerve is a hugely important nerve in the body that goes to so many organs. One of its functions is to calm the body down into a parasympathetic state. Its vital to support the vagus nerve. Some ways that you can do this are:
Take a look at this short video explaining about the vagus nerve.
When we are in a fight or flight situation -(which nowadays is not the sort of life-threatening scenario as running away from a saber toothed tiger, but more likely work or family related stress) our body creates stress hormones for us to be supported at that time.
These stress hormones take priority, at the detriment of digestive juices. Stress has a massive impact on our digestion. Our body doesn`t produce enough hydrochloric acid (stomach acid) and so food is under-digested. This can cause huge problems from acid reflux to severe abdominal bloating.
To support our digestion, a key part of the process is to support the balance of the autonomic nervous system (this is the nervous system that keeps us calm) to support digestion by managing stress.
Stress Management In General
One of the key reasons why so many people suffer with digestive symptoms is the sheer level of stress modern living brings. A key component of supporting digestion is in managing stress at mealtimes and supporting vagal tone. This will support the parasympathetic nervous system to allow effective digestion to occur.
Stress Management Tips
It`s so important to escape the hamster wheel of life and spend time with your own thoughts without being at the demand of others. The vagus nerve is a hugely important nerve in the body that goes to so many organs. One of its functions is to calm the body down into a parasympathetic state. Its vital to support the vagus nerve. Some ways that you can do this are:
- Meditative practices: Yoga, meditation, me-time, deep breathing, T`ai chi, Inside timer app, headspace app, guided meditations on youtube, massage, reflexology, acupuncture, reading, gardening, walking in nature, journaling.
- Support vagal tone: singing out loud, gargling loudly, deep breathing, intermittent fasting
- Use a sensate device regularly.
- Sleep support: live within your circadian rhythms. Avoid blue light at night. Get up at the same time each day. Get plenty of daylight in the mornings. Get to bed by 11pm.
Take a look at this short video explaining about the vagus nerve.
The cephalic stage
Have you ever had the experience where you think about a lemon and your mouth starts watering? or, perhaps someone is describing your favourite meal and you start to salivate? This is a normal and beneficial stage of your digestion. It is called the cephalic stage.
Our senses, particularly our sight, smell and taste actually increase our gastric juices by anticipating what we are about to eat. Our gastric juices are essential for digesting our food properly so that we aren`t left with uncomfortable, heavy and undigested food in the stomach, leading to reflux and bloating.
The more we anticipate our food, the better our juices flow. Cooking our own meals from scratch is a great way of doing this. Time should be spent inhaling the smells of the cooking and looking at the food as we cook it. It`s all part of the process of digestion.
Unfortunately, modern pressures and lifestyles have impacted on the cephalic phase of digestion. Where mealtimes used to involve the process of preparing and cooking food and the anticipation of eating, many of us now eat most meals on the go.
Ready prepared food is easy to obtain and oftentimes we grab food seconds before consuming it, leaving the digestive system playing catch-up. This can mean that gastric acid secretion occurs too late to support the effective digestion of the meal and be more likely to be released into the oesophagus. It is important to practice mindful eating to support the digestive process and enable the body to assimilate nutrients from the food.
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Mindful eating
If stressed at mealtimes practice deep breathing before your meal. Sit quietly and concentrate on taking several deep breathes through your nose. Nose breathing is calming. We tend to breathe through our mouths when we are running, which the body interprets as a stress respnse. Slow your breathing down and try alternate nostril breathing to suppress the sympathetic nervous response. Avoid any external stimuli at mealtimes; computers, phones, tablets, television, news programmes or anything likely to stimulate a stress response. Avoid eating and working, if possible leave the office and go somewhere calm, outside if possible, but mostly where you won’t be disturbed. |
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Prepare your own meals when possible to help with the cephalic phase due to the handling and smelling of the food. If this isn’t possible, take time to think about the food that you plan to eat. What does it smell like, how does it taste, what is the texture like - this should start the saliva process as part of the anticipatory response. Ideally you should do this at least 20 minutes before actually eating.
Eat in a calm environment preferably at a table and take time to eat properly - many people eat so fast they virtually inhale their food. Put down knife and fork between mouthfuls to slow down and be sure to chew food thoroughly. Aim to chew the food until it is liquid before swallowing, or at least ten chews per bite. Chewing thoroughly coats the food in saliva enzymes, one of the first stages of digesting your food properly.
Take time to savour the taste and texture of food to support better gastric secretions and whilst you should ensure adequate levels of hydration throughout the day to make your gastric juices, don`t drink more than 150 mls of water with your meal, to avoid diluting your hydrochloric acid.
Eat in a calm environment preferably at a table and take time to eat properly - many people eat so fast they virtually inhale their food. Put down knife and fork between mouthfuls to slow down and be sure to chew food thoroughly. Aim to chew the food until it is liquid before swallowing, or at least ten chews per bite. Chewing thoroughly coats the food in saliva enzymes, one of the first stages of digesting your food properly.
Take time to savour the taste and texture of food to support better gastric secretions and whilst you should ensure adequate levels of hydration throughout the day to make your gastric juices, don`t drink more than 150 mls of water with your meal, to avoid diluting your hydrochloric acid.
Bitter herbs
The flavour of bitterness causes the non-hydrochloric acid juices to flow. These include digestive enzymes and bile, which help break down your food. By tasting bitter flavours around 20 - 30 minutes before a meal, you can prepare your stomach for the food that is about to arrive so that you can optimise your digestion.
It is important to hold the bitter herbs in the mouth until the flavour is detected before swallowing to stimulate the bitter receptors on the tongue. The easiest bitter herbs to use are what are often referred to as digestive bitters. This is something that many cultures around the world do before a meal. Perhaps you have heard the term "aperitif"? This is the exact purpose of an aperitif.
Examples are Swedish bitters by Granary Herbs, Napiers English bitters and other digestive bitters that you can readily find on the internet.
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Foods to avoid and to increase
Avoid foods and drinks which relax the lower oesophageal sphincter. These include: chocolate, caffeine, alcohol, peppermint. Avoid fatty foods and avoid eating within 2 hours of going to bed. Avoid dairy, gluten and soy Increase dietary fibre - non starchy vegetables such as asparagus, dark green leafy veg, beetroot, courgettes, turnips and green beans Increase beneficial bacteria foods such as fermented kimchi, sauerkraut and kefir. |
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Drink ginger root, lemon balm, hibiscus and rosepetal tea.
There are various herbs and supplements that I can advise you to use to help to soothe the mucosal linings of the digestive tract and to help support GORD, without resorting to PPI`s. I also have a protocol for those who wish to gradually come off of their PPI`s that is very effective. You should never just stop taking your PPI`s without being under the guidance of a professional. It is common to experience rebound symptoms which can be very painful otherwise. You should also check with your GP first about reducing your PPI`s and unfortunately, this isn`t an option for everybody.
There are various herbs and supplements that I can advise you to use to help to soothe the mucosal linings of the digestive tract and to help support GORD, without resorting to PPI`s. I also have a protocol for those who wish to gradually come off of their PPI`s that is very effective. You should never just stop taking your PPI`s without being under the guidance of a professional. It is common to experience rebound symptoms which can be very painful otherwise. You should also check with your GP first about reducing your PPI`s and unfortunately, this isn`t an option for everybody.
