GERD (Gastro-Esophageal Reflux Disease)
aka Acid Reflux, Heartburn

What’s the difference between all three?

  • GERD encompasses both acid reflux and heartburn, and occurs when the sour gastric acid ascends up the esophagus as far as the mouth. Heartburn specifically refers to the sensation of retro-sternal burning that spreads upward to the throat.
  • GERD can present with other symptoms like stomach pain, abdominal distention, nausea, and a vague hunger, but can also occur alone.
  • The acid from chronic GERD can scar the esophagus leading to difficulty swallowing or regurgitation, cause a sore throat and hoarseness, and if it enters the lungs can lead to bronchitis or asthma. Long-term: Barrett’s Esophagus, cancer.

What caused this condition?

  • Diet: foods that are overly hot in nature like chile and spices, alcohol, coffee and chocolate; foods that are overly acidic in nature like citrus fruits, tomatoes, uncooked peppers, radishes, onions and garlic. Excessive use of cold, raw foods, medications like antibiotics, and overly strict dieting can all damage digestive functions.
  • Lifestyle: eating at odd hours or on the go, overeating, and, of course, stress. Stress can stagnate Qi and attack the Stomach causing it to “rebel upwards.” Qi Stagnation can also cause constipation backing up the intestinal system leading to more rebellious Qi. And one of the great causes of Qi Stagnation is unexpressed, unresolved emotions that get stored in the gut.
  • WHAT you eat, WHY you eat, WHEN you eat, and HOW you eat!
  • Lower Esophageal Sphincter dysfunction: Food stagnation, high-fat meals, lying down post-meal, weak muscle control; decreased clearance of refluxate from esophagus; delayed ST emptying
  • Your internal pattern:
    -  Liver Qi Stagnation Invading the Stomach:
    A clear relationship to your emotional state and stress, hypochondriac and epigastric tenderness, bloating, alternating constipation and diarrhea, loss of appetite, frequent sighing or burping, irritability, depression, anxiety, tension headaches, PMS, cold fingers and toes, and shoulder and neck tension.
    -  Stomach and Liver Heat: This may evolve from Liver Qi Stagnation, but may be aggravated by the excessive consumption of heating foods where the GERD is most noticeable just after eating. You may experience it in the middle of the night around 1-2am with sour reflux and burping, a burning sensation, dry mouth and thirst, irritability and easily angered.
    -  Phlegm-Damp Accumulation: This can result from long-term Spleen Qi Deficiency producing a pathological by-product called Dampness that impairs healthy circulation and can further congeal to produce Phlegm. In the end, the normal downward direction of Stomach Qi is disrupted. The symptoms are similar to those above plus a decreased sensation of taste, a tendency to loose stools, tiredness and heavy limbs, poor concentration, a tendency to be over-weight, mucus, dizziness and headaches, and a musty body odor.
    -  Food Stagnation: This can occur due to frequent over-eating and irregular eating especially when coupled with a sedentary lifestyle. Symptoms include: the GERD is worse after a large meal and is relieved by vomiting or burping up undigested food particles, bad breath is common, along with constipation or diarrhea that relieves the pain.
    -  Spleen-Stomach Qi/Yang Deficiency: Long-term digestive weakness inhibiting the proper movement of food in the GI tract. Symptoms include: intermittent, worse with hard to digest or raw foods, bending or any increase in abdominal pressure; waking during the night with heartburn is common; abdominal pain which is better with warmth and
    pressure; bloating post-meal, drooling, sour belching, poor appetite, fatigue, loose stools, and cold intolerance.
    -  Stomach and Liver Yin Deficiency: Long-term excess heat (from stress, overly heating foods, etc.) in the Stomach can damage the Yin. Symptoms include: chronic GERD, acidity and heartburn worse with stress or in the evening, may wake 1-4am with reflux which can be relieved by eating; dull pain, loss of appetite or vague hunger, dry mouth and throat, and dry stools or constipation.over-eating and irregular eating especially when coupled with a sedentary lifestyle. Symptoms include: the GERD is worse after a large meal and is relieved by vomiting or burping up undigested food particles, bad breath is common, along with constipation or diarrhea that relieves the pain.

What can I do about it?

  • Foods: Aloe vera juice, raw potato juice mixed with water 3x/day, 1 Tbsp apple cider vinegar in water with food, digestive enzymes pre-meal without HCl acid, stop eating 3 hours before sleep, lay on your left side to keep your stomach below your esophagus. Be cautious with estrogen use, Aspirin/Advil. Rx drugs: Zantac, Nexium, Prevacid, Protonix, Pepcid, and Tagamet all inhibit stomach acid production. Deglycyrrhizinated Licorice (DGL)

    -  Liver Qi Stagnation/Food Stagnation: smaller portions, ginger tea, digestive enzymes pre-meal, exercise, eat dinner earlier; veggies and complex carbs, decrease fats and heavier proteins, reduce or learn to better cope with stress.
    -  Stomach and Liver Heat: bitter, cool, pungent foods; raw foods like fruits and veggies, decrease proteins to primarily fish; avoid spicy or overly spiced and complicated meals, fried greasy foods, and COFFEE and ALCOHOL.
    -  Phlegm-Damp Accumulation: decrease carbs, except rice barley and millet; decrease sugars and sweets, fats and oils, and raw foods. Ginger and other warming acrid spices like garlic, mustard, horseradish, and pepper are helpful. Plus the food suggestions below for Qi Deficiency.
    -  Spleen-Stomach Qi/Yang Deficiency: lightly cook all veggies, avoiding raw foods; soups and stews, broths; chew your food more thoroughly; simpler combinations of foods; smaller portions and more frequent meals. For Yang Deficiency: same as Qi Deficiency, but more warming foods are indicated; avoid cold raw foods. Cinnamon, Ginger, Cloves and Garlic are indicated
    -  Stomach and Liver Yin Deficiency: nourishing roots, soups, and stews; seeds and beans can moisten; rich-colored veggies; Flax seed oil! Avoid overly spiced foods, coffee, and other stimulants like caffeine.
  • Acupuncture and Chinese Medicinal Herbs: Your second and third lines of defense. Sometimes, modifying your daily food intake is not enough, and you need some extra assistance. Working together, we can create a specific treatment plan to meet your individual needs. This can include Acupuncture, a Chinese Medicinal Herbal Formula, and Nutritional and Lifestyle Counseling.
  • Cautions about over-the-counter antacids: These can be effective at giving you symptomatic relief, but pose some long-term problems. The first is that they are not actually addressing the root cause of the imbalance. And the second is the concern about the side effects related to the metal content which include constipation, diarrhea, belching, gas and nausea. For example: calcium and aluminum-based drugs can lead to constipation, and magnesium can act as a laxative, sodium bicarbonate can cause gas and bloating, and calcium carbonate can have a stomach acid rebound effect. Antacids can also adversely affecting your electrolyte imbalance, inhibit nutrient absorption and proper digestion, and are useless for gas and bloating.


© Jordan Hoffman, L.Ac., Dipl. OM, 2007. All Rights Reserved.

The information presented here is not medical advice, is not intended as medical advice, and is intended to provide only general, non-specific information related to Chinese Medicine and Acupuncture and is not intended to cover all the issues related to the topic discussed. You should consult a licensed health practitioner before using any of this information.