Ask the Herbalist The most common symptom of GERD, gastroesophageal reflux disease, is heartburn. Heartburn is usually experienced as a burning sensation behind the breastbone that may rise all the way to the face. Discomfort is caused by acid reflux from the stomach because the lower esophageal sphincter isn’t working properly. Heartburn may accompany regurgitation or excessive salvia. Complications include esophageal stricture, ulceration, and Barrett’s esophagus, a pre-cancerous lining of the esophagus. Inflammation of the esophagus may cause pain during swallowing and bleeding.
Other symptoms of GERD may include nausea, burping, coughing, a bitter taste in the mouth, and respiratory conditions such as asthma, pneumonia and chronic bronchitis. Physicians conduct diagnostic tests such as X-ray, esophagoscopy, and a visual exam with a flexible tube. Other tests include measuring the lower esophageal sphincter, biopsy, and acidity tests.
If you or a client suspects GERD, it is important to get a thorough diagnosis to rule out complications, respiratory disease, and heart conditions. Lifestyle suggestions to alleviate GERD and heartburn include elevating the head of your bed with 3-6 inch blocks, or foam wedges that lift your body from the waist up; sleeping on your left side, stress reduction, exercise, quitting smoking, and reducing alcohol intake. It is important not to eat before going to bed. Eating 4-6 light meals a day, instead of two or three large meals is highly important. Food triggers may include dairy products, tomatoes, citrus fruits and beverages, garlic, peppermint and fish oil supplements.
Gastrointerologists and other physicians treat GERD with antacids, and acid blocking drugs such as Prilosec and Prevacid. Side effects of these drugs include headaches, diarrhea, abdominal pain and nausea. Furthermore, symptoms may worsen once you stop taking the drug, and the underlying imbalance is not corrected. Finally some individuals taking Prilosec for several years notice a degradation of the stomach lining. It may be helpful to experiment with a rotation diet such as the Digestive Clearing Program (see my book: Healing Digestive Disorders) to help identify food intolerance. Medications such as aspirin and other NSAIDs (non-steroid anti-inflammatory drugs) calcium channel blockers, asthma drugs, and hormones may cause reflux.
According to traditional Chinese medicine (TCM), heartburn is usually caused by emotional upset and eating the wrong foods. Reflux is seen as rebellious Qi that is rising where it should be sinking. Luckily there are several herbal remedies that can be used in addition to the lifestyle and dietary suggestions mentioned above. Ease Plus is based on Chai Hu Mu Li Long Gu Tang it treats emotional disturbances that cause a combination of digestive problems, headache, nervousness, and insomnia. Minerals are used to reverse reflux by quenching acidity and redirecting rebellious Qi downward. Costus (mu xiang) substituted for jujube (da zao) to promote better digestive functions. Chinese rhubarb (da huang) eliminates heat through the intestines. Asian ginseng (ren shen) supports the spleen. Cassia (gui zhi) relieves the surface. The formula harmonizes by dredging the liver and strengthening the spleen, thus preventing the liver from disrupting the digestion. Liver heat is also cleared by Chinese skullcap (huang qin), which prevents the disturbance of heart shen by rising liver yang. Oyster extract (Ostrea gigas) and calcium carbonate weigh stabilize the heart shen.
In general I recommend combining Ease Plus with Quiet Digestion, a remedy traditionally used for food stagnation. With emotional distress combine Ease Plus with Escape Restraint. If the patient has copious phlegm, Ease Plus can be combined with Clear Phlegm (Wen Dan Tang). With heat signs including fast pulse and red tongue, and bitter acid regurgitation, Coptis Purge Fire is the adjunct of choice.
CASE 1
Thelma was a health worker attending night school who was advised to go off Prilosec by her physician as she was having an interaction with coumadin a medication she took for heart disease; Prilosec can increase the blood thinning effects of coumadin. Currently she was taking an over the counter antacid, and having symptoms of burning, acid regurgitating and frequent burping. She also reported intestinal gas and bloating after meals, and diarrhea. When inquiring about her diet, Thelma mentioned she ate fast food at least once per day especially on her way home after night school. Thelma also did not drink water, her beverages consisted of coffee, soft drinks, and iced tea. Her pulse was soggy, her tongue was red covered with a gray yellow coat.
We recommended that Thelma bring a thermos of Chamomile tea to work to drink. We also suggested she abstain from iced beverages, and that she try to reduce or eliminate the fast food especially at night. We recommended Quiet Digestion to improve her absorption of food 1 capsule with each meal and 1-2 capsules between meals TID. We also recommended Colostroplex (Bovine colostrum) 2 capsules between meals TID. Quiet Digestion was recommended to reduce food stagnation and Colostroplex was used to stop diarrhea, and reduce inflammation. Within two weeks Thelma had virtually stopped taking the antacid and all symptoms were ninety percent reduced.
DISCUSSION
We did not use Ease Plus as it might have increased diarrhea. Usually, diarrhea needs to be stopped before other symptoms can be addressed.
CASE 2
Antonio was a high strung photographer, diagnosed with GERD. He called the office many times for information before his appointment, often asking repetitive questions, like “How much experience has the herbalist had in treating GERD?” During the appointment he appeared skeptical that anything including herbs could help him. He appeared to find it very difficult to listen or sit still. He complained of anxiety, reflux, heartburn and some shoulder neck tension and jaw tightness. His pulse was wiry, and his tongue red with yellow coat. He was not receptive to any dietary or lifestyle changes.
After his appointment was over he created disruption for the staff by complaining that his bill was too high. Antonio said he hated taking pills and we therefore prepared a decoction for him, however, the next day he called back complaining about the bitter taste, and again about the expense. He didn’t show up for his next appointment although he did return a few weeks later demanding capsules, so we gave him Ease Plus and Quiet Digestion. He was also referred to acupuncture. When he was contacted several weeks later by staff he said he was back on the Prilosec and said he hadn’t seen any benefit from the herbs.
DISCUSSION
Sometimes we have seen clients that are so nervous they can’t really receive any value from the herbs or treatment. They seem to be going through the motions hoping that a magic bullet might save them, but because they are unwilling to do any self-help it is unlikely that they will make progress.
REV 2022