by Dr. Sydney Malawer, DAIM L.Ac.
Many people in our practice are suffering from GERD and gastritis (aka heartburn & reflux). Their symptoms vary from mild irritation of the throat and burping to severe stabbing pain in the epigastrium and inability to lie flat due to the pain. Many of them feel that their condition is not under control even though they are taking proton-pump inhibitors such as omeprazole. While regular acupuncture and herbal medicine has helped many of them control their symptoms, the best results I have gotten with patients have been those who have adopted a GERD-friendly diet based on Chinese dietary therapy along with herbal medicine and occasional acupuncture.
Below is an adapted excerpt from Andrew Sterman's work on Chinese dietary therapy that I have found extremely helpful clinically in controlling and even reversing GERD symptoms.
What is GERD?
Gastroesophageal reflux disease (GERD) is the official name for what we colloquially refer to as heartburn. Symptoms range from unnoticed to extreme pain mimicking heart attack. The cause is often said to be a timing malfunction of the lower esophageal sphincter which allows stomach secretions to be pushed up into the esophagus, which is not equipped to withstand the acidity of the stomach secretions. Individuals suffering from GERD sometimes have high stomach acid production, but sometimes they actually have low stomach acid production. Since the standard of care in modern medical settings for GERD is antacid medications, if someone has low stomach acid production these medications can inadvertently make the symptoms worse as the body produces more stomach acid in response to there not being enough. Proper identification of the cause is key to treatment from modern medications.
Understanding that reflux is fundamentally a problem of directionality provides the key to treatment from a Chinese medical point of view. Food needs to be on a descending path. The stomach needs to be ready to welcome food. When the stomach has fulfilled its role, it needs to open only the lower (known as pyloric) sphincter in order to allow the food to continue to be digested properly in the intestines. If the stomach has its energetic directionality disrupted or reversed, we say that it is rebellious and that the individual is experiencing “rebellious stomach qi”.
Dietary Therapy for GERD
Include foods that nourish the stomach and help qi to descend (aka not be rebellious anymore). See the table below for specific foods that help this function. These foods and others like them help restore descension of the stomach. Avoiding trigger foods, clearing constipation or sluggish elimination, strengthening the digestive organs and including soothing, descending foods such as those mentioned in the table will permit healing to take place. Chewing food well and eating warm, cooked foods helps to improve digestive function and ensure proper directionality of food in the stomach. Also be sure to prioritize hydration and to separate fluids from foods by 15 minutes (aka don’t drink while you’re eating - drink before and after).
Certain foods are best to avoid for anyone with reflux; other offending foods may be personal. Detective work may be required to tailor diets to the individual’s needs. In general, it’s best to avoid foods that tend to be disruptive to the descending qi of the stomach (see table below). It is also important to not eat when worried, not hungry or with erratic timing as this will negatively impact digestion.
Along with Chinese dietary therapy, acupuncture and herbal medicine is able to help reduce the severity and frequency of GERD flares. To learn more about our approach to digestive issues, visit the Digestive Health page. If you have questions about how acupuncture, herbal medicine, and Chinese dietary therapy can help you, chedule a Free Phone Consultation here.