Gird Yourself for GERD

One in 10 people in Singapore suffers from Gastroesophageal Reflux Disease. Here’s what you need to now about this increasingly common disorder.

Belching aloud at the dinner table may be viewed as an expression of appreciation for the cook’s skills in some societies, but for people with gastroesophageal reflux disease (GERD), such actions can be a constant and involuntary source of embarrassment. GERD, commonly known as acid reflux, is the condition in which stomach acids and its contents flow back up the oesophagus, or our food pipe.

Considering the Emotional in TCM

Traditional Chinese medicine (TCM) takes into account the anatomical cause of GERD as well as the internal disharmonies within the body, such as emotional imbalances and unnatural movement of the qi. Physician Lan Hui from the Eu Yan Sang TCM Clinic at Khoo Teck Puat Hospital, shares that GERD is caused by an imbalance in the liver and stomach, causing rebellious qi to flow upwards, which is in turn manifested in backflow of stomach contents. While imbalances and rebellious qi directly cause GERD, TCM also lists several trigger factors for the condition: bad or improper dietary habits, exhaustion, going to bed late, and excessive stress.

The choice of TCM treatments is dependent on the causes as well as the varying symptoms that patients present. “But if GERD is caused by anxiety or stress or lifestyle habits, we can change these habits with TCM methods and relieve the symptoms.” Physician Lan explains.

The disorder is commonly treated with herbs and other ingredients. According to Physician Lan, a variety of ingredients are used to address the different symptoms. “The treatment should first target the patient’s diet, then balance the rebellious qi. When there is heartburn and sour fluid backing up, we must balance their stomach acid,” she reveals.

While these TCM ingredients may relieve the symptoms, they don’t address the root of the problem if emotional imbalances lie at the heart of it. GERD sufferers have to slow down their pace of life and re-evaluate their trigger factors. Exercises such as tai ji and qi gong can also have a positive effect on their mental state that may be helpful in managing the disorder.

“GERD patients are likely to be young to middle-aged people. This is because their pace of life is faster, and they are more likely to skip meals, go to bed late and have bad dietary habits,” explains Physician Lan. However, Dr Poh Choo Hean, Gastroenterologist at Mount Elizabeth Novena Hospital, observes that GERD is more common and severe in male and elderly patients because of the physiological changes of the ageing body. Dr Amitabh Monga, Specialist in Gastroenterology and Consultant at Raffles Internal Medicine Centre, adds that most GERD patients he sees are overweight to obese middle-aged patients.

The Dangers of GERD

Both TCM and Western science consider GERD to be a chronic disease that requires long-term management in the form of lifestyle modification, drugs and surgery. Longstanding GERD means constant gastric acid irritation of the lower oesophagus. Gastric acid that reaches the mouth causes tooth decay and other dental damage. Potential complications for severe reflux include bleeding, narrowing of the food pipe, and oesophageal cancer in severe cases.

“GERD is an easily recurrent and chronic condition,” states Physician Lan. “Left untreated for a long time, GERD can cause inflammation in the food passage in our bodies, which can result in ulcers. This can be a potential risk factor for cancer,” she warns.

While the risk of cancer from GERD is small, it is nevertheless of concern to Western-trained doctors. “It is rare that GERD is left untreated as most patients will approach neighbourhood general practitioners and polyclinics for help and treatment,” says Dr Poh. “But longstanding GERD can result in Barrett’s oesophagus, which can develop into pre-malignant lesions and oesophageal cancer.”

Photo courtesy of Thinkstock. This article first appeared in NATURA magazine issue No.11. Find NATURA at Eu Yan Sang retail outlets, newsstands and major bookstores in Singapore.