What is GERD?
GERD or Gastro-oesophageal reflux disease occurs when the acidic contents in the stomach move upward to the oesophagus. In a normal digestive pathway the food moves into the stomach for digestion through the oesophagus. Once the food moves into the stomach a valve like structure at the bottom of the oesophagus closes to prevent the upward movement of the food. This structure is called as the lower oesophageal sphincter or LES.
Due a variety of reasons the lower oesophageal sphincter can lose its ability to close properly. This results in the possibility of the upward movement of the food from the stomach back to the oesophagus. This partially digested food that contains a lot of acidic content can irritate the lining of the oesophagus. This results in the symptoms like heart burn that is characteristic of GERD and is also called Acid Reflux disease.
As already said GERD occurs due to the weakening of the lower oesophageal sphincter. There are number of factors that can impair the functioning of the lower oesophageal sphincter. It is normal for everybody to feel an occasional acid reflex that can be due to overeating or certain foods. But a regular occurrence of acid reflux is treated as GERD.
The risk factor for GERD include:
• Hiatal hernia
• Diseases like Scleroderma
• Improper food habits
Factors that can aggravate the acid reflux include:
• Certain types of food like oily, spicy or fried food
• Eating large meals
• Eating just before sleeping
• Beverages like alcohol or coffee
• Medications like aspirin
Heartburn is the most common symptom of GERD. It is usually felt in the chest area but may extend to the throat. Other common symptoms include:
• Chest pain
• Difficulty in swallowing
• Sour taste in the tongue due to acid reflux
• Feeling of a lump in the throat
• Recurrent cough
• Hoarseness of voice due to laryngitis
• Disruption of sleep
GERD treatment in Ayurveda:
Ayurveda offers various treatment protocols for controlling the symptoms of GERD. The aim of ayurvedic treatment is to restore the levels of pitta dosha, which is aggravated during GERD.
According to Ayurveda a disease occurs due to an imbalance of doshas or body humors. There are three types of doshas or humors in a human body namely vata, pitta and kapha. These doshas are made up of the five basic elements or ‘panchabhutas’ of nature namely earth, fire, water, air and space. These doshas regulate the various functions assigned to various organs of the body.
The vata dosha regulates the neuromuscular functions in the body. Pitta dosha regulates the metabolic activities of the body while kapha controls the fluids in the body.
Usually the three doshas are in a state of dynamic equilibrium. Any change in the level of a particular dosha is counteracted upon by the other two doshas to restore the equilibrium. But an abnormal increase in the levels of a particular dosha can create a severe disharmony in this balance. This according to Ayurveda leads to a disease condition.
In GERD there is a severe aggravation of pitta in the body. The increased levels of pitta dosha affect the metabolic activities of the body. The digestive process is impaired and there is an increase in the level of acids in the stomach. This increased level of acids or ‘amla’ in the stomach creates various disturbances throughout the digestive system.
Ayurveda calls this condition as amlapitta. The symptoms of amlapitta and GERD are very similar in nature. The aim of ayurvedic treatment for GERD or amlapitta is to restore the aggravated pitta levels to a normal state. The treatment approach to achieve this goal is multipronged.
Ayurveda is a holistic system of medicine that puts emphasis on treating the body and the mind as a single unit.
A lot of stress is placed on the modification of the food habits of the patient. This is called ‘pathya’ or avoidance of food that aggravate the particular dosha, pitta in the case of GERD. In fact, according to Ayurveda one of the main causative factors of amlapitta or GERD is unhealthy food habits. Another causative factor is an improper daily routine or ‘dinacharya’. These two factors combine together to create the disease.
Excess and improper intake of pitta aggravating food increases the level of acids. An unhealthy daily routine include sleeping at odd hours, prolonged inactivity, lying down soon after a meal etc. These create impairment in the normal digestive process resulting in the increased formation of acidic contents in the stomach. There is also an upward flow or regurgitation of the acidic food contents to the oesophagus. This condition is called as urdhwagami amlapitta, the symptoms of which are similar to GERD. Virudhahara or food with contradicting properties is a major contributor to the disease. So is dushyahara or improperly cooked or stale food.
The GERD treatment in Ayurveda includes panchakarma, oral medications and observance of pathya or specific diet. All or some of the treatments in panchakarma may be employed in treatment. Oil massages or snehana is the preparatory phase of panchakarma treatment. Swedana or induced setting is also a pre-panchakarma procedure. Abhyanga or full body oil massage is done to relax the body. The major panchakarma treatment for GERD include-
• Vamana or therapeutic vomiting-medicines that induce vomiting is administered during therapy. The toxins that have built up in the body are eliminated through this process.
• Virechana or purgation-Medicines are administered for purgation which helps to clean up the digestive tract as a whole.
• Vasti- this procedure involves the administration of medicated enema to clear the digestive tract.
A lot of emphasis is placed on Pathya or adherence to a specific diet. Foods that increase pitta levels are strictly avoided and those that help to restore the pitta to normal are prescribed. Ayurveda also prescribes methods for relaxing the mind as well since mental stress can cause hyperacidity. Yoga and meditation are helpful for relaxing the mind according to Ayurveda.
The duration of treatment is around 14 -21 days in hospital and the cost of GERD treatment in Ayurveda is in the range of 900 to 2800 USD