February 2015

Root cause Ayurveda management to GERD [GASTRO ESOPHAGEAL REFLUX DISEASE]

Prevalence of gastro-oesophageal reflux disease (GERD) in all ages has shown an upward trend over the past decadesin India. This disease affects 15 million Americans. Latest to join the club of GERD was Mr President OBAMA!!

GERD Acid reflux occurs when stomach acid flows backwards up into the esophagus. The esophagus is the structure that connects the throat to the stomach. Gastroesophageal refers to the stomach and esophagus. Reflux means to flow back or return. Therefore, gastroesophageal reflux is the return of the stomach's contents back up into the esophagus.

In normal digestion, the lower esophageal sphincter (LES) opens to allow food to pass into the stomach and closes to prevent food and acidic stomach juices from flowing back into the esophagus. Gastroesophageal reflux occurs when the LES is weak or relaxes inappropriately, allowing the stomach's contents to flow up into the esophagus.

The severity of GERD depends on LES dysfunction as well as the type and amount of fluid brought up from the stomach and the neutralizing effect of saliva.


a. A burning sensation in your chest (heartburn), sometimes spreading to your throat, along with a sour taste in your mouth.
b. Chest pain.
c. Difficulty swallowing (dysphagia)
d. Dry cough.
e. Hoarseness or sore throat.
f. Regurgitation of food or sour liquid (acid reflux)
g. Sensation of a lump in your throat.

Ayurveda Classics have mentioned a disease Urdhwag Amlapitta which has a striking resemblance to GERD. Effective formulations are suggested for the management of GERD along with dietary recommendations.

According to Ayurveda, an improper diet and lifestyle is the main cause of disease. All pitta aggravating foods and behaviour lead to Urdhwag Amlapitta.

Causes:


1. Excessive use of the oily and spicy foods
2. Impaired agni- body metabolism
3. Stressful situations - Anxiety, depression and anger
4. Irregular eating habits.
5. Consumption of refined products/processed foods in large quantity.
6. Use of leafy vegetables in excess
7. Sleeping/lying down immediately after meals
8. Irregular/inadequate sleep in the night, long working hours.
9. Excessive intake of alcohol, caffeine and nicotine products.
10. Long Standing Constipation
11. Frequent and excessive use of aerated drinks
12. Foods which are rich in fats, such as chocolates,cheese etc.
13. Skipping Meals

Heartburn is also common during pregnancy and as a result of obesity. Its frequency increases with age.

Although we tend to regard antacids drugs lightly, they are real medicines with real consequences. In the end, they just mask the symptoms of acid reflux or heartburn and do nothing to fix the underlying problem; in fact, they make the problem worse in the long run.

1. Antacids may cause dose-dependent rebound hyperacidity and milk-alkali syndrome.
2. Antacids that contain aluminium hydroxide may cause constipation, aluminium-intoxication, osteomalacia[Vitamin-D deficiency], and hypophosphatemia[Phosphate deficiency].
3. Antacids that contain magnesium have a laxative effect that may cause diarrhoea, and in patients with renal failure they may cause increased magnesium levels in the blood, because of the reduced ability of the kidneys to eliminate magnesium from the body in the urine.

Sometimes GERD results in serious complications. Esophagitis, i.e., collection of excessive stomach acid in the esophagus, could lead to esophagaeal bleeding or ulcers. In addition, a narrowing or stricture of the esophagus may occur from chronic scarring. Some people develop a condition known as Barrett's esophagus[Changes in cellular structure of esophagus due to excessive stomach acid]. This condition can increase the risk of esophageal cancer.

Ayurveda management focusses on Diet, lifestyle, Medicine and treatment to bring the pitta in place. Avoid all hot, sour, oily, fried and fermented foods, alcohol and tobacco.Appropriate foods are those that are light, fresh and easy to digest. In your diet, include foods that are sweet, cool and preferably alkaline. Herbal decoction made from coriander, cumin, and fennel seeds is cooling to the system and is an effective digestive aid.

Mindful eating and stress free lifestyle is recommended for proper digestion and general well-being.

Ayurveda Classical medicines of choice in treating GERD are shatawari, amalaki, narikel (coconut), sharkara, haritaki etc. These are gentle yet effective and free from side effects.

Intensive deep cleansing therapies like Vamanam and Virechanam are advised as per the clinical presentation of GERD.


Shatawari
      
Yashtimadhu
      
Amalakki
      
Gudchi

Dr Mahadevan Iyer, Medical Superintendent – Senior Physician at AyurVAID Has expertise in the area of Gastro Esophageal Reflux Disease. He has had several patients from India and abroad treated for this severe diseasHe has treated several patients from India and abroad for this sever disease.

Dr Mahadevan is of the opinion that Ayurveda provides an effective solution to GERD through root-cause management.

A careful diet, disciplined lifestyle with a right prescription of Ayurveda medicines and treatments will work wonders for GERD!!

One of Dr Mahadevan’s patient who completed the treatment for GERD writes to us: “He was completely in bad health with severe acidity reflux problem and body heat before he came to AyurVAID”. He met Dr Mahadevan at AyurVAID Hospitals Domlur for the root cause management of GERD. “He is now completely fine; his acid reflux has been resolved and is following a strict diet and lifestyle pattern suggested.

Recipe: Moong Dal Soup

Ingredients:
1 cup whole green mung beans, 5-6 cups water, 2 tbsp sunflower oil, 1 tbsp cumin seeds, 1 tbsp black mustard seeds, 1 pinch hing, 2 large cloves garlic chopped, 5 curry leaves fresh or dried, 1 Small handful cilantro leaves chopped, ½ tbsp turmeric, ½ tbsp salt

Method:
Wash the beans twice and soak overnight in plenty of water. Drain. Add the beans and 4 cups of water to a soup pot and bring to a boil. Stir beans occasionally to prevent sticking. Cook on medium heat, uncovered, for 30 min.

Add 1 more cup of the water and continue to cook for another 15-20 minutes or until beans are tender. Set aside.

Heat the oil in a small pan until medium hot, then add the mustard seeds, cumin seeds and hing. In a moment, when the seeds pop, stir in the garlic and brown lightly.

Add the curry leaves, cilantro, turmeric. Mix quickly. Stir this spice mixture into the soup. Add the salt. Add some or all of the last cup of water, depending on how thick you want the soup.

Bring to a boil for 2 minutes and serve.

Benefits:

1. Green mung is sweet and astringent with a cooling energy.
2. This soup is a high protein combination and an energizer when used wit rice and chapattis.
3. It is ligh to digest and balances the three doshas.
4. People with indigestion can easily digest green mung soup.

Doctor of the month


Dr Akarshini A M, BAMS, FRHS, MD, PhD Ayu (GAU), AyurVAID Diabetes Speciality Clinics, Jaynagar, Bangalore; She brings around 5 years of experience in the field of Ayurveda. She holds a Bachelor of Ayurveda Medicine and Surgery from JSS Ayurveda Medical College and Hospital, Mysore; Post Graduation from Government Ayurveda Medical College, Mysore and PhD from prestigious, Gujarat Ayurveda University, JamNagar.

She specializes in diabetes and diabetic complications, like Diabetic Nephropathy and Diabetic Polyneuropathy. She also specializes in the fields of neurodegenerative diseases, gastrointestinal disorders, psychiatric disorders, musculoskeletal disorders and respiratory illness.