Heartburn (Pyrosis) and Gastroesophageal Reflux (GER)
Heartburn and gastroesophageal reflux (the return of food and acidic stomach juices back up into the esophagus) is a relatively common phenomenon in the current population. As a result of insufficiently strong esophageal sphincter, stomach juices return to the esophagus. Strongly acidic gastric juices (containing hydrochloric acid) irritate the esophagus mucosa and cause an unpleasant feeling of “heartburn” (pyrosis), sometimes even esophagitis. It is a painful burning sensation behind the sternum (similar to angina pectoris) that extends from the stomach to the neck. It is practically similar to vomiting, but the process is not reflexive and is not accompanied by nausea or convulsions. Other typical symptoms of heartburn include a feeling of acidity in the mouth, bad breath, abdominal pain and flatulence. Initially heartburn occurs only after some meals (sweet, baked, fried foods, alcohol, black coffee), in advanced cases of gastroduodenal reflux the patient suffers from heartburn after each meal, sometimes at night. This is aided by the supine position, where gravity disappears. This also results in the inhalation of returned food, which can be manifested as recurrent laryngitis and bronchitis, accompanied by chronic hoarseness and night whooping cough simulating asthma attacks. Furthermore, the patient suffers from repeated inflammations of the middle ear and has increased tooth decay (due to hyperacidated environment in the mouth). Typical symptoms of gastroesophageal reflux include heartburn, a feeling of acidity or bitterness in the mouth, chest pain, dry cough, hoarseness, dental caries, painful swallowing or swallowing disorders.
Risk factors of heartburn
One of the reasons for heartburn and GER may be the so-called hiatal hernia. It is a disorder where a part of the stomach is prolapsed through the esophageal opening in the diaphragm into the chest, and thus facilitates the unwanted return of gastric juices back to the esophagus. However, in many cases hernia is completely free of symptoms and if there is no problem, there is no need to solve it. Hiatal hernia can be detected by X-ray examination. Other reasons for heartburn are related to diet and lifestyle. The cause may be an unhealthy lifestyle involving irregular eating, large portions of food at irregular intervals throughout the day. Also, eating richer meals in the evening, when the metabolism slows down and is not ready to digest complex and fatty foods. Foods that generally cause heartburn are fatty foods such as mayonnaise or fried and deep fried foods, heavily spicy or too hot and cold foods, strong coffee, sour drinks such as red and white wine. Furthermore, it is also difficult to digest foods such as legumes, onions, hard-boiled eggs, cabbage or fresh bread. Alcohol or tobacco smoking can also be a major cause of heartburn, as both substances can lower the tension of the lower esophageal sphincter and thereby promote reflux of gastric juices. One of the common causes of heartburn, namely overweight, is also associated with lifestyle. Increased pressure on the stomach logically causes greater pressure on the esophageal sphincter (a mechanism similar to that of pregnant women), therefore heartburn occurs in overweight people more often. Another cause may be stress unresolved for a long time. Under long-term stress, stomach contraction and possible leakage of gastric juices into the esophagus occur. Heartburn can also occur quite often as a side effect of some chemical drugs.
The view of traditional Chinese medicine or the good life’s gone to our heads
Today’s bells and whistles (food, drink, entertainment, work, stress …) help the emergence of these so-called civilization diseases, which previously did not occur so much. According to TCM, the causes of the aforementioned problems arise from this. There are 4 basic causes detailed in the table below:
|The liver heat attacks the stomach, whose qi rises in the opposite direction GAN RE – WEI QI NI
|the return of acidic undigested food, a burning sensation in the stomach, coming in seizures, belching, heartburn, inflation and abdominal pain.
|left strained XIAN||Herbal mixtures: Cultivation of burned land (code 015) + Harmony of Magic Change (code 063) + Beverage of Chinese sages (code 900)
|Stagnant liver qi attacks the stomach GAN QI FAN WEI
|return of acidic food, feeling of distress in the upper abdomen, nausea, belching, heartburn, sighing, irritability, anger tendency, stress in the anamnesis||red edges and red tip of tongue||strained and strong XIAN SHI||Falling heart stone (code 081) + Harmony of Magic Change (code 063) + Beverage of Chinese sages (code 900)|
|Food stagnation JI SHI
|return of acidic food, overeating in the anamnesis, vomiting of acidic fluids, belching, heartburn, feeling of fullness, pain and inflation in the upper abdomen that is relieved by vomiting, nausea, bad breath, insomnia, loose stools or constipation, loss of appetite||thick yellow sticky coating||tense XIAN or slippery and full HUA SHI||Grace of slender gazelle (code 025) + Beverage of Chinese sages (code 900) + Beverage of five starts (code 850)|
|Damp-heat in the stomach WEI SHI/RE
|return of acidic food, heartburn, nausea, feeling of fullness and pain in the abdomen, feeling of heaviness, thirst without desire to drink, feeling hot, dull yellow skin, sticky||red with sticky yellow coating||slippery and rapid HUA SHUO
|Drying up the rice terraces (code 021) + Cultivation of burned land (code 015) + Beverage of Chinese sages (code 900)
Prevention of heartburn
Prevention of heartburn consists mainly in the elimination of risk factors causing stomach reflux. Preventing these difficulties is therefore related to diet and lifestyle adjustment. We recommend smaller portions of food more often and regularly during the day, sufficient chewing of food and slow swallowing, not devouring! Furthermore, reducing too fatty foods and poorly digestible foods, especially in the evening. Other restrictions should apply to foods that promote the formation of gastric juices, mainly spicy foods and beverages such as coffee or alcohol, as well as sugar, cakes, biscuits, chocolate and sugared drinks. It is not advisable to eat sugars and proteins together, for example, meat and dumplings etc., it is also not recommended to eat fruits immediately after meals – either 1.5 hours before meals or 3 hours after meals! It is not recommended to relax in the supine position after a meal. Sleep with your head in a raised position. It is advisable to drink a glass of settled clean spring water. Adjust your weight in the case of overweight. Include more vegetables and fruits as well as forage (millet, coix, buckwheat, rice, polenta). Drink Beverage of Chinese sages (code 900) at breakfast. Last but not least, prevention of long-term stress that can easily lead to heartburn is mentioned. As far as possible, from the perspective of TCM, it is not advisable to take long-term chemical drugs such as antacids or proton pump inhibitors, as they never cure the cause and only exacerbate the current situation.
It is suitable to use the following herbs, either in the form of decoctions or as part of food: rosemary, sage, chamomile, licorice.