Gastroesophageal Reflux Disease(Gerd)
Gastroesophageal reflux disease (GERD/ esophagitis, is a complex disease with serious complications. It results from reflux (backward flow) of the stomach contents into the esophagus and causes trouble symptoms at least two times a week. Reflux of infectious agents, chemical irritants, physical agents, such as radiation and nasogastric intubation can cause GERD and can irritate and inflame the esophagus causing heartburn, belching, sore throat and other symptoms.
Causes :
GERD is caused by frequent acid reflux or reflux of nonacidic content from the stomach.
When you swallow, a circular band of muscle around the bottom of the esophagus, called
the lower esophageal sphincter, relaxes to allow food and liquid to flow into the stomach.
Then the sphincter closes again.
If the sphincter does not relax as is typical or it weakens, stomach acid can flow back into
the esophagus. This constant backwash of acid irritates the lining of the esophagus, often
causing it to become inflamed.
Common Symptoms :
- A burning sensation in the chest, often called heartburn. Heartburn usually happens after eating and might be worse at night or while lying down.
- Bitter/sour taste in the back of the throat.
- Sense of a lump in the throat.
- Abdominal bloating/Abdominal discomfort.
- Gas.
- Chest pain.
- Laryngitis.
- Dysphagia.
- Chronic Cough.
- Feeling the food is trapped behind the breastbone or in the throat.
- Nausea after eating.
- Burning sensation that begins at the xiphoid process and radiates up toward the neck.
- Intense sharp pain behind sternum with radiation to the back.
Less Common Symptoms :
- Difficulty swallowing (dysphagia).
- Hiccups.
- Hoarseness or change in voice.
- Sore throat.
- Wheezing.
- Ear Ache.
Endoscopic findings can be used to grade the severity of reflux esophagitis :
- Grade A: One or more mucosal breaks ≤ 5 mm that do not cross the tops of 2 mucosal folds.
- Grade B: One or more mucosal breaks > 5 mm that do not cross the tops of 2 mucosal folds.
- Grade C: One or more mucosal breaks that cross ≥ 2 mucosal folds and involve < 75% of the esophageal circumference.
- Grade D: One or more mucosal breaks involving ≥ 75% of esophageal circumference.
Ayurvedic View :
In Ayurveda, GERD is known as Amlapitta.
Pitta is one of the three primary bioenergies responsible for digestion. when it becomes
excessively sour, it results in this condition.
According to Ayurveda, digestive fire is the underlying cause of Amlapitta.
Several reasons can weaken your digestive fire, including:
- Incompatible food combinations.
- Contaminated food, mainly fried or processed items.
- Spicy foods.
- Carbonated beverages.
- Fermented foods.
If GERD is left untreated, the aggravated pitta bioenergy can also imbalance vata and kapha bioenergies, worsening it further
Treatment :
- Vamana – therapeutic emesis.
- Virechana – therapeutic purgation form the key treatments to combat amlapitta in an effective way. Emesis is preferred in the amlapitta having upward course and purgation is the treatment of choice in amlapitta having downward course.
The intension is to eliminate the disease causing doshasin the direction of their manifestation.