Reflux: Written by an acupuncturist who gets it!
Reflux occurs when stomach acid works its way into the oesophagus and often travels as far up as the throat. A minor form of reflux might be considered indigestion, perhaps causing bloating and burping. A severe attack can cause terrible pain to radiate through the chest and back up into the throat. Often reflux can mimic the symptoms of a heart attack, and/or include a burning bile sensation from the chest to the throat, hence the very apt and common name of ‘heartburn’. If you suffer from reflux more than a few times a week you may be diagnosed as having gastroesophageal reflux disease (GERD).
Why is my heart on fire?
There are various reasons why reflux occurs. The primary reason is failure of the oesophageal sphincter. This is a ring type muscle that acts as a valve, allowing food to pass into the stomach and then preventing acid from flowing back up. But let’s face it, sometimes the pressure on this little value might just be too much to bear. Pregnancy is an obvious cause, as the bigger the baby the less room in the tummy for usual digestion. Other causes may be over eating, eating very spicy or rich food and perhaps lying down or reclining after feasts which literally forces gastric acid up rather down. Another common cause of heartburn is a hiatus hernia. This is where the stomach bulges beyond the diaphragm and into the hiatus region of the oesophagus, thereby bypassing the diaphragm and the sphincter and allowing the acid to travel up, up and away.
Why me and not you?
If you’re not pregnant and don’t have a hernia it may be perplexing as to why your friend can munch down a whole bowl of tasty chilli con carne but if you even cast a glance at the dish you can feel your throat burning. Well, biomedicine doesn’t offer much here, besides luck of the draw and some genetic influences. Traditional Chinese Medicine (TCM), however, explains why someone may be more prone to reflux. Fundamentally reflux represents a pattern called stomach Qi rising or rebellious Qi. Normally, as with digestion, the stomach Qi or energy churns and turns then descends into the small intestine. However when a disharmony occurs the Qi will rise instead of descending, causing reflux. This makes sense but it’s important to note why the Stomach Qi may become rebellious. Usually it is the result of an underlying pattern. A pattern in Chinese medicine represents the nature of disharmony or imbalance in the body that can lead to symptoms.
Here are some common TCM patterns of reflux:
Liver qi stagnation
The liver in Chinese medicine is said to support the digestive system. If the Qi of the liver stagnates, rather than being supportive, it can attack the gut and cause a disturbance in the stomach. What causes Liver Qi stagnation? The main thing is stress. A constant emotional pressure, such as work or something more personal, will eventually create an imbalance. The extent of the impact of this imbalance depends on many issues, but heartburn or indigestion is a common one.
Liver heat is often a follow on effect of Qi stagnation, particularly if the Qi blockage is chronic. Other things may cause liver heat directly, such as excessive alcohol or spicy food. These can create what is known in TCM as internal heat, or more specifically liver heat. Once again an imbalance in the Liver will disturb the gut, particularly if there is heat. The nature of heat is to rise. You can see where this is going. Generally, you might be OK with a slight tendency to have reflux, but if you mix a curry and a couple glasses of red and throw in a stressful day, prepare to burn.
This pattern is a little self-explanatory. If on a regular basis you overeat, or are particularly naughty with what you eat, the gut function may weaken. The stomach’s ability to churn and turn, eliminate and absorb is comprised. The gut becomes permanently congested and as soon as more food enters it rather than descending and creating the digestive process, the stomach simply returns to sender.
What can be done?
To soothe acute reflux, using over-the-counter or prescription anti-acids will often help. However, if these are taken too often they will disturb the equilibrium of the stomach and potentially cause more or different digestive problems. Another biomedical strategy is using a proton pump inhibiter medication. This medication inhibits the production of stomach acid completely. It is not without side effects, however, such as diarrhoea, excessive gas or bone density issues due to the compromised calcium absorption. It is important to note that sometimes these treatments are necessary as excessive long-term reflux may cause damage to the oesophagus, which could lead to serious consequences such as cancer.
But perhaps more can be done to treat reflux and prevent further occurrence. If we change the how the body behaves by improving the health of the gut, perhaps it won’t be as prone to reaction. Naturally, tweaking some habits may help a lot here. I enjoy wine as much as the wobbly person next to me, but overindulgence (particularly regularly) will certainly harm my gut function. Other foods that seem to exacerbate heartburn are:
- Spicy foods
- Rich foods
- Wheat based foods
- Acidic foods
- Processed foods with a high level of sugar and salt
This list is not exclusive and different foods react with different people. It is important to identify either what food or what combinations of foods create reflux. If you can, avoid or reduce them. If you love them, make them a special occasion. If you react to almost everything and are in constant pain it may be time to get some help.
Acupuncture can have a profound effect on the gut. It can send that stomach Qi down and usually provide instant relief. I have seen this in the clinic time and time again. However, it’s not magic. Acupuncture is only one slice of that spicy pizza, and more than one treatment is usually needed for sustained relief.
Chinese herbs are also given to the client to take home. Chinese herbal medicine is obviously ingested, therefore having a direct impact on the gastrointestinal tract. Coupled with some lifestyle changes, herbs may begin to create change in the gut. And remember, it’s not ideal to suffer reflux for a long time. Apart from it ruining the moment, it can lead to complications down the track. So if you need help with reflux, get in touch.
Here are some recent journal articles demonstrating how Traditional Chinese Medicine can help with reflux. Hopefully there will be some more thorough research papers on the way.
- Daijing Lu (2015). ‘The Effect of Combined Use of Acupuncture and Medicine on Astrin and Motilin in Reflux Esophagitis Patients’. International Journal of Clinical Acupuncture, 24(2), 83-86.
- Zhen Ci Yan Jiu (2016). ‘Clinical Trial of Acupuncture Treatment of Gastro-esophageal Reflex Disease by Needling Dorsal Segment of the Governor Vessel’. 41(2), 150-3.
Chinese Medicine Practitioner