By Dongfeng Zhou, AP, Dip. OM – When you’re rubbing your full belly after a big Thanksgiving dinner and heading off to bed, you may start experiencing a burning sensation and sour taste in your mouth after lying down. It’s not only unpleasant to taste the same turkey twice, but you are experiencing acid reflux!
Western Medicine Overview and Treatments – According to the American College of Gastroenterology, over 60 million Americans experience heartburn or acid reflux at least once a month. Acid reflux is a condition of the backward flow of stomach acid into the esophagus. Acid reflux is more specifically known as gastro-esophageal reflux disease (GERD). Typical symptoms of the acid reflux include regurgitation of food or sour liquid, heartburn sensation, difficulty swallowing, and coughing or wheezing.
A ring of muscle which connects the upper part of the stomach and the lower part of the esophagus called gastro-esophageal sphincter normally acts as a valve letting food into the stomach but not back up into the esophagus. When this valve is weak and stomach contents are regurgitated into the esophagus, the symptoms of acid reflux are felt such as heartburn. Although acid reflux is closely related to lifestyle factors such as obesity, smoking, drinking alcohol, and high stress, eating choices are important factors as well. Reflux can worsen by eating too much or too close to bedtime, consuming acidic foods such as coffee, chocolate, spicy or fried foods and tomato-based foods. These could trigger acid reflux.
In most circumstances, acid reflux is not life threatening. However, chronic reflux can cause erosion and damage to the esophagus long-term and even increase a person’s chance of getting esophageal cancer. Occasional acid reflux can be reduced by taking over-the-counter antacids. In severe cases, it may require a hospital stay. Medications such as Prevacid, Zantac or Prilosec may be prescribed by a doctor.
Although antacid medications are effective in reducing the symptoms of heartburn, recent warnings by the Food and Drug Administration show that these drugs that may increase the risk of hip, wrist and spine fractures in long-term use. It can also lead to low levels of magnesium in the blood, which can cause muscle spasms and seizures. Hydrochloric acid in the stomach serves an important role in breaking down food and killing bacteria as a first line of defense in gastrointestinal health. Reducing stomach acid with medication allows harmful bacteria into the body and decreases the stomach’s ability to digest food. Several studies have also reported that long-term use of Prevacid and Zantac may reduce the absorption of other essential nutrients such as vitamins and minerals, increasing one’s vulnerability to infections and malnutrition.
Traditional Chinese Medicine (TCM) Overview
Back in 221 BC, Huang Di Nei Jing (Yellow Emperor’s Internal Classic), the first systematic medical book in TCM history, documented the onset of the disharmony that causes gastric issues including acid reflux. It states: “the diseases stem from The Foot Taiyin Channel of Spleen [with symptoms of] vomiting, pain in the gastric cavity, abdominal distention, burning pain below the heart…” It also describes when the liver (wood) energy over-acts on stomach (earth): “In the bursting out of the suppressed wood energy, people often contract the diseases of stomach ache over the epigastrium, fullness of the hypochondria, obstruction in the throat, inability of swallowing the food and drink…”
In Traditional Chinese Medicine, acid reflux is viewed as an imbalance of energy. Three organs closely related to the rebellion of gastric acid are the Stomach (earth in five elements), Spleen (earth in five elements), and Liver (wood in five elements). The Stomach organ-meridian system is the “cooking pot” and responsible for the extraction of nutrients and Qi (energy) from the food, while the Spleen governs the distribution of nutrient substances around the body and directs the waste matter downward to be excreted. The Liver is the director of the flow of the Qi for the entire body, serving the role of policemen for the “traffic control.” Poor dietary habits interfere with the transformation and transportation function of the spleen and stomach. Overeating food causes delays in stomach emptying and generates heat. When under long-term stress, the liver Qi pushes up the stomach heat, thus, stomach acid and contents are allowed back up into the esophagus creating the “heart burn” sensation.
Acupuncture in treating Acid Reflux
Several studies have proven the effectiveness of acupuncture for the treatment of GERD. Studies indicate that symptoms remain resolved even after treatment stops. A clinical trial in 2010 observed over sixty patients with a conclusion that acupuncture can effectively inhibit the intra-esophageal acid and bile reflux in GERD patients and alleviate patients’ symptoms. Some of studies have even had their findings verified by laboratory and imaging tests in addition to patient reports.
Chinese Herbs in Treating Acid Reflux
As mentioned previously, the liver, spleen, and stomach are the primary organs related to acid reflux in TCM. Chinese herbal formulas are based on individual patterns, treating the patient as a whole. Generally speaking, there are three types of disharmonies:
- Liver Over-acting with Stomach Heat Pattern 肝火犯胃
When Liver Qi stagnation turns into heat, it assaults the stomach and pushes the stomach contents upwards.
Signs and symptoms: acid regurgitation, burning sensation in the epigastrium or throat, bitter taste in the mouth, dry throat with thirst and preference for cold drinks, distending pain in the hypochondria and irritability. The tongue is red with a yellow coating.
Representative herbal formulas: Chai Hu Shu Gan San and Zuo Jin Wan. Both formulas address the Liver Qi stagnation, which may manifest as anxiety and depression with agitation. Zuo Jin Wan focuses more on the stomach heat, such as burning and regurgitation. Huang Lian (Coptis Rhizome), the key herb in the formula, is bitter and cold, and it is the number one herb for draining stomach fire. Berberine, a natural chemical in Huang Lian, is proven to have antibacterial and anti-inflammatory effects to help protect the stomach lining or any eruptive dermatitis.
- Stomach Cold Pattern 脾胃虚寒
This pattern is less common and usually seen on spleen and kidney yang deficient patients. Those patients have poor digestive function due to a weak constitution.
Signs and symptoms: acid regurgitation with clear fluid, burping frequently, stomach pain and distention relieved with warm and pressure. Preference for warm drinks, cold limbs, and loose stools. The tongue is pale with a white tongue coating.
Representative herbal formulas: Xiang Sha Liu Jun Zi Tang and Shen Ling Bai Zhu San. These two formulas strengthen the spleen’s and stomach’s normal transportation and transformation functions. Ren Shen, Bai Zhu, Fu Ling and Zhi Gan Cao in these formulas help fortify the Qi, warm spleen yang, facilitate nutrient absorption and prevent loose stool. Xiang Fu and Sha Ren are key herbs that move the Qi for the gastrointestinal tract and help with bloating and regurgitation of stomach acid. Sheng Jiang (ginger) is an another herb commonly used for stomach cold and can be added to descend rebellious stomach Qi.
- Disharmony of Spleen and Stomach Pattern 脾胃不合
Disharmony of spleen and stomach is usually caused by poor diet, Western drugs and high stress. It compromises the ability of gastrointestinal system to bear the clear fluids and energy upward and down-bear the turbid. The end result is congestion of the middle burner with a mix of heat and cold signs.
Signs and symptoms: fullness and distention of the gastrium, indigestion, agitation, sighing frequently, vomiting bitter fluids, and sluggish stools. The tongue is pale with a yellow coating.
Representative herbal formulas: Ban Xia Xie Xin Tang and Bao He Wan. The first formula most treats glomus or feeling of fullness below the heart, but it’s also very effective in preventing acid reflux due to congestion. Ban Xia is the “phlegm” herb and an antiemetic due to its inhibitory effect on the CTC reflex, suppressing vagal gastric activity, acting as a facilitation agent on drying the mucus and down bear the turbid. Bao He Wan is the classic formula for digestion stagnation due to dietary intemperance, and it contains naturally fermented enzymes as a gentle formula for pediatric patients to promote digestive function and a healthy appetite.
Lifestyle Changes Cane Help Acid Reflux
TCM and Western medicine agree on many lifestyle suggestions to reduce acid reflux such as avoiding spicy foods, sugar, coffee, and alcohol. These add “heat” to the stomach and irritate the stomach. Eating frequent, small meals helps reduce reflux by reducing the pressure on the valve between the stomach and the esophagus so that less acid is pushed into the esophagus. Laying down can allow stomach acid into the esophagus, so raise the head of the bed 2 inches or lay on pillows, and don’t eat less than two hours before bedtime. Excess body weight puts pressure on the internal organs, pushing stomach acid up into the esophagus, so losing weight if one is overweight will help with reflux. Lastly, acid reflux is almost always worse with stress. Exercising, meditating, and using breathing techniques can reduce stress and help reduce reflux.
Food Therapy Help for Reflux
Homemade tea can help acid reflux if herbal therapy isn’t available. Two or three nickel-sized pieces of fresh (peeled) ginger, two or three quarter sized pieces of organic orange peel, and a tablespoon of lemon juice can be steeped in hot water for 5 minutes. This will help soothe the stomach, increase peristalsis, and reduce the reflux symptoms. The tea should be a temporary fix, not to replace a physician’s assessment of the cause for the reflux.
Acid reflux or GERD is not a new phenomenon. TCM has a rich history of treating reflux disease based on a person’s underlying condition. In addition to herbs and acupuncture, lifestyle changes and food therapy can help patients manage acid reflux symptoms. Seeking an assessment from a qualified acupuncture physician will help ensure proper diagnosis and treatment.
- Bratianu, Patricia. “Get Relief From Acid Reflux With Traditional Chinese Medicine.” Sepalika.com, Sepalika, 13 Nov. 2017, www.sepalika.com/gerd/chinese-medicine-acid-reflux/.
- Ellis, Andrew. Notes from South Mountain: a Guide to Concentrated Herb Granules. Thin Moon Pub., 2003.
- Feleke, Yoseph. “Natural Treatment for Acid Reflux: Traditional Chinese Medicine.” Natural Treatment for Acid Reflux: Traditional Chinese Medicine, Acupuncture and Massage College, 7 Apr. 2016, www.amcollege.edu/blog/natural-treatment-for-acid-reflux.
- Gaeddert, Andrew. “How Do You Treat Heartburn and GERD?” How Do You Treat Heartburn and GERD?, Acupuncture Today, 1 Feb. 2001, www.acupuncturetoday.com/mpacms/at/article.php?id=27754.
- Huang, Kee Chang. The Pharmacology of Chinese Herbs. CRC Press, 1999.
- “Indigestion and Reflux.” The Traditional Chinese Approach to Digestive Problems – Fusion Health, Fusion Health, www.fusionhealth.com.au/health-categories/digestion-liver-detox/indigestion-and-reflux.
- Mae, Senia. “Curing Acid Reflux with Chinese Medicine.” Curing Acid Reflux with Chinese Medicine, Healing InSight, 12 Dec. 2016, healinginsightonline.com/curing-acid-reflux-with-chinese-medicine/.
- Rabin, Roni Caryn. “Ask Well: Taking Heartburn Drugs Long-Term.” The New York Times, The New York Times, 15 Oct. 2015, well.blogs.nytimes.com/2015/10/15/ask-well-taking-heartburn-drugs-long-term/.
- Zhang, C X, et al. “Clinical Study on the Treatment of Gastroesophageal Reflux by Acupuncture.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Aug. 2010, www.ncbi.nlm.nih.gov/pubmed/20697939.
- 中医内科学。中国中医药出版社。2007 年第二版。
- 黄帝内经。 中华书局。2010 年。