Gastrointestinal (GI) conditions are among the most common health problems in America today. According to the American College of Gastroenterology, more than 60 million Americans suffer from acid reflux alone. Many GI conditions such as IBS, constipation, diarrhea, acid reflux, food allergies, and GI infections can be managed and improved through the use of traditional Chinese medicine (TCM).
Understanding the Phases of Digestion
Acid production in the stomach is regulated by the vagus nerve. The vagus nerve plays a central role in the regulation of gastric acid secretion. The first phase of digestion is the cephalic phase and occurs before meal ingestion. During the cephalic phase, the brain stem produces thyrotropin-releasing hormone (TRH) which is the central excitatory mediator that activates the vagus nerve. As much as 50 percent of the maximal acid response to a meal may occur during the cephalic phase. Experiments have shown that microinjections of small doses of TRH into the dorsal nucleus of the vagus nerve in rats cause significant stimulation of acid secretion and contractions of the stomach.
The second phase, the gastric phase, occurs upon meal ingestion. In response to the activation of the vagus nerve, stomach cells secrete gastric acid (HCl) and gastrin cells secrete gastrin, a peptide hormone that stimulates secretion of acid.
Causes of Acid Reflux
Stress is one of the main root causes of acid reflux. Both the cephalic and the gastric phases of digestion can be affected by stress. The cephalic phase can be affected by stress through interfering with TRH secretion causing a reduction in stomach acid secretion. Administration of oxytocin, a peptide that is known to be released during stress by the intracisternal area of the brain produces an inhibitory effect on acid secretion.
Stress can also cause reduced acid secretion by interfering with the gastric phase. Stress-induced blood flow reduction to the stomach can substantially decrease the stomach cells such as gastrin cells response to the vagus nerve impulses.
The closure of the lower esophageal sphincter (LES) or cardiac sphincter is partially controlled by stomach acid levels. A high quantity of stomach acid triggers a tight closing of the LES. Reduced acid levels under stress produce a weaker signal to close the LES. Therefore, the stomach stays open and allows what little acid is in the stomach to come up and irritate the esophagus and cardiac sphincter, causing symptoms of heartburn, reflux, and even indigestion.
The Role of TCM in Prevention / Treatment
Acid reflux due to reduced stomach acid secretion and compromised blood flow is referred to as middle jiao yang deficiency in TCM. The esophageal structural damage due to acid reflux and stomach lining degeneration caused by reduced blood flow is referred to as stomach yin deficiency. Herbal ingredients such as Linum usitatissimum, Lycium barbarum, rhizome atractylodis macrocephalae (RAM), and many more have all been shown to improve the function and structure of the gut to relieve acid reflux symptoms and eliminate the causes.
A stomach yang product helps eliminate stomach coldness and enhances acid production and stomach contractions by enhancing middle jiao yang and improving stomach blood supply. Ingredients such as Radix ophiopogonis help to repair the stomach and esophageal lining structural damage, as well as restores the health of stomach cells that produce the acid. This helps to increase stomach acid levels and aid in the process of digestion. Normalized stomach acid levels lead to the tight closing of the LES to prevent acid from entering into the esophagus.
Stomach qi in TCM is also an important aspect to consider because the arrested stomach qi can cause tightness of the pyloric sphincter, causing food to not be emptied promptly. This causes further aggravation of the acid reflux. Herbal products that nurture the spleen and the descending stomach qi help regulate the pyloric sphincter to allow for an optimal stomach-emptying process.
Other herbal products can further support improvement by removing heat from the GI tract. For patients who struggle to handle stress or experience chronic stress, formulas containing herbal ingredients, as well as green tea extracts, can help to reduce stress-related symptoms by decreasing excitatory neural activity and reducing free-radical levels in the brain.
Sample Case Study
Complete Resolution of Acid Reflux and Reversal of Esophageal Damage — Dr. Christopher Lewis, DC, Tenn.
A 79-year-old male presented with chronic acid reflux believed to correlate with his idiopathic pulmonary fibrosis. Dr. Lewis recommended a protocol consisting of natural herbal formulas that help restore the patient's digestive enzymes, as well as repair esophageal lining and stomach damage by enhancing stomach yin, middle jiao yang and descending stomach qi, and clearing GI heat.
After a six-week herbal program, an upper gastrointestinal endoscopy by his medical doctor revealed the best report in the past 20 years, showing less esophageal damage. The patient had little to no heartburn symptoms, and had an increased rate of digestion and absorption. The medical doctor recommended continuing the herbal formulas.
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