Gastroesophageal Reflux Disease ( GERD)

Posted on April 18, 2019

Put out the fire!

By Dr. Alexandra Shustina, DO

The feeling the chest is on fire after eating can be from Gastroesophageal Reflux Disease or GERD. This is affecting more and more Americans today. As our society becomes more obese and fast food oriented, GERD has increased. How do you know if you have GERD? Typical symptoms are “heartburn” and indigestion. There are also atypical symptoms such as chest pain and hoarseness. Chest pain can also be a sign of something more serious and that always needs to be evaluated by a doctor.

The esophagus is the food passage connecting the mouth to the stomach. It is a pipe with an opening at each end. It is important for those openings to stay closed so that the acid and food in the stomach does not “reflux” and go back up into the esophagus. Many foods can keep these openings from properly being closed and worsen reflux symptoms. Typical foods which can do this are caffeine, alcohol, and peppermint. Eating large meals or eating late at night can also make things worse.

Reflux has also been associated with “visceral hypersensitivity.” which means normal bodily functions are “hypersensitive” and painful (1). Since we all process pain differently, we may all experience symptoms of reflux differently. Bodily functions which appear “normal” may cause significant pain to a person. Pain is a marker that something is wrong. The body is sending a red flag and screaming for help How can we treat this? There are gentle hands on therapies which can alleviate this at the root level (2). Visceral manipulation is a light manipulative therapy which corrects mobility and motility and removes the ligamentous and fascial restrictions allowing the organ to function optimally.

I often hear from patients that they get heartburn symptoms or worsening of their already present reflux symptoms when they are involved in an emotionally stressful life event. This is because of the vast neurological connections between the brain and digestive organs. Studies have shown that stress is intimately related with symptoms of reflux (3)

The standard therapy for reflux disease is to decrease acid in the stomach. Since the contents of the stomach are less acidic and caustic, there is less discomfort to the esophagus. Although this can be effective at relieving symptoms, stomach acid is an important part of digestion and protecting us from infections. Lower stomach acid can predispose someone to infections and alter the vital bacterial populations in and outside of our bodies called the microbiome.

Diet is an important part of preventing and treating reflux. Greasy and spicy food can aggravate symptoms and large meals can also cause problems. It is important to avoid food at least three hours before bedtime since gravity works against us while we are laying down. Most importantly, eat a healthy, natural diet with lots of organic vegetables and good fats. Processed foods and refined sugars, are always out. Keep the acid in your stomach where it belongs and keep your esophagus healthy!


  1. C. Prakash Gyawali, MD Esophageal Hypersensitivity. Gastroenterology and Hepatology (NY) 2010 Aug; 6(8) 497-500. 
  2. Visceral Manipulation and Dyspepsia Study [PDF] – The Barral Institute – by M Harrow.
  3. Eun Mi Song, Hye-Kyung Jung and Ji Min Jung. The Association Between Reflux Esophagitis and Psychological Stress. Dig Dis Sci. 2013 Feb, 58(2): 471-477.

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