Acid Reflux (Gastroesophageal Reflux) Disease, Defined:

Acid Reflux Disease, or gastroesophageal reflux disease, is a common, relapsing disorder that occurs when the liquid content of the stomach is regurgitated (i.e. refluxing) into the esophagus by passing through a barrier valve which normally separates the two structures. Because the liquid contains acid and pepsin (products of digestion within the stomach), and possibly bile, many individuals will experience heartburn, reflux, and chest pain. Although the exact mechanisms of esophageal inflammation and damage are not fully understood, the stomach acid is thought to be the most injurious component. 

Most individuals have regular bouts of reflux, but most of us do not realize that this process is taking effect. Gravity and swallowing act as protective mechanisms for the esophagus. Additionally, our saliva contains bicarbonates which effectively neutralizes any remaining acid in the esophagus once the actions of gravity and swallowing have subsided. GERD patients, however, often possess greater concentrations of acid in the refluxed liquid. As well, the acid remains in the esophagus for longer periods of time than in non-sufferers, as saliva cannot effectively neutralize these increased concentrations of acid.

What Causes Acid Reflux?

There are a multitude of causes that are thought to contribute to the onset of this condition. However, these mechanisms operate differently from person to person. The most common and universal causes of GERD remain;

• Abnormal function of the lower esophageal sphincter (LES)
• Esophageal contractions (peristalsis)
• Emptying of the stomach
• Hiatal hernia
• Specific dietary concerns

Of these, the action of the lower esophageal sphincter is thought to be the most important contributing factor in reflux prevention. LES relaxations are thought to be a probable causative factor in the abnormally slow emptying of the stomach after meals, as well.

Diagnosis of Acid Reflux:

A patient's desire to eliminate the condition's most common and most uncomfortable characteristic, heartburn, is used by doctor's as a preliminary means of assessing condition severity. The term 'heartburn' describes the burning sensation felt in the middle of the chest that occurs after meals or when a person is lying down. If acid reflux is suspected, your physician may warrant the use of prescription medications to suppress productions of stomach acid. If heartburn is eliminated, GERD, or acid reflux, is then confirmed. However, there are problems with this method of diagnosis because the validation of disorder through various diagnostic tests has been omitted. Other procedures used to diagnose and confirm underlying complications include; endoscopy, biopsies, X-rays, and gastric emptying and acid perfusion studies.

However, because of the many discrepancies relating to discomfort and pain sensations from each acid reflux patient, the two most effective standards for GERD diagnosis are:

Esophageal acid testing: The esophageal acid test is used to determine the amount of acidity within the esophagus over a 24-hour period. A catheter is passed through the nose and into the esophagus with an attached sensor that is used to gauge esophageal acidity (Ph). The end of the catheter exiting from the nose is wrapped around the ear and, most commonly, down the waist to a reflux recorder. Each time acid reflux occurs, the recorder does it's job; recording Ph data for a 20 to 24-hour duration. Today, there are newer, more refined, and prolonged measurements detailing acid exposure in the esophagus. Esophageal acid testing is also employed to monitor treatment effectiveness and to evaluate patients prior to surgical treatments for acid reflux. 

Esophageal motility testing: Motility testing is used to determine the health and function of esophageal muscles, or how well the muscles of the esophagus are working. As well, abnormal contractions of the esophagus often mimic GERD even if reflux is absent. This test has two important functions in GERD assessment:

1. Evaluating symptoms that do not respond to conventional acid reflux treatments
   
2. Evaluation prior to endoscopic treatments, or surgery, for GERD; enabling the physician to make any needed modifications in these evaluations and/or subsequent treatments

Signs and Symptoms of GERD:

The symptoms of acid reflux are denoted by disease type; either uncomplicated or complicated GERD. Uncomplicated reflux is associated with:

• Heartburn
• Regurgitation
• Nausea

Complicated GERD, on the other hand, is injurious to the esophagus and may lead to the development of other complications, such as:

• Ulcers
• Strictures (formation and shrinking of scar tissue; narrowing the lumen of esophagus)
• Barrett's esophagus
• Cough and asthma
• Inflammation of the throat, larynx, or lungs
• Infection of the lungs
• Fluid in sinuses and middle ear

Standard GERD Treatments:

Today, treatments for acid reflux are all-encompassing and range from modifications of diet and lifestyle to surgical procedures. Most physicians will implement aggressive techniques, since reflux can worsen and lead to other problems associated with the esophagus. Upon the evaluation of your personal history, the first method of treatment and esophageal preservation is lifestyle change. Changes in lifestyle are actually a combination of several alterations in habit, most notably through diet, but may also include limiting alcohol consumption, quitting smoking, and regular exercise. Certain foods are known to reduce the pressure of the lower esophageal sphincter and promote acid reflux.

Despite their short-action, antacids are also widely employed to neutralize the acid in the stomach, ensuring that reflux does not occur. These may be aluminum, magnesium, or calcium-based products. Stronger, longer-lasting, prescription medications can also be used for substantial, and often permanent, neutralization of stomach acid. These can include:

• Histamine 2, or H2 antagonists (Tagament)
• Proton pump inhibitors (PPIs)

PPIs are used when H2 antagonists do not adequately reduce symptoms, or when other complications caused by GERD exist. This classification of medicines include Prilosec and Prevacid. PPIs work by blocking the secretion of acid into the stomach by our body's natural acid-producing cells. Finally, when drug treatments fail, surgery and endoscopy treatments exist as highly effective techniques to relieve the existing symptoms of GERD.

Alocid: Your non-invasive stand against GERD and its many discomforting symptoms:

The problem with prescription and surgical treatments is the sheer number and amounts of drugs needed to be taken. Additionally, the invasiveness to one's quality of life often outweighs the potential benefit. In fact, many patients who have had surgery (approximately 50%) will need to continue prescription drug treatments for acid reflux management. This further underscores the importance of early diagnosis, and addressing the disease by alternate means, namely nutritional supplementation.

Alocid contains clinically evaluated ingredients, known to support both esophageal health and the body's complex digestive process; thereby lessening the chance of developing the many discomforting symptoms associated with your reflux condition. Progressive Health's unique blend of nutrients include:

• Orange Peel Extract 4:1- Orange peel can provide symptomatic relief from reflux and indigestion. Interestingly, citrus peel extracts have even shown the ability to induce programmed cell death in stomach cancer cells.
  
  
• Aloe Vera Extract Powder (100X)- Aloe vera extract has been used for years to aid in digestion and has a documented history of clinical use for the treatment of ulcers in the digestive tract (4). This soothing plant is considered to be a gastroprotective agent, containing anti-inflammatory fatty acids. Extracts of aloe can reduce secretion of acid from the stomach (functioning similarly to antacid medications), and have been shown to actually prevent injury to the lining of the stomach from irritating substances.
  
  
• Picrorhiza- This medicinal plant has a long tradition of use for indigestion in Ayurvedic medicine. Picrorhiza acts similarly to other ‘digestive tonic’ herbs by assisting digestion. Research has shown that as many as 6 compounds in Picrorhiza have anti-inflammatory activity, inhibiting the COX-2 enzyme. This is useful for patients with chronic inflammation in the digestive tract resulting from maldigestion.
  
  
• Deglycyrrhizinated licorice (DGL)- Deglycyrrhizinated licorice (DGL) is licorice that has had the glycyrrhetinic acid removed for safety reasons. Extracts of licorice have demonstrated the ability to accelerate the healing of gastrointestinal ulceration (especially in the stomach and esophagus) possibly due to its antioxidant effect.
  
  
• Digestive Enzymes (Protease, Amylase, Lipase)- Digestive enzymes aid digestion and help prevent heartburn. The primary digestive enzymes are released from the pancreas: proteases (to digest protein), amylases (to digest carbohydrate), and lipases (to digest fat). Evidence shows that crude protein digestion is improved with supplementation of pancreatic enzymes.