GERD (gastroesophageal reflux disease), or heartburn as it's commonly known, is the most common digestive disorder in the United States; approximately 10-20% of Americans experience symptoms at least once a week. Conventional treatment is to take antacids.... chances are you've probably used these drugs at one time or another. Tums, Zantac, Pepcid... ring any bells? Or if you're really serious about your heartburn, maybe prescription Nexium? Drug stores sell these things like candy. Literally. Tums is placed right next to the candy and gum in the checkout area, and for the first ten or so years of my life, I thought it was candy. On the prescription side, Nexium was the number two best selling prescription drug on the market in 2006, just behind Lipitor (don't even get me started), bringing in $5.1 billion. People generally find heartburn relief in these medications, so all is well right? Not quite.
Although this topic may seem tame, there is more than you know going on behind the scenes. I recently read a fantastic set of articles by Chris Kresser about the physiology and treatment of GERD that brought this to my attention. It's a long six-part series, something I probably wouldn't have made time for if not for the combination of my iPhone and a boring afternoon class. Since I will be summarizing a large amount of material here and simplifying some of the concepts, it would be unrealistic for me to cite all of my claims like Chris did. So if you don't believe me, just refer to the link above.
For starters, let's talk about what exactly GERD is. Out of Taber's Medical Dictionary, GERD is: "A common condition in which acid from the stomach flows back into the esophagus, causing discomfort and, in some instances, damage to the esophageal lining." You see, there is a one-way door between the esophagus and the stomach called the lower esophageal sphincter. In digestion, food moves through this door to the stomach, and when everything is functioning correctly, nothing comes back up. In GERD, small amounts of stomach acid are able to creep up into the esophagus, causing burning and damage to the wall of the esophagus, which can lead to a number of problems including esophageal cancer if left untreated.