With an estimated 23-35% of the U.S. population affected by gastroesophogeal reflux disease (GERD) and 10-15% reporting symptoms of IBS, the prevalence of gastrointestinal imbalance is shockingly common. IBS and GERD are two of the primary reasons people pay visits to their gastroenterologist each year, frequently leaving with a “band aid” medication without an answer as to what is causing their discomfort. The reason being that these conditions often have a multifactorial etiology, making it difficult to pin point a single, exact cause. However, upon delving a bit deeper than surface symptoms we can gather more information on what might be going on.
With continually progressive research into gut imbalance, it is becoming quite clear that IBS is one of the most ambiguous and somewhat complicated conditions to treat. However, once we step outside of the actual diagnosis of IBS (which is usually a “bucket diagnosis” when no other conclusion can be reached), the picture of the imbalance becomes much larger to encompass not only the gut (enteric nervous system), but also the mind, the stress response, and the sympathetic nervous system as well.
Classically known GERD symptoms include a burning sensation in the chest or throat, sour taste in mouth and regurgitation of food or sour liquid, but there really is anything but a “classic” presentation or cause. Cough, asthma, nausea, hoarseness and excessive saliva can all be indications of GERD, and, much like IBS, GERD often has several contributory factors. While it is often assumed that reflux is a result of having too much acid, this is only one of many possible causes. Certain bacteria, poor esophageal tone, a stressful lifestyle, even not having enough stomach acid can all lead to GERD indicating how important to look at each case individually.
When addressing IBS or GERD (or any gut imbalance, really), we often look at several contributing factors: lifestyle, stressors, diet, emotions, mental state, and the whole constitution of the person. The gut has an entire nervous system (called the enteric nervous system) that functions autonomously from the brain, and on average, the gut is sending up 9 messages to the brain for every 1 message the brain sends to the gut. A huge chunk of the immune system resides in the gut, and a vast network of probiotics (some 3-4 pounds!) regulates the absorption and health of the epithelial lining of the intestines and colon. A large majority of your hormones are produced within the gut as well (including the ever important serotonin). Receptors for serotonin are found on the enteric smooth muscle, enteric neurons and epithelial cells, so serotonin influences almost every aspect of gut function. Serotonin also plays a role in clinical depression, which is often why people presenting with IBS also struggle with symptoms of depression as well. It all comes down to the gut.
Gastrointestinal disorders such as IBS and GERD also have an undeniable psychosomatic relationship with the brain and our learned emotions. This is a classic example of a “mind/body” imbalance, where our conscious (and sometimes subconscious) emotions affect the motility and visceral sensitivity of the gut. This is quite often why people presenting with a diagnosis of IBS or GERD cannot pin point particular food triggers. It’s not always a certain food that causes pain and digestive upset, but a combination of hypersensitive large intestine spasms, weakening of the lower esophageal sphincter, mental and emotional stress, dysregulation of the gut flora (probiotics) and overall motility of the gut.
It is clearly imperative to get a whole understanding of the individual before we can embark on support plans for IBS, GERD or any other gastrointestinal disorder. Along with nutrition and dietary modifications, we recommend specific strains of probiotics in the appropriate potency, as well as lifestyle and self care practices that help to bring balance back to an unbalanced digestive (and psychosomatic) system. Occasionally, we do further testing for hormone imbalance or small intestinal bacterial overgrowth (SIBO). Herbal medicines can be enormously helpful to build the integrity of the gut lining, sphincter tone and also act as antispasmodics for oversensitive digestive systems and adaptogens (to help the body adapt to stress). Homeopathy is a powerful tool targeted toward stimulating the body to heal from within and is often recommended after identifying the very specific way IBS or GERD shows up for each person individually. With time and a personalized support plan, IBS and GERD can be healed and the gut can repair itself.