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Chinese Medicine and GERD

Gastro-Esophageal Reflux Disease, or GERD, can be a very difficult symptom to deal with on a daily basis. It burns, it aches, it keeps us up at night, and it causes us to want to snack so that the discomfort may momentarily pass. It is one of the conditions that most of us will experience in our lives, and which most of us will attempt to treat on our own with the wide variety of over the counter ant-acids that are now available at grocery stores. Most of the drugs which once required a Medical Doctor’s prescription can now be bought by the case and gallon at Costco. On any given trip to the store, I will see people analyzing and comparing ingredients, trying to discern their many differences. Which pill is right for me? Which type of heart burn do I have? Is there an alternative to taking these pills everyday and if I keep taking them will something bad happen to my stomach?

These are all the questions I see mixed into the facial expressions of shoppers as they navigate the aisles at the drug department. I wanted to write this blog entry about the different types of ant-acids out on the market and what options there might be to come off of them. I will also address the potential side effects of long term use of over the counter medications.

Some people feel heartburn, a burning sensation beneath the sternum, immediately after eating a meal. Our stomachs have a small opening at the top which is kept shut by something called our pyloric sphincter. This structure helps keeps stomach hydrochloric acid, HCL, from regurgitating back up into our esophagus. While our stomach has intricate systems in place to protect itself from the powerful effects of HCL, our esophagus has no such protection, and thus become corroded and burned by the high acidity. If the pyloric sphincter becomes relaxed and allows acid to leak out to the esophagus we feel pain. This problem could be due to over eating, lying down to rest after a meal, or consuming certain foods like coffee, chocolate, or wine. These foods, along with certain others, should be avoided by those who suffer from chronic heart burn. They can aggravate the problem through both their acidity and their effect on our stomach’s containment of HCL.

Ginger Root

For those people who suffer discomfort immediately after eating a meal, Pepcid AC might be the preferred antacid as it quickly neutralizes the PH of our stomach. Old favorites like Tums and Rolaids, are made up of Sodium Bicarbonate (Baking Soda) and also work by neutralizing acidity in the stomach, providing a rapid change in the PH levels. When the acid levels are reduced than the burning should decrease, although, some damage may already have been done and it may take some time for the inflamed tissues to recover. This gnawing pain causes some people to want to snack to reduce it, which only increases acid production in the stomach, starting the chemical cycle over.

If you suffer from constant over production of stomach acid, even at times when your stomach is empty, you may end up developing more serious problems such as gastric ulcers. If your problem has advanced to this stage you may be recommended to take Prevacid 24hr. Prevacid is an over the counter drug which is in the class called Proton Pump Inhibitors or PPIs. This type of drug works by completely stopping the production of acid in your stomach. Good news for stopping the pain but one might wonder how a person is supposed to digest food, especially protein, if this production is limited or shut down completely. Prilosec, containing Esomeprazol, the active ingredient in Nexium’s “little purple pill”, is another over the counter PPI drug which can be used to treat chronic over production of HCL in the stomach. It is important to note that this class of medication, PPI’s, is not the type which provides immediate relief. These drugs take time to build up in the system and must be taken regularly if one wishes to see healing of the damaged tissues of the stomach and esophagus. Simply using these PPI medications on an as needed basis, as one would use Tums or Prevacid, will not give you results.

The long term effects of taking antacids or proton pump inhibitors are generally the same as any medication. The body become accustomed to their presence and may actually increase the amount of acid the stomach produces to reach the desired PH for digestion of proteins. You may have to take more of the medication to get the same results and if you miss a dose the pain could now be significantly worse than it was at the start of the problem. Additionally, there is the problem of tampering with the stomach’s natural self-protective measures. It is the natural rise in acidity that triggers the stomach to release chemicals which protect its lining from the acids, stimulate the mechanical digestion of food, and signal the lower digestive tract, gallbladder and pancreas, that food is coming. Every time our bodies release a chemical messenger there is another part of the body waiting for the message to signal the next process to begin. Using medications to stop or reverse these natural chemical processes can cause problems further down the digestive line. Lastly, it is the stomach acid which represents our best line of defense against foreign bacteria which enter our bodies with food. Without adequate acidity these bacteria will survive and pass to the intestines where some believe they cause chronic bacterial infections such as Candida Albicans which can cause another cascade of negative effects on our health.

Turmeric powder and root

Chinese medicine has a long lineage of treating high acidity with herbal medicine to reduce the production of acid and increase the tone of the stomach’s sphincters. It does this without shutting down acid production so that digestion may still occur. Essentially strengthening the digestion to get an improvement rather than down regulating the stomach’s function to reduce pain. In Japan, some of the population has historically relied on tea made from turmeric, to calm the over production of stomach acid. In China, one can find tablets made from orange peel and ginger for aiding in the gastric reflux after a night of over-eating. Acupuncture works best when treating patients who suffer these digestive problems only when experiencing high periods of stress or anxiety. Acupuncture works extremely well at reducing all the effects of stress on the body and studies of acupuncture for digestive disorders are becoming more and more common in the medical research literature.

You have many options in dealing with chronic stomach pain including medication when necessary to control pain. Sometimes over the counter medicines are needed to bring the problem under control or to deal with an acute discomfort, as many of us will be experiencing at the family feasts of Thanksgiving and Christmas in the coming months. Chinese Medicine will be there to shift the patterns in your life and personality that cause this problem to re-occur and you should ask us how we can help you make these changes now, before the turkey and stuffing, the sweet potatoes and pecan pie, and do not forget, all that family.

China Blog: Tibet

Top of the Johkram Temple

When I arrived in Tibet this summer, I had whittled down my ideas of what I might see as much as possible to the one source I found to be credible; though definitely written by a Tibetan Buddhist and so biased in that way, The Tibetan Book of Living and Dying by Sogyal Rinpoche gave me what I felt was an accurate depiction of the religion and belief system of the people before the Communist Revolution. Since my one source was from a Tibetan–and I knew that the film Seven Years in Tibet did not count as a source–I felt compelled to seek the viewpoint of the Han Chinese people as I traveled through mainland China.

Some of my fellow Americans on the trip, seemingly getting most of their notions of Tibet and the Dalai Lama from Hollywood, were demanding explanations for the reasons for abusing the poor last Emperor of China (reference the movie The Last Emperor), or seeking clarification about why Chinese people hate the lovely Dalai Lama because Brad Pitt helped him in the Hollywood film. I wanted to simply ask the young Chinese my age what they thought about the situation in Tibet.

What they told me was generally consistent from person to person: regardless of what Americans believe, Tibet is in fact part of China and has been for hundreds of years. There has always been a special relationship of mutual support between the two countries; China has graciously granted Tibet the status of Semi-Autonomous Region, as it has with the Islamic region of the Uyghurs in the far West of China, or the Special Economic Zone status of Hong Kong. Chinese who are struggling to get by in Beijing are quick to point out that not only are Tibetans allowed to live in newly constructed housing, built by the central government, but get to do so for extraordinarily small amounts of money. Tibetans, as well as other minority groups, are allowed to have two children while the one-child policy binds the lives of the Han Chinese people. New bridges, rail lines, airports, hospitals and schools have also been built by the Chinese government–for their own purposes of course–but the Tibetans benefit from them.

The subject of the Dalai Lama and the fact that Americans perceive Chinese as atheists because of the Communist system was surprising to most Chinese I spoke to. One Chinese person pointed out that it is believed that there had been a type of monarchy in Tibet before Communism that supported a caste system in which average people were desperately poor and relegated to near-slavery by the religious leadership. In China it is believed that the Chinese form of Buddhism is more egalitarian though I could not tell in what way the role of the monks was different in either society. Both Tibetans and Chinese said that the monk’s role was simply to pray for the people and not necessarily conduct charity work. Either way, Buddhist temples are very commonly visited for many reasons throughout the year and Tibet is looked to as a one of the centers of the religion. People practice ideals of Confucian and Taoist beliefs in their daily activities, and there are growing communities of Christians and Muslims throughout the country which the government allows with some restrictions (for instance, Catholic churches are unaffiliated with the Holy Roman See at the Vatican).

When the chance to visit Tibet came up and permission was granted by the Chinese government, I jumped at the opportunity and the chance to see blue skies and breathe clear mountain air. In Tibet, one of the first things the guide–a local Tibetan–told us was that he could not answer any questions at all about the exiled Tibetan government, the Chinese government, the politics of the regions and specifically the status of the Dalai Lama. We were not allowed to leave the hotel on our own other than to buy water next door which was disappointing (but frankly, the pounding headache and shortness of breath from the altitude made us pretty happy to lie down when we got there). Security was heavy on the drive from the airport to Lhasa, and while visiting the temples and palaces we were under surveillance by men on the rooftops and by cameras inside the buildings– a very similar situation to that of the Old City in Jerusalem, where armed police and soldiers stand on many of the corners and cameras watch everything. Our guide was anxious about having to keep an eye on the Americans, as we were one of only two non-Chinese groups in the whole region who were allowed in…and I–this blonde boy–definitely did not blend in with the locals.

Prayer Wheels

What I was able to speak at length about was religion and its role in Tibetan life. Monks and the Dalai Lama are extremely revered to the point of being infallible in the same way of that of the Pope in the Catholic faith. They are on a level above the average Tibetan, and to visit the Jokhram Palace and the Potola Palace in Lhasa is considered one’s obligation in the same way Muslims are supposed to make the Haj pilgrimage to Mecca in their lifetimes. Within the temples and palaces in Lhasa I saw nearly everyone throwing money over the railings to the Buddhas–of which there are dozens–as offerings towards them in return for protection. If true Buddhism is about self-sacrifice for others this act of offering money for one’s own protection seemed to me to be contradictory. As I watched a Chinese couple negotiate the purchase from a monk of yards of gold cloth to be wrapped around a statue of the Buddha for protection, I had the strong feeling that I was watching them buy forgiveness for a sin that was weighing on their conscience.

The Chinese-Tibetan dynamic is full of contradictions; every story, of course, has two sides. I was told by our guide that Tibetans are provided with housing, but it is worth noting that the original town center was demolished by the Chinese government when it built the People’s Liberation Plaza and the giant monument to the military victory over Tibetan rebels. I was told that education is free for Tibetans but that they are required to speak Chinese in school and not Tibetan…and that religion is legal, but pictures of the Dalai Lama are forbidden in public or private. Many jobs have been created by mining activity in the mountains, but perhaps this is to enrich the Central government’s supplies of copper, uranium and plutonium so essential for the growth and development of China.

I learned a great deal about Tibet while I was there, but the inability to talk openly with Tibetans left me feeling that I know little to nothing about what they really think or feel about the situation they live in. I would love to have the opportunity to return, wander the streets, read more books about the Chinese version of the story, and talk openly with both sides to see what the future holds for this beautiful country at the top of the world.

Chinese Medicine and GERD

China Blog: Tibet

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