Gastroesophageal Reflux Disease (GRD or
reflux) is exhausting, painful, and potentially
life-threatening—untreated it can lead to esophageal cancer. The
immediate cause is simple enough: the lower esophageal valve (LEV,
located between the esophagus and stomach) fails to stay closed
between meals, allowing gastric juices to escape into and burn the
esophagus. The problem is most noticeable when we go horizontal —
for example, at bedtime.
Allopathic medicine considers reflux permanent and focuses on
symptomatic relief with drugs. This is a little like shooting a fly
with a gun. Reflux is essentially a mechanical problem, which is why
mechanical approaches are simpler, safer, more economical, and more
permanent than pharmaceutical approaches.
A Tough Job in a Rough Neighborhood
A look at LEV mechanics shows why. A ring-shaped muscle just below
the respiratory diaphragm, the LEV is often caught in a tug of war
between the stomach and the equally muscular esophagus. Refluxes
resulting solely from imbalances between these two are common and
the easiest to treat.
Enter the respiratory diaphragm. The diaphragm maintains a partial
vacuum in the lungs to facilitate breathing. The associated pressure
differential across the diaphragm provides lift to the abdominal
organs, especially those closest to the boundary. Lung or thorax
restrictions can upset the delicate balance between esophagus and
stomach and cause reflux. (Extreme imbalances can also produce
hiatal hernias, another painful, dangerous, but manually-treatable
condition where part of the stomach is actually pulled into the
esophagus.)
By sequentially contracting its three layers of muscles, the stomach
churns ingested food and hydrochloric acid into a partially digested
slurry. In the presence of abnormal tensions which can come from
anywhere, these contortions may open the LEV and cause reflux. In
addition to the upward tensions exerted by the esophagus and
diaphragmatic lift in the vertical plane, there is the downward pull
of gravity and the colon via the greater omentum, a curtain-like
structure which carries much of the colon’s blood supply and
enervation. The stomach may also have posterior-anterior
restrictions from previous infections, physical and emotional
trauma, or scar tissue and adhesions from thoracic or abdominal
surgery. If the spinal nerves controlling the LEV fire when they
shouldn’t, reflux may result.
A Repetitive Motion Injury
Exceedingly common, restrictions in the lung or heart may also
interfere with the LEV. Given that the lungs inflate approximately
12 times per minute, and the heart beats approximately 72 times a
minute, pulmonary and cardiac restrictions will eventually change
the geometry and function of the LEV tissues. At 6.3 million breaths
and 34 million heartbeats per year, the resultant reflux surely
qualifies as a repetitive motion injury!
Pop! Goes the Weasel: The Neighborhood Worsens
Chinese medicine often talks of one organ ”attacking” another. This
concept is helpful because it acknowledges the importance of
relationships and interactions between neighboring organs.
Frequently, restrictions and attacks involve emotions that are held
by the tissues. This is because when we experience emotional
overloads, the nervous system dumps this energy or information into
our tissues, especially the abdominal viscera. This is so common
that usually we don’t even notice, though most of us have felt that
initial flip-flop in our belly on occasion. The stomach also happens
to be the body’s second-most favorite organ for storing stress.
Furthermore, criticism typically lands in our solar plexus, a highly
enervated region in the upper abdomen, overlapping the LEV and the
pylorus valve.
The LEV is also the first of five one-way valves in the GI tract
that function as emotional circuit breakers (the pylorus is the
second). In other words, the body routinely deals with emotional
upsets by directing the excess energy to one or more of these
valves, which then spasms for a day or two. Again, few of us connect
the unpleasant symptoms that arrive hours later with the upset.
The pylorus valve guards the entrance to the first part of the small
intestine, the duodenum. The pylorus must stay closed during the
stomach’s vigorous churning to prevent improperly digested food from
reaching the duodenum. After opening at the appropriate time to
allow the stomach’s contents to pass, the pylorus must close again
to keep stomach acids from attacking the tissues lining the duodenum
and to keep duodenal bile and enzymes from moving upstream and
attacking the stomach. Catching the stomach between the proverbial
rock and hard place, pylorus problems can thus cause reflux. Reflux
can also be a side-effect of the nervous system’s being chronically
in fight-or-flight— an exceedingly common and typically unrecognized
condition.
Finally, even when not going through digestive contortions, the
stomach is never motionless. Every internal organ’s function and
vitality depends on continuous movements called motility. Rotating
part-way around a horizontal axis six to eight times a minute,
stomach motility approaches 1.5 inches in each direction on each
cycle. These repetitive motions add up rapidly: approaching 600
meters a day, nearly 150 miles a year! Motility can exacerbate
reflux, and reflux impedes motility and function.
Rough neighborhood, indeed! No wonder reflux is so common. Treating
the causes of reflux may take longer than scribbling a prescription;
it may even take a few treatments, but typically each treatment
improves overall health and may prevent other problems.
Alaskans are lucky: many of our larger communities boast at least
one such practitioner. So, if you feel like you’ve been shooting
reflux with the wrong gun, call one of us today and gird yourself
for a pleasant surprise.
Mike Macy, CST, combines
CranioSacral Therapy and Visceral Manipulation to eliminate chronic
pain, optimize the Circulatory and Central Nervous Systems, and
release emotions from the tissues. In Anchorage: 907 258-7261.
www.healingjourneysak.com
