There are so many incredible foods and cuisines throughout the world. Salty, sour, bitter, sweet, and spicy flavors all combine to create a multitude of tastes that make our mouths water for our favorite dishes. Unfortunately, many of our favorite foods can cause various digestive upsets, including acid reflux. The pain and discomfit of acid reflux can vary by person, and it can severely limit and restrict our eating and drinking habits. If you are not finding relief with over-the-counter or prescription medications, try acupuncture for acid reflux.
Acid reflux, which can also be referred to as GERD, is a relatively common reason for Americans to seek medical treatment. Acid reflux can present with heartburn, acid regurgitation, chest pain, and sleep disturbances, among other symptoms. According to Western Medicine, acid reflux can be caused by anatomical abnormalities of the lower esophageal sphincter (LES), as well as various lifestyle and dietary causes. These lifestyle and dietary factors include smoking, alcohol consumption, obesity, body and head position while sleeping, and the consumption of citrus/fruit juices, carbonated beverages, coffee, spicy foods.
Similar to Western medical thinking, Chinese medicine would agree that dietary factors are major etiological mechanisms for acid reflux. CM also suggests that improper eating behavior can impact acid reflux; behaviors such as standing while eating, hurried eating, and distracted eating can result in acid reflux. Further, like many other conditions according to CM, emotional upset or disturbances can impact acid reflux. With this understanding, we can begin to plan a diagnosis and treatment plan of acupuncture for acid reflux.
Western medicine places a large focus of the mechanism of acid reflux on the lower esophageal sphincter. Researchers Kaltenbach, Crockett, and Gerson, note that “the major mechanism for GERD is transient relaxation of the lower esophageal sphincter.” The consumption of various aforementioned foods and drink have been shown to result in temporary relaxation of the lower esophageal sphincter, which allows for acids and stomach content to be regurgitated up into the esophagus, causing pain and irritation of the esophageal lining, as well as dental decay. Takashi also suggests that motor dysfunction of the GI tract and visceral hypersensitivity are significant mechanisms for reflux. Certain body positions, such as laying down flat while sleeping, can allow further access for the acids to move through the relaxed sphincter, leading to further irritation.
According to Chinese medicine, many digestive symptoms and patterns stem from complications with the liver, particularly from liver qi stagnation. During periods of emotional upset or unexpressed emotions, liver qi can begin to stagnate, which often results in the liver beginning to insult or overact on the stomach (and spleen). The liver is charged with ensuring the smooth flow of qi, and when it cannot, qi begins to rebel against its proper natural movement. In the case of the stomach, rebellious stomach qi moves upward, rather than it’s typical downward, descending direction. This rebellious upward movement of qi results in the acids and digestive contents to push up past the LES. Understanding this helps guide our acupuncture for acid reflux relief treatment plan. Poor diet can contribute to further stomach disfunction and can cause more severe symptoms; this rebellious qi will also present with ST heat or ST cold, depending on the patient’s diet and lifestyle.
In addition to heartburn, acid regurgitation, food regurgitation, chest pain, dental erosion, a feeling of food stuck in the throat, and sleep disturbances, acid reflux from a CM view can present with nausea, belching, vomiting, hiccups. Chinese medicine practitioners would also find a tight pulse at the right middle site, and there is not necessarily going to be a difference in the tongue.
In diagnosing acid reflux or GERD, Dinamithra and Nawarathne note that an assessment is made using presenting symptoms, testing with endoscopy, and reflux monitoring. They note that symptoms of heartburn and regurgitation are “the most reliable to arrive at a presumptive diagnosis based on history alone.” A CM practitioner would use pulse and tongue information to make their diagnosis, as well as perform a physical examination of the abdomen and upper torso, along with other regions of the body. Hypochondrial pain may be a signifier that there is LR disharmony, which would support looking toward the ST for rebellious qi, which may present with abdominal pain. Based on the symptom presentations, pulses, tongue, and physical exam, a patient experiencing GERD or acid reflux would be diagnosed with a pattern of ST qi rebelling upward, with possible ST cold or ST heat; the distinction between the two, or presence of either, would be diagnosed based on further questioning of the patient’s symptoms. After making our diagnosis, we can design a care plan for acupuncture for acid reflux treatment.
Researchers Dickman, Schiff, Holland, Wright, Sarela, Han, and Fass note that proton pump inhibitors provide the highest rate of relief from various GERD-related symptoms, as they decrease the amount of acid released in the stomach. Antacid medication is also a common treatment to counter the effects of stomach acid. To address the pattern of ST qi rebelling upward, a CM practitioner would treat the person with the following principle: subdue rebellious ST qi and stimulate the descending function of the ST. To accomplish this and use acupuncture for acid reflux, the practitioner could use the points CV13, CV10, CV 12, PC6, SP6, ST12, ST19, ST36, and LR3. Reducing/dispersing methods would be used on these points; moxa would be applicable if ST cold was also present.
Dickman et al. crafted a study in which 30 patients who had at least a 3-month history of GERD-related symptoms at least twice a week while taking a PPI received acupuncture treatment to manage their symptoms. Participants were randomized into one of two groups: a twice-daily dose of PPI or a once-daily dose of PPI plus acupuncture treatment. Patients kept a daily GERD symptom diary and filled out a GERD symptom checklist and SF-36 quality of life questionnaire prior to beginning and upon completion of the study. Those in the acupuncture group received the following point protocol: PC6, ST36, CV12, CV17, LR3, and SP9; SP9 was sometimes excluded depending on the practitioner’s assessment of the patient at the time of treatment. Ten acupuncture treatments were conducted per participant over four weeks, each one lasting about twenty-five minutes long. Acupuncture was administered three times a week for the first two weeks, and twice a week during the final two weeks. After completing their study and analyzing the data, Dickman et al. found that:
Therapeutic intervention in the form of acupuncture was more efficacious than adding a second PPI in controlling residual symptoms of patients who failed PPI once daily. Acupuncture resulted in a significant improvement in daytime heartburn, nighttime heartburn and acid regurgitation when compared with doubling the PPI dosage.
Along with acupuncture for acid reflux, dietary changes and lifestyle changes are supported by both Western and Chinese medicine to prevent further acid reflux and GERD symptoms. Avoiding spicy foods, citrus, and acidic foods can reduce the likelihood of experiencing reflux symptoms. Lifestyle changes such as avoiding alcohol and smoking, not eating late at night, as well as weight loss (for obese patients), can also be effective prevention methods. For patients with issues at nighttime, elevating one’s head, neck, and/or upper torso can help keep acids confined to the stomach to help prevent reflux. From a Chinese medicine perspective, in addition to avoiding certain foods, eating habits may also be addressed. Not eating in a rush, not being distracted while eating, and not multitasking while eating can all be beneficial in preventing reflux symptoms. In addition to this, CM would recommend expressing or releasing pent-up emotions, so they do not cause further qi stagnation or rebellion.
Ease the pain and discomfort of GERD with acupuncture for acid reflux. By using various acupuncture points and lifestyle modifications, we can build a treatment for you to see lasting results from your acid reflux symptoms. Contact me to learn more about acupuncture and what it can do for you.
References
Dickman, R., Schiff, E., Holland, A., Wright, C., Sarela, S. R., Han, B., & Fass, R. (2007). Clinical trial: acupuncture vs. doubling the proton pump inhibitor dose in refractory heartburn. Alimentary Pharmacology & Therapeutics, 26, 1333-1344. doi:10.1111/j.1365-2036.2007.03520.x
Dinamithra, N. P., & Nawarathne, N. M. (2015). Diagnosis and management of gastro-oesophageal reflux disease. The Sri Lanka Journal of Surgery, 33(1), 14-19.
Kaltehbach, T., Crockett, S., & Gerson, L. (2005). Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach. Gastrointestinal Endoscopy, 61(5), 1-7. doi:10.1016/s0016-5107(05)00786-8
Takahashi, T. (2006). Acupuncture for functional gastrointestinal disorders. Journal of Gastroenterology, 44, 408-417. doi:10.1007/s00535-006-1773-6
Wang, J. H., Luo, J. Y., Dong, L., Gong, J., & Tong, M. (2004). Epidemiology of gastroesophageal reflux disease: A general population-based study in xi’an of northwest china. World Journal of Gastroenterology, 10(11), 1647-1651.
DISCLAIMER: this blog post is intended for informational purposes only. Do not perform any treatments included in the post yourself. This includes, but is not limited to, acupuncture, herbal medicine, and Chinese nutritional therapy. They should only be performed by educated and licensed acupuncture practitioners.
National Institutes of Health (NIH) studies have shown that acupuncture is an effective treatment alone or in combination with conventional therapies to treat the following:
Nausea caused by surgical anesthesia and cancer chemotherapy
Dental pain after surgery
Addiction
Headaches
Menstrual cramps
Tennis elbow
Fibromyalgia
Myofascial pain
Osteoarthritis
Low back pain
Carpal tunnel syndrome
Asthma
It may also help with stroke rehabilitation.
If you are curious about the benefits of acupuncture, scheudule an appointment for a personal consultation, and evaluation.
