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Whether the invaders such as bad bacteria (pathogenic lining, including aspirin, naproxen, ibuprofen

diagnostic flora), harmful viruses and injurious para- and other anti-inflammatory drugs. With all of
these, the end result is the same—damage to
sites.
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label is and spasm of the stomach wall and refluxing of
dysbiosis, IBS A simple search on PubMed will produce a food back up into the esophagus, which weakens
or small bevy of research papers that speak to this point. the stomach’s ability to produce acid and digest
Whether the diagnostic label is dysbiosis, IBS or food effectively. The pressure from the spasm
intestine small intestine bacterial overgrowth (SIBO), we and fermentation also weakens the LES, as
bacterial know that there is a link between the changes in noted previously, setting the stage for passage
overgrowth the natural flora of the intestinal tract and our of acids up into the esophagus. Therefore, the
first variable I rule in or out when examining a
digestion, specifically with regard to GERD.
(SIBO), we patient with GERD is medication. I believe this
know that MEDICATIONS should be standard protocol because without it,
In some patients, another common causative any intervention to assuage the GERD will be
there is a link factor for GERD can be, at least in part, taking negated by medication side effects.
between the prescription medications that delay gastric emp-
changes in tying (gastroparesis). Gastroparesis leads to an HIATAL HERNIAS
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the natural overall reduction in gastric acids and a rise in A third variable when examining a GERD
pH, which allows for fermentation of ingested patient is evaluation of whether a hiatal hernia
flora of the food from the bacterial proliferation that occurs exists. A hiatal hernia occurs when the up-
intestinal now that the stomach’s pH is no longer low permost portion of the stomach, termed the
tract and our enough (due to the hypochlorhydria) to inhibit fundus, herniates up through the LES (Figure
the overgrowth. (Remember, bacteria are not 1). According to the Cleveland Clinic, the most
digestion, supposed to grow in the stomach.) The classic common cause of hiatal hernia is an increase in
specifically example of this is overgrowth of Helicobacter the pressure in the abdominal cavity. Pressure
with regard pylori (H. pylori), often blamed for causing ul- can come from coughing, vomiting, straining
cers. This bacterium normally cannot grow in during bowel movements, heavy lifting or physi-
to GERD. the highly acidic environment of the stomach, cal strain. It is my opinion that the increased
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but when the stomach becomes hypochlorhydric intra-abdominal pressure caused from SIBO and
for any of the reasons outlined throughout this bacterial dysbiosis and the resultant gas produc-
paper, H. pylori can thrive. The sinister part of tion also is a leading cause of LES weakening,
this problem is that H. pylori has the ability to increasing the likelihood of hiatal hernia forma-
further shut down stomach acid production. The tion. This condition will often create the feeling
resultant fermentation of foods in the stomach of fullness that patients with GERD complain
then leads to gas production (and the bloated or of, or the inability to eat even a modest amount
full feeling with which many GERD sufferers of food without becoming full very quickly.
are familiar), as well as production of caustic The most common allopathic medical tests used
organic acids. As a result of these gases, which to confirm hiatal hernia are a barium swallow
naturally want to rise, pressure builds in the followed by an X-ray or endoscopy. It is always
stomach, putting further pressure on the LES prudent for the physician to consider this when
and opening the door for reflux. evaluating a patient with GERD.
The many drugs known to cause GERD In my clinical practice, I use a very special
include anticholinergics, bronchodilators for chiropractic adjustment approach (see Figure 2)
asthma, calcium channel blockers for high blood combined with a manual adjustment of the stom-
pressure, dopamine-active drugs for Parkinson’s ach to treat a hiatal hernia when it is involved in
disease, progestin for abnormal menstrual bleed- GERD. Yes, you read that correctly—I manually
ing and birth control, sedatives for insomnia and adjust the stomach. In fact, I have seen cases
anxiety, and tricyclic antidepressants. The of hiatal hernia where, despite strict dietary
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culprit also can be more common “everyday” changes and compliance, a patient could not get
medications that directly damage the gastric off of their medication (without exacerbation of

20 Wise Traditions SUMMER 2018