Friday, March 02, 2007

Acid Reflux

Sometimes I can't believe how many patients I see that have some form of acid reflux. Symptoms can include upper abdominal bloating soon after a meal, a dry persistent cough, bad breath, heartburn, or full out burning acid regurgitating up to the throat. There are many levels of acid reflux and all of them should be addressed. Letting small symptoms like these develop further could damage the esophagus and can even lead to cancers of the upper digestive tract.

The biggest problem I have with acid reflux is the most common approaches to treating it. Treating acid reflux usually means suppressing the acid with calcium (TUMS) or various medications that inhibit the production of acid in the stomach. This approach may sound simple and correct but there are consequences to suppressing or blocking the acid. For one our stomach is supposed to be a very acidic place. The acid from our stomach mainly in the form of hydrochloric acid helps us to digest our foods. Without the proper acidity levels we have trouble digesting foods. Some of the more difficult to break down nutrients are Calcium, Magnesium and many proteins (amino acids). Utilizing acid blocking can be necessary for short periods of time to allow the esophagus to heal but staying on these acid reducers can lead to other problems from the loss of these vital nutrients.

The best way of going about fixing the symptoms of acid reflux is by adressing the deficiencies or structural imbalances that lead to the symptoms in the first place. That is always the treatment approach at our office, treat the person not the symptom. The two main causes that we see in our office for acid reflux are either a zinc deficiency, a hiatal hernia, a TMJ (jaw) problem, or a subluxation (misalignment) of the mid thoracic vertebrae. Usually it is a combination of a few or all of these problems.

I will begin by explaining the relationship of the TMJ imbalance and acid reflux because it ties things together. It starts off with the trigger for every problem Stress. Stress can be physical(getting punched in the mouth), chemical(smoking ciggarettes), or emotional(trying to meet a 9:00am deadline for the project. Either way one of the things people do when under stress is to clench their teeth together placing stress on the jaw joint the TMJ. If there happens to be even a slight imbalance in the alignment of your bite then that clenching or grinding of your teeth can cause TMJ dyscomfort. As soon as your innate senses TMJ dyscomfort there should be a compensation to alleviate that dyscomfort. Remember your jaw is very important, if it doesn't work properly you don't eat and you die. So preserving the function of the jaw takes priority over many other problems. The classic compensation for a jaw problem is to create tension in muscles around the neck area to help bring the jaw back into alignment. If that muscular compensation subluxates (mis-aligns) either the 3rd,4th,or 5th cervical bones there can be an impact on the function of your diaphragm (C3,4,5 all innervate the diaphragm muscle).
A weakness in the diaphragm muscle can lead to a hiatal hernia.

A hiatal hernia happens when a weakness in the diaphragm allows a part of the stomach to rise up above the diaphragm where the esophagus should be. Why is that a problem? There is a small sphincter that separates the esophagus and the stomach. That sphincter keeps the acid in the stomach. In the case of the hiatal hernia that sphincter may not be working properly and acid or regurgitated food can escape.

When there is a problem with the optimum function of the diaphragm there can be tension that builds up in the 5th,6th,and/or7th thoracic vertebrae which all contribute to the innervation of the stomach itself.

When there is a zinc deficiency(either from lack of zinc in the diet or too much copper in the diet which competes with zinc) there may be a decrease in the production of hydrochloric acid in the stomach. If there isn't enough hydrochloric acid you can also get acid reflux. Sounds crazy I know but if there is enough acid in the stomach that acidity actually triggers that sphincter we mentioned at the junction of the stomach and the diaphragm to close. With a lack of acidity that sphicter gets lazy and if there is little acid to stimulate it to close it can become weak. If you have a wak sphincter and you eat a meal that will temporarily incerase your stomach acidity that acid can escape out of the weakend valve and give you symptoms of acid reflux. So if you have the proper acidity your acid reflux will improve.


The way to fix all of this is to see a health care practiotioner that understands all of these parts. This is why I love applied Kinesiology so much it gives the practitioner the tools to understand why the patient is having symptoms from many different perspectives without the use of drugs or surgery.

The typical protocol in our office would involve checking for and fixing subluxations in the spine and the TMJ by adjusting and/ or using muscle balancing techniques. Also we would check fotr nutritional needs for supplemental Betaine Hydrochloride, digestive enzymes, and zinc. We can also release stress from the diaphragm itself with different muscular corrections.

The longer you have had these imbalances the more difficult they are to fix but given time most people can get healthy without the use of drugs or surgery.

Hope this addition to the blog helps more people to understand about what we do.

Yours in Health,

Jason Piken DC, CNS

21 comments:

Unknown said...

Ok Dr. I just found y article ,its been 10 years now with same symptoms y describe ,burning inside my Jaw ,daily ,no hiatal hernia, PPI do not work at at ,have done the fundoplication Nissins surgery but no help ,so any releife??

Jason Piken DC, CNS said...

Henan,
There may be relief. My best recommendation is for you to locate an Applied Kinesiology doctor near you that is familiar with your symptoms. If you are not in NYC and can't get to our office then the best resource for you is:

WWW.ICAKUSA.com

Use the Find a doctor tab. Let me know if you have any other specific questions.

Unknown said...

I have a hiatal hernia, tmj as well as acid refux with burning in the throat. I have tried just about everything. Well I surfing the net I came across something relating to zinc giving some relief. I purchased some zinc lozengers I purchased some and got immediate relief. So couple with my other problems I wonder if I had a zinc deficiency. I really wish that I was in the new york are I would come see u

Jason Piken DC, CNS said...

If you can't see me check out www.icak.com to locate an applied Kinesiology doctor near you!

Unknown said...

Your blog Is Impressive. I am able to get every information regarding acid reflux. Thank for sharing your information.


Acid Reflux

Monda said...

Hi there. I have TMJ, along with acid reflux, pain in my middle back around the spine and a racing heart, mostly at night. I've worn a holter monitor and done an EKG, etc, but nothing has been found. Can this be related to the reflux and/or TMJ as well?

Monda said...

Hi there. I have TMJ, along with acid reflux, pain in my middle back around the spine and a racing heart, mostly at night. I've worn a holter monitor and done an EKG, etc, but nothing has been found. Can this be related to the reflux and/or TMJ as well?

Jason Piken DC, CNS said...

Monda,

Its difficult to say just from reading about your symptoms but it is common to have stress in your spine create many different kinds of symptoms. my best advice is to get checked by a chiropractor, hopefully that also practices Applied Kinesiology.
Check out our website for more info to contact us.

Nadie said...

Dr. Piken,

Could you recommend an applied kinesiologist in the Denver area.
I have been diagnosed with a hiatal hernia but the Zantac and other acid reflux meds have not done anything to help. I quit taking them after 6 months.
Thanks for the article.

Jason Piken DC, CNS said...

Nadie,


Glad you read the blog...I do not know an Applied Kinesiology doctor in Detroit personally but Applied Kinesiogy was founded in Gross Pointe Woods Michigan, there's got to be be someone close to you. Check out the ICAK website.


www.icakusa.com use the find a doctor tab.


Hope that Helps!


Dr. Piken

Melanie said...

Hi Dr. Piken, during a very stressful time in my life, I apparently was grinding my teeth in my sleep and I ground my right, upper wisdom tooth down to almost nothing. Lately I've noticed my bite is "uncomfortable", my left jaw seems to be taking all the strain now, and I also have some kind of muscular pain above and below the left jaw, going down into my throat (left side.) Also, after I eat, it seems like the food/acid seems to irritate that side of my throat too. I feel a "poking" feeling at times, shooting all the way up the left side of my esophagus. My left tonsil has a "cobblestone" appearance and it almost seems as if I have GERD/LPR on that left side as well. I now see a brown floater in that left eye during the first half of the day, and the area around that eye seems a bit tender. It's as if my left jaw is taking all the weight now since there's nothing to bite on on the right side, ever since most of that huge wisdom tooth is gone. My left jaw also clicks when I bite down on food and I hear grinding noises in my ears, mostly the left. My sublingual salivary gland on the left side is a little swollen too. I went to a doc about all of this and he said it was due to some kind of irritation, said I had heartburn, also gave me anti-anxiety meds, and told me to follow up with a dentist (haven't done that yet.) I hear a click when I swallow on the left side, but only when my head is shifted downward. When I raise my head up, I noticed my left jaw seems lower than the right one now. Could a misaligned bite/left-sided TMJ be the cause of all this? Thanks so much for any advice! -Melanie

Jason Piken DC, CNS said...

Melanie

Just read your post. Outside going to a dentist to determine if there is any acute infection that needs to be addressed I strongly suggest you find a great chiropractor. The best resource to start with is the Applied Kinesiology website....www.icakusa.com
If you are in New York City you can contact our office for a consult. Www.innatechiro.com

Melanie said...

Thanks so much for the info, Doc. I'll do that. -Melanie

Jason Piken DC, CNS said...

Monda

In response to your question...of course it CAN be related. Wether it truly is can only be determined after a n exam and history are done. If you are in NYC give us a call @212-581-9079. If not in New York then goto www.icakusa.com

Jason Piken DC, CNS said...

Monda

In response to your question...of course it CAN be related. Wether it truly is can only be determined after a n exam and history are done. If you are in NYC give us a call @212-581-9079. If not in New York then goto www.icakusa.com

Unknown said...

Hi, my name is Tyler and I am 19. I was diagnosed with Acute Bronchitis and Acute Sinusitis on June 5th, to which I was prescribed Amoxicillin, Benzonatate, and an Albuterol Inhaler, I wasn't aware that you need to eat with Amoxicillin so I didn't. And I took them for about 5 or 6 days like that and got really sick, so I stopped taking them, I have been on Omeprazole and Ondansetron since June 13th, I am stopping because it isn't helping much, and I've been taking Escitalopram for the last 3 or 4 days and I just get really bad side effects so I'm stopping that too. I have had Bad acid reflux 24/7 nonstop (It even wakes me up at night) since About the time I got really sick from the antibiotics. I also have what I think might be constipation, dry cough, post nasal drip, Burning sensations in stomach and chest, gagging when I yawn, and sore throat. I've had TMJ since January of this year and I think it's gotten worse and I read that that can cause it. Is it the TMJ or the Amoxicillan or what? Also my urine and blood tests came back normal.

Jason Piken DC, CNS said...

Tyler,

You're not alone! Unfortunately the common thread of simple symptoms being treated by medications causing side effects that cause the need for more medications and treatment is something I hear in my office all the time. I wish there was a simple answer to your question of "is it TMJ or Amoxicillin or what?"
The truth is that we can't really tell if its the chicken or the egg, what we CAN do is get you to focus on getting healthier. You have an innate ability to heal whatever is ailing you...you need to find the right doctor to help guide you.
As I have written in previous posts if you can get to our office we can perform a screening that will help me determine what the best path of action is. If you cannot I would visit the Applied Kinesiology website and find a doctor close to where you live. The site is www.icakusa.com
There is more info on my website as well...I recently placed an interview I did with Meg Richichi, an acupuncturist I know, all about acid reflux. It's on my website under the education Tab.

I hope the info helps you. Let me know if there is anything more I can do.

Yours in Health,
Dr. Piken

Shaun said...

Dr. Piken,
Over the last 2 months, I have been dealing with tmj. The biggest issue i have with it is tightness in my throat and the feeling of something in my throat when swallowing. I have had some dryness in my throat and slight heart burn. I first went in thinking it was sinus infection and so did my doctor. He also prescribed me magic mouth wash believing I had canker sores on my throat. After a couple more visits, he believed it was anxiety (prescription for that) and did a strep test, ekg, and thyroid blood work and both of those tests came back normal. Should I talk to my doctor about tmj and his thoughts? I have talked to my dentist and he thinks it's tmj but didn't give me a lot of ideas for relief. At this point I'm just looking for answers and relief of my throat issues.

Any info will help.

Thanks.

Jason Piken DC, CNS said...

Shaun

I'm sorry to learn that you have been dealing with the stresses of TMJ dysfunction and other symptoms. My best advice is to locate a chiropractor near you that has experience helping people with TMJ dysfunction. Preferably you should find a chiropractor that practices a technique named Applied Kinesiology. I'm not sure what part of the country you are in but a great resource is the website for the International College of Applied Kinesiology...ICAK.com

They have a FIND A DOCTOR area where you can enter your zip code and they will list other AK doctors in your area.

I hope that helps!

Unknown said...

Dear Dr. Piken,

I am from India and have a TMJ problem. It used to feel muscle spasms only on my left side till recently but over the last few days have started feeling sever spasms around my right side as well and its really bad on the right side. The acid reflux has increased and worsened and the right side problems have started after having a heavy meal and felt sudden contractions around my top rib referring the contraction to the neck, behind the ear and under the shoulder

I have no clue what is causing the muscle stiffness in my body? Is it TMj or acid reflux which is the root of my problems?

Ps Have already been using a splint but to no avail and multiple PPIs have been tried and I also suffer from allergies IgE 1243

Jason Piken DC, CNS said...

Sachin,

If you've read through the comments section for this post you'll find a similar reply to many posts like yours. I'm not sure what else to do for you other than suggest that you find a holistic health practitioner that can work on the physical problem in your jaw and most likely neck, and your nutrition. I see many people get relief but each person is different and requires an in person evaluation and course of care. If there is anything else I can do please let me know.