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GERD / Acidity / Acid Reflux

Original price was: ₹4,975.Current price is: ₹4,478.

AIC’s GERD, Acidity, Acid Reflux Wellness bundle targets the root causes of GERD and Acidity, providing FAST and LASTING relief from heartburn, bloating, and discomfort. This bundle combines clinically-proven ingredients to address low stomach acid, reduce inflammation, enhance digestive enzymes, and promote a healthy gut microbiome.

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Understanding GERD / Acidity / Acid Reflux

Gastro Esophageal Reflux Disease (GERD) – also referred to as acid reflux or ‘heartburn’ is a chronic digestive condition characterized by the backflow of stomach contents into the esophagus, often leading to a range of unpleasant symptoms such as heartburn, regurgitation, and difficulty swallowing.

It affects approximately 11.0%-29.2% of the population worldwide and can significantly impair an individual’s quality of life. (Cho et al., 2013) In India, the prevalence of GERD is estimated to be around 7.6%-30 % (Bhatia et al., 2019).

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Gastro Esophageal Reflux Disease (GERD) - also referred to as acid reflux or ‘heartburn’ is a chronic digestive condition characterized by the backflow of stomach contents into the esophagus, often leading to a range of unpleasant symptoms such as heartburn, regurgitation, and difficulty swallowing. It affects approximately 11.0%-29.2% of the population worldwide and can significantly impair an individual's quality of life. (Cho et al., 2013) In India, the prevalence of GERD is estimated to be around 7.6%-30 % (Bhatia et al., 2019).

The abnormal relaxation of the lower esophageal sphincter (LES) – the valve between the stomach and esophagus – is the primary underlying cause of GERD. Several factors can lead to a lax LES and contribute to the development of GERD, including: Increased intra-abdominal pressure (IAP) - obesity, pregnancy. Hiatal hernia - a condition in which the upper part of the stomach bulges into the chest cavity. Medications - Calcium channel blockers, non-steroidal anti-inflammatory drugs (e.g., aspirin and ibuprofen), nitrates, anticholinergics. Diet - fatty, spicy, or acidic foods. (Gaddam & Sharma, 2011) (Bhatia et al., 2019) Hypochlorhydria - Contrary to the common belief that high stomach acid levels cause GERD, it is often linked to low stomach acid levels. Stomach acid plays a key role in stimulating the lower esophageal sphincter muscles to tighten, preventing the backflow of stomach contents. In cases of hypochlorhydria (low stomach acid), the sphincter muscles fail to contract properly, resulting in a relaxed lower esophageal sphincter and allowing reflux to occur. Delayed gastric emptying (peristalsis) also contribute to reflux. Other risk factors for GERD are advancing age, alcohol use, smoking, and genetics. Small intestinal bacterial overgrowth (SIBO), reduced amounts of digestive enzymes and poor digestion have also been linked to GERD (Wang et al., 2023) (Katz et al., 2021) (Dirac et al., 2020).

• Heartburn - a burning sensation in the chest or throat • regurgitation • nausea • difficulty swallowing, • chest pain • upper abdominal pain • bloating • chronic cough • hoarseness of voice • sore throat • dental erosions. The symptoms of GERD tend to worsen after heavy meals and on lying down.

GERD is diagnosed through patient history, physical examination, and diagnostic tests. A trial of proton pump inhibitors (PPIs) can confirm the diagnosis if symptoms improve. Other diagnostic methods include: • Endoscopy: Visualizes the esophagus and stomach for damage. • Esophageal Manometry: Measures esophageal pressure. • pH Monitoring: Assesses acid exposure in the esophagus. Identifying the root cause, including potential gut microbiome dysbiosis, is essential. Treatment should be personalized based on individual causative factors.

The conventional treatment for GERD primarily focuses on medications like antacids, proton pump inhibitors (PPIs) and H2 antagonists to suppress stomach acid production, combined with lifestyle modifications. However, prolonged use of these medications can cause side effects such as nutrient deficiencies, an increased risk of infections (including Clostridium difficile and pneumonia), and bone loss (Kim et al., 2022). Additionally, if GERD symptoms are caused by hypochlorhydria (low stomach acid), further acid suppression can worsen the condition over time. Diet - Avoiding trigger foods like fatty, fried, ultra-processed, sugary, spicy, acidic, and caffeinated items. Avoid eating 2-3 hours before bedtime. Focus on an anti-inflammatory diet with more fibers, probiotics and enzymes. Lifestyle changes - Weight loss, smoking cessation, elevation of the head of the bed while lying down, 10-20 minutes of walking post meals, inculcating relaxation and stress management techniques. Certain causes of GERD like Hiatal hernia may require more advanced interventions like endoscopic or surgical correction. Surgical procedures like fundoplication can help strengthen the lower esophageal sphincter. A thorough root cause analysis to identify the underlying factors driving GERD is crucial and the use of a well-planned treatment approach, including the use of supplements maybe beneficial.

Berberine, neem leaf - address bacterial overgrowth and reduce inflammation. Alginates - form a physical barrier to prevent reflux. Probiotics - help restore gut microbiome balance. Adding Lactobacillus reuteri and Bifidobacterium have shown benefits. Betaine hydrochloride (HCl) - supplementing with betaine HCl in cases of hypochlorhydria can help restore proper stomach acid levels. Digestive enzymes - pepsin, trypsin - improve digestion. Melatonin - aids sphincter relaxation and tissue healing. Zinc Carnosine - protects the esophageal lining. N acetyl cysteine, Vitamin C, Vitamin D also have therapeutic potential. Herbs – Soothing Herbs: Licorice (especially deglycyrrhizinated licorice or DGL), marshmallow root, slippery elm, calendula, and aloe vera, which help coat and protect the esophagus and stomach lining. Alkalizing Herbs: Alfalfa, which may help neutralize excess acidity. Bitters and Digestive Stimulants: Gentian, ginger, and other digestive bitters that stimulate stomach acid production and improve digestion, potentially alleviating GERD symptoms caused by hypochlorhydria. Others like fermented soy, artichoke extract also show promise (Kim et al., 2022) (Hernández-Mondragón et al., 2020) (Jones et al., 2009) (Jones et al., 2007).

Reference

Bhatia, S., Makharia, G., Abraham, P., Bhat, N., Kumar, A., Reddy, D. N., Ghoshal, U. C., Ahuja, V., Rao, G. V., Devadas, K., Dutta, A. K., Jain, A., Kedia, S., Dama, R., Kalapala, R., Alvares, J. F., Dadhich, S., Dixit, V. K., Goenka, M. K., … Wadhwa, R. T. (2019). Indian consensus on gastroesophageal reflux disease in adults: A position statement of the Indian Society of Gastroenterology. In Indian Journal of Gastroenterology (Vol. 38, Issue 5, p. 411). Springer Science+Business Media.

Cho, J., Ahn, Y., Lee, D., & Son, C. (2013). Distributions of Sasang constitutions and six syndromes in patients with functional dyspepsia and healthy subjects. In Deleted Journal (Vol. 33, Issue 5, p. 626). 

Dirac, M. A., Safiri, S., Tsoi, D., Adedoyin, R. A., Afshin, A., Akhlaghi, N., Alahdab, F., Almulhim, A. M., Mini, G., Ausloos, F., Bacha, U., Banach, M., Bhagavathula, A. S., Bijani, A., Biondi, A., Borzì, A. M., Colombara, D. V., Corey, K. E., Dagnew, B., … Veisani, Y. (2020). The global, regional, and national burden of gastro-oesophageal reflux disease in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. In ˜The œLancet. Gastroenterology & hepatology (Vol. 5, Issue 6, p. 561). Elsevier BV.

Gaddam, S., & Sharma, P. (2011). Shedding light on the epidemiology of gastroesophageal reflux disease in India—a big step forward. In Indian Journal of Gastroenterology (Vol. 30, Issue 3, p. 105). Springer Science+Business Media. 

Hernández-Mondragón, O. V., Mottú, R. A. Z., Contreras, L. F. G., Aguilar, R. A. G., Solórzano-Pineda, O. M., Blanco‐Velasco, G., & Pérez, E. M. (2020). Clinical feasibility of a new antireflux ablation therapy on gastroesophageal reflux disease (with video). In Gastrointestinal Endoscopy (Vol. 92, Issue 6, p. 1190). Elsevier BV.

Jones, R. C., Junghard, O., Dent, J., Vakil, N., Halling, K., Wernersson, B., & Lind, T. (2009). Development of the GerdQ, a tool for the diagnosis and management of gastro‐oesophageal reflux disease in primary care. In Alimentary Pharmacology & Therapeutics (Vol. 30, Issue 10, p. 1030). Wiley. 

Jones, R., Coyne, K. S., & Wiklund, I. (2007). The Gastro‐oesophageal Reflux Disease Impact Scale: a patient management tool for primary care. In Alimentary Pharmacology & Therapeutics (Vol. 25, Issue 12, p. 1451). Wiley. 

Katz, P. O., Dunbar, K. B., Schnoll‐Sussman, F., Greer, K. B., Yadlapati, R., & Spechler, S. J. (2021). ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease [Review of ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease]. The American Journal of Gastroenterology, 117(1), 27. Lippincott Williams & Wilkins.

Kim, M. J., Schroeder, S. E., Chan, S., Hickerson, K., & Lee, Y. (2022). Reviewing the User-Centered Design Process for a Comprehensive Gastroesophageal Reflux Disease (GERD) App. In International Journal of Environmental Research and Public Health (Vol. 19, Issue 3, p. 1128). Multidisciplinary Digital Publishing Institute.

Wang, X., Wright, Z., Patton-Tackett, E., & Song, G. (2023). The Relationship between Gastroesophageal Reflux Disease and Chronic Kidney Disease. In Journal of Personalized Medicine (Vol. 13, Issue 5, p. 827). Multidisciplinary Digital Publishing Institute.

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