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Acid Reflux: An inflammatory condition – Why Diet and Licorice work.

Acid reflux, GERD, heart burn or as my Big Fat Italian Family calls it – Agita, has gained same attention main stream media recently. A study published in the prestigious JAMA took an outside the box look at acid reflux and found that this condition is not caused by chemical damage from stomach acid but instead it is an inflammatory disease.

What you need to know about the study:

  • Who: N of 12: 12 middle aged men
  • How was it run: 12 men were taken off their PPI drug (Proton pump inhibitor – Prilosec, Prevacid, Nexium) – and researchers analyzed their lower esophagus. 
  • What was the result: These men, all 12, showed increased inflammation in their esophagus (Esophagitis) NOT caused by increased acid production. 
    • Other things they found:
      • Widened space between esophageal cells
      • Decreased protective mucus (commonly found in the esophagus)
      • Cell hyerplasia without erosion (Abnormal increased cell growth)

 

Researchers found that after stopping the PPI these men had a relapse of their acid reflux, and they found some parts of the esophagus to be damaged by the acid as evidence by inflammatory cells (T lymphocytes). However what they noticed more, in areas that was not affected by the acid there was still evidence of inflammation.

One would expect that if acid was really causing the issue then the inflammation would only been in the cells that were in contact with the acid. BUT NO, this was noticed in all lower esophageal cells, meaning.

My first question was, well then why were these 12 guys OK on the PPI which is designed to reduce acid production. Turns out that PPIs may reduce inflammation as well by inhibiting two inflammatory cytokines, IL-8 and IL-1b. 

Clinically food modifications and a select few herbs are sometime enough to cure acid reflux without any medications. We know diet changes have a profound impact on acid reflux, and so I suspect that these individualized food plans don’t reduce acid production but they reduce inflammation and prevent the body from reacting to these inflammatory foods (bread, pasta, rice, sweets, junk…). A few simple lifestyle changes can make a big change without any drugs.

Licorice is an herb commonly used by naturopaths and functional medicine practitioners to treat acid reflux. One main reason is because licorice works as a demulcent, meaning it helps build and strengthen the mucus of the stomach, esophagus  and intestines. This is the part im excited for… Licorice is also ANTI-INFLAMMATORY by reducing IL-1b1 (1), IL-8 (2) (Do these look familiar?!) and NFkB (3). Licorice protects in 2 different ways: Increase protective mucus and reduce inflammation.

Pretty important stuff here. With some diet changes and a few herbs we can avoid the use of drugs that may have other adverse effects. We know that PPIs have been linked to dementia, so why not avoid these things if we can!.

References:

  1. Feldman M, Grenier D Cranberry proanthocyanidins act in synergy with licochalcone A to reduce Porphyromonas gingivalis growth and virulence properties, and to suppress cytokine secretion by macrophages . J Appl Microbiol. (2012)
  2.  Lee KH, et al Xia-bai-san inhibits lipopolysaccharide-induced activation of intercellular adhesion molecule-1 and nuclear factor-kappa B in human lung cells . J Ethnopharmacol. (2009)
  3. Kang JS, et al Glabridin suppresses intercellular adhesion molecule-1 expression in tumor necrosis factor-alpha-stimulated human umbilical vein endothelial cells by blocking sphingosine kinase pathway: implications of Akt, extracellular signal-regulated kinase, and nuclear factor-kappaB/Rel signaling pathways . Mol Pharmacol. (2006)

 

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