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Treating-Acid-Reflux.Pdf www.acupunctureceus.com OPTIONS FOR WELLNESS, INC. 7059 SW 53 LN MIAMI, FL 33155 305-665-0615 [email protected] CEU PROVIDER Florida Board of Acupuncture 50-2489-1 NCCAOM ACHB-038 CALIFORNIA CEP 722 Acid Reflux More than 60 million Americans experience heartburn at least once a month and some studies have suggested that more than 15 million Americans experience heartburn symptoms each day. (American College of Gastroenterology ). Acid reflux disease is described as heartburn 2 or more days a week despite treatment and diet change. Acid reflux disease is caused by reflux of stomach acid into the esophagus. In most patients this is due to a transient relaxation of the "gate" or sphincter (LES) that keeps the lower end of the esophagus closed when a person is not swallowing food or liquids. This transient relaxation happens a few times each day in people without acid reflux disease. The esophagus is not able to cope with acid as well as the stomach and is easily injured. It's the acid refluxing into the esophagus that produces the symptoms and potentially damages the esophagus. GERD can masquerade as other diseases Increasingly, we are becoming aware that the irritation and damage to the esophagus from continual presence of acid can prompt an entire array of symptoms other than simple heartburn. Experts recognize that often the role of acid reflux has been overlooked as a potential factor in the diagnosis and treatment of patients with chronic cough, hoarseness and asthma-like symptoms. In some instances, patients have never reported heartburn, and in others the potential causal link between reflux and the onset of these so-called “extra-esophageal manifestations” has not been fully recognized. It is good clinical practice to evaluate the possible presence of reflux in patients with chronic cough and asthma-like symptoms. Chinese Medicine differentiates signs and symptoms. The western diagnosis of acid reflux or GERD needs to be catagorized as hot or cold, as the wrong herbal formula will cause a worsening of symptoms . Western Medicine Diagnosis for Acid Reflux: Gastric ulcer, gastritis (chronic), indigestion, GERD 2 Chinese Medicine Etiology (causes): Diet : sweet/greasy/hot and spicy or bad quality food Exterior pathogen invasion: cold invading the middle Jiao deficiency yang Qi turns to turbid dampness causing acid. Emotion: liver attacks stomach spleen creates damp/phlegm which creates acid Deficiency Middle Jiao congenital dysfunction: retention of food Spleen can’t transform or transport which creates acid Differentiatiion and Treatment of Acid Reflux in Chinese Medicine COLD Acid regurgitation, frothy fluids, fullness in abdomen, belching, cold limbs, soft stools, fatigue, ameliorated by warm drinks Tongue - pale and flabby with a think white coat - may have teethmarks Pulse – weak, deficient Syndromes SP Qi Xu (with Phlegm-Damp and pain) ST Qi Xu ST Cold 3 Clinical Manifestations could include: Nausea / vomiting Emaciation Sallow complexion Anorexia with a full feeling after very little food Weak abdomen Abdominal distention or pain Belching (subtle) Rolled lips Pale lips Stiff tongue Tired limbs Heavy limbs Chest fullness Acid regurgitation Muscle weakness in arms and legs Loose stools or diarrhea Maybe bleeding Thin muscles. Lethargy-fatigue Does not like to speak Weak, soft voice Maybe enuresis Maybe cold extremities Maybe borborygmus Principle of Treatment: Warm middle jiao, disperse cold to harmonize Stomach and reduce acid Herbal Medicine Formula: Xiang Sha Liu Jun Zi Tang which is Six Gentlemen Decoction with Aucklandia and Amomum Also known as: Saussurea and Cardamon Combination or Saussurea, Cardamon and the Six Gentlemen Decoction Tonifies Qi, Strengthens SP, Harmonizes ST, Regulates Qi and Stops pain. 4 The Formula Treats Biomedically defined disorders such as: Indigestion Acute or chronic gastritis Gastric or duodenal ulcer Acute or chronic gastroenteritis Gastroptosis Gastric distention Emotional instability Chronic peritonitis Rickets Nervous exhaustion Gastralgia Delayed menstruation due to Phlegm Obstruction Morning sickness Chronic bronchitis Modifications For severe cases of Stomach Cold: add Liang Fu Wan aka Pills of Galanga and Cyperus or add Wu Zhu Yu (Evodia) Wu Zhu Yu has a marked warming effect on the body, helping to relieve headaches and a wide range of digestive problems warms the middle, lower qi, rids cold of stomach, lower blood pressure. Useful for vomiting, excess acid of stomach, pain in solar plexus, cold type of hernia, cold and dampness of swelling of legs. Acupuncture Points: Commonly used tonifying acupuncture points include ST36, SP9, SP6, LI10, LIV8, REN6, and REN4. 5 Differentiatiion and Treatment of Acid Reflux in Chinese Medicine HOT Frequent acid regurgitation with belching of old food, fullness in abdomen, dry mouth, thirsty, smelly stools, liver Qi stagnation symptoms Tongue - red, yellow coat Pulse - Wiry, slippery, rapid Syndromes Liver-Heat causing Liver and Stomach disharmony. Clinical Manifestations could include: Acid regurgitation Peptic ulcer Acute gastritis Vomiting Chronic gastritis Belching Distension of the epigastrium Bitter taste Excessive hunger Dry mouth Hiatus hernia Red tongue, yellow coating Pain of the hypochondrium (along Rapid-Wiry pulse the Liver channel) Principle of Treatment: Clear heat, sooth liver, descend St. Qi Herbal Medicine Formula: Zuo Jin Wan aka Left Metal pill or Coptis & Evodia Clears Liver-Heat , Drains Liver-Heat, Stops vomiting, Subdues Rebellious Qi The Formula Treats: Biomedically defined disorders such as: Gastritis, peptic ulcer, esophageal reflux, hiatal hernia 6 Modifications Acid regurgitation (severe cases) add Wu Zei Gu (Os Sepiae seu Sepiellae) Cuttlefish Bone, Cuttlebone and Wa Leng Zi (Concha Arcae) Cockle Shell, Ark Shell Severe distension of the epigastrium add Chuan Lian Zi (Fructus Meliae Toosendan) Sichuan Pagoda Tree Fruit Acupuncture Points: CV 12, PC 6, SP 4, ST 34, ST 36 Common Sense Additions: Food Therapy: It is very helpful to ask the patient to keep an honest Food Diary. For approximately two weeks, ask them to write down what they eat, when they eat and where they eat. Noting any symptoms they may experience. This will help you decide on any change in eating habits that may be necessary. Foods To Avoid These commonly consumed foods often cause problems: Orange juice, Cranberry juice, Fried Foods (think of potato chips and donuts too, tomato, vinegar, garlic, coffee, wine, liquor, cigarettes ( Tobacco inhibits saliva.) Posture: Slouching and not keeping the back straight can cause symptoms to worsen. Sleeping at a 45 degree angle by using a wedge under the mattress seems to help a lot of people who’s symptoms are worse at night. No eating 2-3 hours before sleep. 7.
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