Yoga For GERD

GERD, short for gastro esophageal reflux disease, is a chronic condition where the lid of the stomach i.e. the lower esophageal sphincter (LES) is unable to hold the mixture of undigested food and digestive juices in the stomach. Due to the inability of the LES to perform its function, the gastric contents make their way upwards into the esophagus and at times even to the mouth. This repeated reflux damages the lower esophageal sphincter (LES) i.e. the lid of the stomach, making the reflux recurrent. People with GERD often opt for surgical correction of the damaged LES. Non-invasive management of GERD with yoga intervention is discussed in this article.

Introduction

Gastro esophageal reflux disease, meaning a prolonged and persistent upward flow of gastric contents into the esophageal region, is a chronic condition of acid reflux and heartburn.

‘Gastric contents’ includes chewed solid and liquid food together with digestive juice which is a mixture of mostly hydrochloric acid, some water, salts and minerals, proteins, pepsin and mucus. It is acidic in nature and that’s how it is supposed to be – in order to convert all the food into a form usable by the human body. Gastro esophageal reflux (GER) becomes a disease (GERD) when the first two sphincters of the digestive tract are damaged due to ignored and untreated acidity over many years.

Yoga Tips For GERD

The Esophageal Sphincters

The esophagus or the food pipe is the tube that delivers chewed food from the mouth to the stomach. At the places where it is connected with the mouth and the stomach, there are bands made of special muscles that can tighten up and loosen according to requirement. These junctions are called sphincters. There are many sphincters in the digestive tract, placed at locations that separate different stages of digestion. The sphincter at the junction of the throat and the esophagus is called the upper esophageal sphincter (UES) and that at the junction of the stomach with the esophagus is called the lower esophageal sphincter (LES). The LES has a major role to play during digestion. A faulty LES is responsible for stomach reflux and regurgitation. A normal LES is highly toned at rest.

Symptoms

GERD is serious and it means that its symptoms were ignored when they were still mild and manageable. It has all the symptoms of acid reflux in severe and aggravated form.

  • Acidity: mild reflux or sour burps point towards one’s possibility of developing GERD in the future. It can be well managed when initially mild.
  • Belching and regurgitation: when food enters the stomach it replaces some volume of air that comes up and exits our mouth. We call it burp. Burping is natural and normal. When the sphincters lose their tone this burping becomes frequent, abnormal and loud, often bringing with it parts of gastric contents.
  • Heartburn: heartburn is called so because of the intense burning sensation that the acid reflux produces close to the heart.
  • Chronic diarrhea: GERD brings with it constantly loose stools that may irritate the skin surrounding the anus while exiting through it.
  • Faster GIT transit: when digestion and absorption is faster than normal or other individuals, the food takes lesser time to exit the gastrointestinal tract and it causes frequent and faster bowel movements.
  • Eye disorders: People who have a history of acid reflux also have irritable eyes. They don’t have weakened eyesight until they are old but they are greatly troubled by sunlight.

Causes

  • Acidity: acidity is a mild and initial form of GERD. Acidity is therefore also called GER. When there have been too many refluxes running again and again over the LES, it loses its tone.
  • Damaged LES & UES: the LES and the UES may even become permanently damaged due to frequent acid refluxes.
  • Pregnancy: pregnancy brings a wave of hormones that alter many physiological processes in the pregnant woman’s body. The most chaotic of them is the hormone relaxin which relaxes and dilates smooth muscles in the body. The sphincters are made of smooth muscles. This is why a new pregnant woman may start having acidity, and if she already has it, it is worsened by pregnancy hormones.
  • Obesity: in most cases of obesity, visceral fat is dangerously high. Visceral fat is the deposit of fat surrounding the digestive tract. It puts excess pressure on the digestive organs, causing the already weak sphincters to loosen further under pressure, hence worsening GERD.
  • Previous surgery: many people who have had one surgery of the LES have to get it done again.

Treatment

The most common medications taken at home for acid reflux are antacids. They are alkaline in nature and are consumed to neutralize stomach acid. They are useful for instant relief but don’t treat GERD.

Other medicines that are used and sold on prescription only are H2 blockers, and Proton-Pump Inhibitors (PPIs). They interfere with the body’s physiology since both of them work by reducing the amount of stomach acid secreted, and have side effects such as irritable bowel syndrome, nausea, etc.

Yoga practices for GERD

Yoga is safe for everyone and restores the body’s natural physiology without interfering with any process. The following practices are especially effective in minimizing GERD. When practiced for long term as a lifestyle, they may also treat GERD.

1. Vajrasana

‘The thunderbolt pose’: limits the blood circulation in the legs so as to concentrate it in the digestive organs. It is also popular since it is the only practice that can be done immediately after having meals. The Japanese also adapt this pose while having their meals. They call it ‘seiza’ meaning proper pose for sitting. It can be practiced on bed, mat, floor, carpet, low-seated chairs, etc.

  • Sit with the legs spread forwards.
  • Fold one leg and place its heel under the buttocks.
  • Fold the other leg and place its heel under the buttocks.
  • In this way, kneel on the floor/mat/carpet.
  • Keep the spine straight and the back relaxed.
  • The thighs, knees, calves, and the feet should be close together in neutral position without any effort of joining them.
  • Rest the palms on the knees or at the sides, if not performing during meals.
  • Breathing should be normal.
  • Sit in the pose for 10 minutes in the beginning. Increase the duration over time upto thirty minutes.

2. Veerasana

‘The hero’s pose’: this pose is a great practice for those who have trouble keeping their spine straight. Keeping the thorax straight and relaxed is beneficial and highly recommended for individuals who face acid reflux. It can be practiced on a mat/blanket/carpet/bed etc.

  • Sit with both the legs extended forwards.
  • Fold the right leg and place its heel under the buttocks.
  • Bend the left leg at the knee and place it heel on the mat besides the right knee.
  • Bend the left elbow and place it on the left knee.
  • Place the left hand below the chin. Let the face rest on it.
  • Place the right palm on the right knee.
  • This is the final position. Breathing should be normal.
  • Practice for upto 30 minutes after having meals. Change the sides in between if required.

3. Sheetkari Pranayama

‘The cooling breath’: this breathing practice is extremely beneficial for individuals with acid reflux. It cools the esophagus and the stomach, making the gastric contents stay below the level of the esophagus. It should be practiced outdoors in a clean environment.

  • Sit in Sukhasana.
  • Close the eyes gently.
  • Very gently clench the jaws.
  • Open the lips to reveal the teeth.
  • Suck in air through the mouth.
  • Exhale through the nose.
  • This is one respiration.
  • Practice 30 respirations.

4. Sheetali Pranayama

Sheetali Pranayama is similar in benefits to Sheetkari Pranayama, but it is a great replacement for those who cannot practice Sheetkari Pranayama due to tooth sensitivity or missing teeth. It can be practiced anywhere but it is better done in fresh air close to nature.

  • Sit in Sukhasana or vajrasana.
  • Roll the tongue in the form of a tube and fit it in between both the lips.
  • Suck in air through the tongue and fill the stomach with it.
  • Keep it in for five seconds.
  • Exhale through the nose.
  • Practice10 such respirations.
  • Do not practice in extremely cold weather.

Lifestyle/Dietary Tips

Do

  • Consume natural stomach acid neutralizers like chilled milk.
  • Observe the gap in between meals.
  • Eat cool foods such as rice, cucurbitaceous fruits, etc.
  • Consume electrolytes such as lemonade, coconut water, etc.
  • Drink water 30 minutes before meals to wash out excess acid production.
  • Keep sitting for 30 min after meal to ensure optimum blood circulation in the digestive tract.

Don’t

  • gnore early and mild acid reflux episodes.
  • all for the temptation of drinking sodas; since the thought of drinking chilled aerated drinks may sound relieving but these drinks contain carbonic acid in them which not only aggravates stomach acid but also dehydrates us.
  • at spicy food, hot food and oily food since it unbalances gastric secretions.
  • Drink water after meals since it interferes with digestion.
  • Drink hot beverages after big meals.
  • Overeat, to allow space in the stomach for proper digestion.
  • Lie down immediately after eating, since it shall weaken the LES.

Conclusion

GERD is uncomfortable but it is not untreatable, especially when the side effects of medication and surgery can be avoided by strictly following a lifestyle with a purpose of minimizing GIT damage. The yoga practices prescribed above can be modified, intensified, or supported by other techniques as per the need of each individual under direct supervision of a dedicated yoga therapist. One should compulsorily and seriously follow the points given under ‘lifestyle/dietary tips’ in order to actually make a difference in their condition.