What goes down should stay down, unless you suffer from acid reflux, and then even the laws of nature don’t seem to apply.

Acid reflux, or gastroesophageal reflux disease, is a symptom that results from a condition known as a hiatus hernia. This occurs when the stomach is pulled or pushed up through the diaphragm muscle, allowing the cardiac sphincter (lower esophageal sphincter) to open. This opening provides a gateway for stomach acids and gases to rise up into the esophagus, creating a burning sensation in the stomach, esophagus or region of the heart. It is sometimes described as heartburn and tends to occur after a meal.

Dr. Nancy Rebellato, a Sudbury-based doctor of naturopathic medicine, said there are a variety of factors that cause a hiatus hernia, including pregnancy, constipation, obesity, improper diet, ulcerations and mechanical or emotional stresses. Mechanical stresses can be from violent vomiting often seen in young children, heavy lifting, or simply eating too fast and not chewing thoroughly while under emotional stress.

“You have to be in parasympathetic nervous system mode (relaxed-mode) when you are eating,” Rebellato said. “Otherwise, the hydrochloric acid normally found in the stomach doesn’t get produced.” As a result, phosphoric acid production begins, which creates a more acidic environment.

Conventional medicine treats acid reflux with proton pump inhibitors (PPIs) such as Generic Omeprazole, Pariet Rabeprazole, Pantoloc Pantoprazole, Prevacid Lansoprazole, Nexium Esomedprazole, and Losec Omeprazole, according to a 2007 report from the Canadian Optimal Medication Prescribing & Utilization Service (COMPUS), a directorate of the Canadian Agency for Drugs and Technologies in Health.

The same report indicated a 15 per cent increase of PPI prescriptions dispensed in Canada - from 10.8 million to 12.4 million between 2003 and 2004.

The PPIs treat the symptoms, suppressing the stomach acid and providing temporary relief.

“Pharmaceutical drugs are OK for the short term, but they won’t fix the problem, because they do nothing to pull or push the stomach back down,” Rebellato said. She sees it as a mechanical problem, and therefore, treats it with a mechanical solution.

Rebellato, who has been practicing naturopathic medicine for 10 years, has a client base of more than 1,000. Of those, approximately 50 per cent see her for digestive problems. She performs a diagnostic process requiring a full history and physical examination, including a spinal and abdominal exam. She will then listen to the stomach to see if it is above the diaphragm.

“Using the stethoscope, I listen for stomach sounds above the diaphragm muscle,” she explained. “I palpate for tenderness or pain. If the stomach is high, it will be tender on palpation.”

Once she has diagnosed her patient, she performs a three-step treatment. The first step is to close the cardiac sphincter valve by bringing the stomach back down using a mechanical, manual approach, which Rebellato performs in her office.

“This approach works with the original design of the valve, so that the valve does not require surgical alteration,” she said. “This technique also prevents stomach cancer, which can occur in the long run if acids are allowed to erode the valve.”

The next step is a series of specific exercises to keep the stomach in position, along with weight loss (if necessary) in the abdominal area. Stress reduction, the use of proper lifting techniques, reducing weight loads and the elimination of acidic and aggravating foods like caffeine products are suggested. If necessary, she may also perform spinal manipulation techniques.

Lastly, Rebellato uses various combinations of foods, botanical medicines in teas or tinctures, homeopathics and other nutritional supplements to heal the ulcerated tissue in the esophagus, stomach and small intestine. Changing lifestyle habits that led to the symptoms in the first place is also recommended.

Also, as people age, the stomach produces less hydrochloric acid, requiring less food.

Rebellato suggests unpasteurized apple cider vinegar prior to eating in order to stimulate hydrochloric acid production.

The severity of the symptoms will determine the number of adjustment s necessary.

However, in her practice she has a success rate between 90 and 95 per cent, with about 50 to 60 per cent of clients requiring only one adjustment, and 30 to 35 per cent requiring possibly two to three adjustments.

Rebellato said pharmaceutical drugs have their place, but she does not recommend them for long-term use because often people end up with symptoms of malabsorption, fatigue, fibromyalgia or pernicious anemia - all symptoms related to low energy.

“I see a lot of people on acid reflux medications that end up in starvation mode,” she said, explaining that if the stomach acids are not breaking down and absorbing food and nutrients at that stage, then there will be little or no digestion and absorption in the stomach and small intestine. As a result, undigested food will end up in the large intestine. Improper digestion can lead to an increased amount of fecal matter in the colon, resulting in constipation and an increased risk of colon cancer.

“It is hard to wean people off acid reflux medications,” she said, indicating they must go back to their medical doctor to be taken off the medications. “It must be gradual or they will experience a massive acid rebound and pain.”

Rebellato has concerns about the increased use and reliance on pharmaceutical drugs to treat acid reflux, particularly when many of the cases can be rectified mechanically.

An August 12, 2008 study in the Canadian Medical Association Journal linked the use of PPIs for at least seven years to an increased risk of osteoporosis-related fractures.

Rebellato said PPIs and antacids will stop the digestion and absorption of calcium, which will result in osteoporosis.

Rebellato is always looking for a logical, simple way to solve problems.

“People have to take more responsibility for their own health. They should practice prevention, because the surgeons are busy enough with the real emergencies, and prevention is more cost effective.”

www.rebellatohealthcentre.com