Gastroesophageal Reflux Disease (GERD) has become inescapably linked with heartburn and indigestion largely because of Food and Drug Administration (FDA) regulations regarding the advertising of prescription drugs. When drug manufacturers petitioned the FDA for permission to advertise “the Purple Pill” type medications they used the most commonly recognized symptoms of GERD, heartburn and indigestion, to plead their case. The designations atypical-GERD or silent-GERD identifies non-heartburn symptoms or problems associated with GERD because heartburn/indigestion is not present in every case of GERD. These unexpected non-heartburn symptoms are common as well as diverse. Such atypical symptoms were not requested for approval thus not approved in the FDA advertising rules for GERD medications. Thus sophisticated advertising, because of FDA statues, mandates heartburn is inevitably associated with GERD. It is just not “advertised” that GERD is common even without heartburn.
Two major neglected concepts I have encountered while studying the body’s response to GERD:1) reflux of digestive contents happens commonly without heartburn; 2) manifestations of the body’s response to the threat posed by GERD are extremely variable. The caustic, harsh digestive juices are very dangerous when they escape the friendly confines of the stomach and travel backward into the esophagus. The vagus nerve traverses the head, neck, chest and abdominal cavity connecting organs thus allowing communication and ultimately regulation of bodily functions. The lower esophagus is richly invested with vagal nerve fibers. The vagus nerve is an internal smoke, burglar and CO2 alarm. It connects with the “head-to-tail” craniosacral nervous system, a division of the “automatic pilot” autonomic nervous system. When the vagus nerve (10th cranial) is activated interesting and unanticipated events can result; some are profoundly life altering. It is most always the vagus nerve that is responsible for typical fainting spells. This often is identified as vagovasal syncope. An unappealing event takes place (the sight of blood, etc.) and the susceptible individual releases chemicals internally that result in a dramatic drop in blood pressure plus slowing of the heart rate. The resultant lack of blood flow to the brain causes the person to temporarily lose consciousness. This is an example of rapid discharge of stored neurotransmitter chemicals when the protective vagus nerve is set in motion. In GERD an ongoing intermittently-amplified, protective response occurs with or without heartburn. The vagus nerve connection explains how, in the research lab,acid artificially placed in the lower esophagus results in sinusitis.
The University Of Virginia School Of Medicine points out, "When GERD presents as a chronic cough or other extraesophageal symptom, G.I. symptoms may be silent. The patient's complaint may focus on the respiratory or other organ system. It is marked by an absence of any report of heartburn or related G.I. problem." They go on to reveal, “Other extraesophageal symptoms or conditions associated with GERD include chronic cough, bronchitis, recurrent pneumonia, globus sensation, hiccups, pharyngitis, sinusitis, otitis media, and erosion of dental enamel."
On the earlier pages of my website under “Meet the Doctor” is chapter of my book christened by the web site GRANDTIMES.com, “GERD: The Surprising Source of Many Physical Disorders”.
My goal is to demonstrate that a cause (reflux of digestive contents) has effects (swelling, congestion, mucus production). I hope you understand that treatment as near to the real source (cause) of the symptom/problem/"disease" means the more likely you are to succeed.
Two major neglected concepts I have encountered while studying the body’s response to GERD:1) reflux of digestive contents happens commonly without heartburn; 2) manifestations of the body’s response to the threat posed by GERD are extremely variable. The caustic, harsh digestive juices are very dangerous when they escape the friendly confines of the stomach and travel backward into the esophagus. The vagus nerve traverses the head, neck, chest and abdominal cavity connecting organs thus allowing communication and ultimately regulation of bodily functions. The lower esophagus is richly invested with vagal nerve fibers. The vagus nerve is an internal smoke, burglar and CO2 alarm. It connects with the “head-to-tail” craniosacral nervous system, a division of the “automatic pilot” autonomic nervous system. When the vagus nerve (10th cranial) is activated interesting and unanticipated events can result; some are profoundly life altering. It is most always the vagus nerve that is responsible for typical fainting spells. This often is identified as vagovasal syncope. An unappealing event takes place (the sight of blood, etc.) and the susceptible individual releases chemicals internally that result in a dramatic drop in blood pressure plus slowing of the heart rate. The resultant lack of blood flow to the brain causes the person to temporarily lose consciousness. This is an example of rapid discharge of stored neurotransmitter chemicals when the protective vagus nerve is set in motion. In GERD an ongoing intermittently-amplified, protective response occurs with or without heartburn. The vagus nerve connection explains how, in the research lab,acid artificially placed in the lower esophagus results in sinusitis.
The University Of Virginia School Of Medicine points out, "When GERD presents as a chronic cough or other extraesophageal symptom, G.I. symptoms may be silent. The patient's complaint may focus on the respiratory or other organ system. It is marked by an absence of any report of heartburn or related G.I. problem." They go on to reveal, “Other extraesophageal symptoms or conditions associated with GERD include chronic cough, bronchitis, recurrent pneumonia, globus sensation, hiccups, pharyngitis, sinusitis, otitis media, and erosion of dental enamel."
On the earlier pages of my website under “Meet the Doctor” is chapter of my book christened by the web site GRANDTIMES.com, “GERD: The Surprising Source of Many Physical Disorders”.
My goal is to demonstrate that a cause (reflux of digestive contents) has effects (swelling, congestion, mucus production). I hope you understand that treatment as near to the real source (cause) of the symptom/problem/"disease" means the more likely you are to succeed.