Thursday, November 26, 2009

An In-Depth Look: Stomach Fire & Its Treatment

By Karen Litton, L.Ac.

Gastro-intestinal issues are common complaints in both Western and Eastern Medicine. In Chinese Medicine, the Stomach is one of our most important yang organs. Together with the Spleen, it is the basis of our post-natal Qi (the body’s energy). Post-natal Qi is the Qi we gather after our birth from the air we breathe and the food we eat. The Stomach’s main function is to aid in digestion and the production of food Qi. A hyperactive Stomach, especially when combined with worry, overwork, or emotional problems, or the hot energy from foods or drink, can lead to Stomach fire. Stomach fire can cause the energy of the Stomach to flow upward (instead of downward, its usual course), causing us to feel the symptoms of heartburn, or acid reflux.

The Stomach needs large quantities of yin to help its digestion. If its capacity to hold the yin is damaged (perhaps by irregular eating, or indulging in mental work while eating, or disease), then a form of heat can develop in the Stomach. We call this empty heat, and it can lead to symptoms such as gastric pain, constipation, a dry mouth, mouth sores, toothaches, or a burning pain in the epigastria. Stomach fire can also be considered an excess type of heat, which burns yin fluids, thus obstructing the Stomach. This can result in symptoms of acid regurgitation, nausea or the sensation of wanting to vomit. In addition, fire in the Stomach can affect the mind, causing insomnia.

There are other emotional and physical issues that can impact the state of our Stomach. The Stomach represents our ability to accept nourishment, which can therefore manifest as difficulty accepting support or nourishment from others, or from a spiritual source outside ourselves. Another manifestation of the Stomach is too much worrying. Any of these Stomach imbalances can bring an inability to rest the mind. Lack of exercise can further exacerbate this problem by not supporting the movement of Qi, which in turn can lead to stagnation in the body.

Western conditions associated with Stomach fire include chronic gastritis, gingivitis, acid reflux, and mouth ulcers. In Western Medicine, acid reflux, commonly called heart-burn, is when the liquid contents of the stomach flow upward into the esophagus, the muscular canal connecting the throat to the stomach. This can cause a burning sensation that can damage the inner lining of the esophagus. The proper Western Medical term for acid reflux is Gastro-esophageal Reflux Disease (GERD). The Western Medical treatments for GERD are lifestyle changes, as well as medications, some over-the-counter.

Before we consider the treatment of Stomach fire from a Western approach, let us look at the role of hydrochloric acid in our digestive processes, as many of the Western drugs prescribed for stomach acid problems are designed to affect this acid. Hydrochloric acid (HCl) is important to the pH of our stomach and is necessary for optimal health. HCl is required for protein digestion in our stomach. It also is a protective agent in our digestive system for ingested pathogens, and prevents bacterial or fungal overgrowth in the small intestine. In addition, it encourages the flow of bile and pancreatic enzymes, and facilitates absorption of a variety of nutrients necessary to several metabolic processes. Therefore, good health and the presence of immunity depend on the existence of an adequate production of HCl and its presence in the blood stream / fluids of our body. Thus, with a reduction of HCl, we can experience a loss of immunity, an imbalance in our blood chemistry (the pH balance), and poor digestion/assimilation.

Another action that occurs in the body from a reduction of HCl is that the body makes up for it by substituting another acid to maintain the blood pH levels. Acid wastes assume the role of HCl in the blood chemistry. They begin to accumulate in our body and challenge the alkaline reserves – causing those reserves to be depleted – thus impacting this pH balance. This change in the pH balance is another factor in the reduced ability of our body to combat invading micro-organisms. Grave results can then appear in our metabolism. Western Medicine shares the same viewpoint of Chinese Medicine, in that the presence of the emotions of worry, grief, anxiety, and depression can lead to a deficiency in the production of gastric fluids, contributing to these degenerative processes.

In treating GERD/Acid Reflux/Stomach Fire with acupuncture and herbal formulas, or with drugs from Western Medicine, it is important to evaluate the function and capability of the Stomach.

Digestion is not just about what you eat, but how well the body is digesting, absorbing and eliminating what you give it. This is an important consideration for both Western Doctors when they prescribe drugs, and for Chinese Medical Doctors when they determine acupuncture treatments and herbal preparations.

Herbs and drugs that alter the pH of the Stomach will affect their absorption. Antacids are predominant used in Western Medicine to treat indigestion, reflecting the opinion that hyperacidity is the cause of the symptoms. The change in pH produced by these drugs, as they interfere with the HCl production, adversely affects the gut’s microbial flora. This has been shown to lead to the promotion of an overgrowth of Helicobacter pylori – the organism linked to ulcers and Stomach cancer. In Western Medicine, the etiologic factors causing a lack of or impaired HCl production are not well understood in Western Medicine. Studies indicate that an important cause of these gastro-intestinal problems could be a lack of HCl secretion.

The Western approach used to treat Stomach acidity includes Axid, Maalax, Mylanta, Zantac, Pepcid and Tagamet, Prilosec (which absorbs HCl acid), and Rolaids/Tums (which neutralize stomach acid). The Western treatment with Tums (which has calcium) blocks the HCl from touching the esophagus. Prilosec and Prevocet work by blocking the production of stomach acid. By reducing the hydrochloric acid of the stomach through drugs, you do not address the underlying cause of the disorder. The situation responsible for creating the fire is still operating, although the symptoms are now repressed. As a result, the Heat can be driven deeper, which may manifest later as a different health problem – such as inflammation, or muscle and joint pain.

Acupuncture and Chinese herbal medicine, in the form of teas and pills, are useful for resolving Stomach fire by addressing the underlying cause of this condition. By working with the body’s systems overall, harmony is restored in the internal pathways and organs, and the situation leading to the Stomach fire is alleviated.