Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease (GERD) is a condition in which stomach contents reflux into the esophagus, causing bothersome symptoms and/or complications. GERD can be classified into three types: non-erosive reflux disease (NERD), erosive esophagitis (EE), and Barrett’s esophagus (BE). In traditional Chinese medicine (TCM), this condition falls within the category of “acid regurgitation” (tusuan).

TCM Pattern Differentiation and Medication Information

|Common Symptoms

Clinical description:

Heartburn, acid regurgitation, pain behind the sternum or in the epigastrium, often triggered by emotional factors; epigastric distension and oppression extending to both flanks; chest tightness with frequent sighing; repeated belching; difficult bowel movements; a pale-red tongue with a thin white coating; and a wiry pulse.

In plain language:

  • A burning feeling in the chest or stomach, often with acid regurgitation
  • Pain behind the breastbone or in the upper abdomen
  • Symptoms are often triggered or worsened by emotional changes
  • A feeling of fullness and discomfort in the stomach, sometimes extending to the ribs on both sides
  • Chest tightness, often relieved by taking a deep sigh
  • Frequent belching
  • Difficulty passing stools
  • A pale-red tongue with a thin white coating
  • A wiry pulse, traditionally associated with emotional factors and Liver–Stomach disharmony

|Treatment Approach

Clinical description:

Soothe the Liver and relieve constraint; harmonize the Stomach and direct rebellious Qi downward.

In plain language:

  • Use methods intended to course Liver Qi and ease constraint, helping Qi flow more smoothly and easing discomfort such as flank distension and pain, chest tightness, low mood, irritability, and frequent sighing.
  • At the same time, regulate Stomach function and direct “Qi rising upward” downward to ease upper abdominal fullness, belching, acid regurgitation, hiccups, nausea, and vomiting.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical description:

Heartburn, acid regurgitation, burning pain behind the sternum or in the epigastrium, irritability, a gnawing or unsettled feeling in the stomach, dry or bitter taste in the mouth, hard stools, a red tongue with a yellow coating, and a wiry or rapid pulse.

In plain language:

  • A burning type of pain in the chest or stomach
  • Frequent acid regurgitation and heartburn
  • Feeling easily irritated or short-tempered
  • Stomach discomfort, as if something is stuck or obstructing it
  • The mouth often feels dry or bitter
  • Hard stools that are difficult to pass
  • A red tongue with a yellow coating
  • A relatively rapid or wiry pulse, traditionally associated with internal heat and Liver–Stomach disharmony

|Treatment Approach

Clinical description:

Soothe the Liver and clear heat; harmonize the Stomach and direct rebellious Qi downward.

In plain language:

  • Use methods intended to course Liver Qi and disperse constrained heat, easing discomfort such as flank distension and pain, chest tightness, bitter taste, red eyes, irritability, and feeling easily angered.
  • At the same time, regulate Stomach function and direct “Qi rising upward” downward to ease upper abdominal fullness, belching, acid regurgitation, hiccups, nausea, and vomiting.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical description:

Difficulty swallowing, with a sensation of something lodged in the throat, often worsening when emotional distress is present; occasional heartburn, acid regurgitation, or stomach discomfort; sometimes an itchy throat and cough, or episodes of phlegmy breathing or wheezing; poor appetite; difficult bowel movements; a pale tongue with a thin white coating; and a wiry or slippery pulse.

In plain language:

  • Difficulty swallowing, with a sensation that something is stuck in the throat
  • Symptoms may worsen when feeling emotionally distressed
  • Occasional heartburn or acid regurgitation
  • Stomach discomfort, as if something is churning
  • Sometimes an itchy throat and a tendency to cough, or phlegmy breathing or wheezing
  • Poor appetite and little desire to eat
  • Difficulty passing stools
  • A pale tongue with a thin white coating
  • A wiry or slippery pulse, traditionally associated with emotional factors and digestive dysfunction

|Treatment Approach

Clinical description:

Regulate Qi and transform phlegm; harmonize the Stomach and direct rebellious Qi downward.

In plain language:

  • Use methods intended to regulate Qi and transform thick phlegm, making it easier to expectorate and easing discomfort such as chest tightness, coughing, phlegm in the throat, and sticky phlegm that is difficult to bring up.
  • At the same time, regulate Stomach function and direct “Qi rising upward” downward to ease upper abdominal fullness, belching, acid regurgitation, hiccups, nausea, and vomiting.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical description:

Stabbing pain behind the sternum or in the epigastrium, abdominal distension and fullness, or vomiting blood or passing black stools; occasional heartburn and acid regurgitation; uncomfortable belching; weight loss; difficulty swallowing; a dusky-purple tongue or purple spots; and a choppy pulse.

In plain language:

  • A stabbing pain behind the breastbone or in the stomach area
  • Frequent fullness and discomfort in the stomach or abdomen
  • Vomiting blood or passing black stools may occur
  • Sometimes accompanied by heartburn or acid regurgitation
  • Frequent belching that feels uncomfortable
  • Gradual weight loss
  • Difficulty swallowing
  • A dusky-purple tongue, sometimes with purple spots
  • A choppy pulse, traditionally associated with blood stasis

|Treatment Approach

Clinical description:

Regulate Qi and invigorate blood; harmonize the Stomach and direct rebellious Qi downward.

In plain language:

  • Use methods intended to regulate Qi and promote blood flow, easing discomfort associated with stagnation, such as upper abdominal fullness and pain, stabbing pain, or tenderness to pressure.
  • At the same time, regulate Stomach function and direct “Qi rising upward” downward to ease belching, acid regurgitation, hiccups, nausea, and vomiting, and to support appetite and digestive comfort.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical description:

Dull pain behind the sternum or in the epigastrium, a gnawing or unsettled feeling with heartburn, dry mouth and throat, a sensation of heat in the palms, soles, and chest, weight loss and fatigue, thirst without desire to drink, hard stools, a red tongue with little moisture, and a fine, rapid pulse.

In plain language:

  • A dull, aching pain behind the breastbone or in the stomach area
  • Frequent heartburn or acid regurgitation
  • Dry mouth and throat
  • A frequent feeling of heat in the palms, soles, and chest
  • Weight loss and easy fatigue
  • Often feeling thirsty but not wanting to drink much
  • Hard stools that are difficult to pass
  • A red, dry-looking tongue with little moisture
  • A fine, relatively rapid pulse, traditionally associated with Yin deficiency and internal deficiency heat

|Treatment Approach

Clinical description:

Nourish Yin and benefit the Stomach; harmonize the middle and direct rebellious Qi downward.

In plain language:

  • Use nourishing and moistening methods to replenish Stomach fluids and help keep the Stomach “moist,” easing dry mouth and throat, upper abdominal burning or dull pain, feeling hungry but unable to eat, and dry stools.
  • At the same time, harmonize the function of the middle burner and direct “Qi rising upward” downward to ease upper abdominal fullness, belching, acid regurgitation, hiccups, nausea, and vomiting.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

References

  1. Dent J, El-Serag HB, Wallander MA, Johansson S. Epidemiology of gastro-oesophageal reflux disease: a systematic review[J]. Gut, 2005(54): 710-717.
  2. Wu JC. Gastroesophageal reflux disease: an Asian perspective[J]. J Gastroenterol Hepatol, 2008(23): 1785-1793.
  3. Chen Shengliang. Characteristics of gastroesophageal reflux disease in the Asia-Pacific region[J]. Gastroenterology, 2009(14): 713-715.
  4. Chinese Pharmacopoeia Commission. Clinical Medication Guide to the Pharmacopoeia of the People’s Republic of China: Chinese Patent Medicines [M]. Beijing: China Medical Science Press, 2011.