Treating Acid Reflux With TCM - CEU PROVIDER OPTIONS FOR WELLNESS, INC. 7059 SW 53 LN
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Treating
Acid Reflux
With TCM
2 CEU’S
OPTIONS FOR WELLNESS, INC.
7059 SW 53 LN
Miami, Fla 33155
305-665-0615
www.myacupunctureceus.com
CEU PROVIDER
50-2489-1 State of Florida
State of California CEP 722
1
ACHB-038 NCCAOMAcid Reflux
More than 60 million Americans experience heartburn at least once a month and
some studies have suggested that more than 15 million Americans experience
heartburn symptoms each day. (American College of Gastroenterology ). Acid reflux
disease is described as heartburn 2 or more days a week despite treatment and diet
change.
Acid reflux disease is caused by reflux of stomach acid into the esophagus. In most
patients this is due to a transient relaxation of the "gate" or sphincter (LES) that
keeps the lower end of the esophagus closed when a person is not swallowing food
or liquids. This transient relaxation happens a few times each day in people without
acid reflux disease. The esophagus is not able to cope with acid as well as the
stomach and is easily injured. It's the acid refluxing into the esophagus that
produces the symptoms and potentially damages the esophagus.
GERD can masquerade as other diseases
Increasingly, we are becoming aware that the irritation and damage to the
esophagus from continual presence of acid can prompt an entire array of symptoms
other than simple heartburn. Experts recognize that often the role of acid reflux has
been overlooked as a potential factor in the diagnosis and treatment of patients with
chronic cough, hoarseness and asthma-like symptoms. In some instances, patients
have never reported heartburn, and in others the potential causal link between reflux
and the onset of these so-called “extra-esophageal manifestations” has not been
fully recognized. It is good clinical practice to evaluate the possible presence of reflux
in patients with chronic cough and asthma-like symptoms.
Chinese Medicine differentiates signs and symptoms. The western diagnosis of acid
reflux or GERD needs to be catagorized as hot or cold, as the wrong herbal formula
will cause a worsening of symptoms .
Western Medicine Diagnosis for Acid Reflux:
Gastric ulcer, gastritis (chronic), indigestion, GERD
2Chinese Medicine Etiology (causes):
Diet :
sweet/greasy/hot and spicy or bad quality food
Exterior pathogen invasion:
cold invading the middle Jiao
deficiency yang Qi turns to turbid dampness causing acid.
Emotion:
liver attacks stomach
spleen creates damp/phlegm which creates acid
Deficiency Middle Jiao congenital dysfunction:
retention of food
Spleen can’t transform or transport which creates acid
Differentiatiion and Treatment of Acid Reflux in Chinese Medicine
COLD Acid regurgitation, frothy fluids, fullness in abdomen, belching, cold limbs, soft stools,
fatigue, ameliorated by warm drinks
Tongue - pale and flabby with a think white coat - may have teethmarks
Pulse – weak, deficient
Syndromes
SP Qi Xu (with Phlegm-Damp and pain)
ST Qi Xu
ST Cold
3Clinical Manifestations could include:
Nausea / vomiting Emaciation
Sallow complexion Anorexia with a full feeling after
very little food
Weak abdomen
Abdominal distention or pain
Belching (subtle)
Rolled lips Pale lips
Stiff tongue Tired limbs
Heavy limbs Chest fullness
Acid regurgitation Muscle weakness in arms and
legs
Loose stools or diarrhea
Maybe bleeding
Thin muscles.
Lethargy-fatigue
Does not like to speak
Weak, soft voice
Maybe enuresis
Maybe cold extremities
Maybe borborygmus
Principle of Treatment:
Warm middle jiao, disperse cold to harmonize Stomach and reduce acid
Herbal Medicine Formula:
Xiang Sha Liu Jun Zi Tang which is Six Gentlemen Decoction with Aucklandia and
Amomum Also known as: Saussurea and Cardamon Combination or Saussurea, Cardamon
and the Six Gentlemen Decoction
Tonifies Qi, Strengthens SP, Harmonizes ST, Regulates Qi and Stops pain.
4The Formula Treats Biomedically defined disorders such as:
Indigestion Acute or chronic gastritis
Gastric or duodenal ulcer Acute or chronic gastroenteritis
Gastroptosis Gastric distention
Emotional instability Chronic peritonitis
Rickets Nervous exhaustion
Gastralgia Delayed menstruation due to Phlegm
Obstruction
Morning sickness
Chronic bronchitis
Modifications
For severe cases of Stomach Cold:
add Liang Fu Wan aka Pills of Galanga and Cyperus
or add Wu Zhu Yu (Evodia) Wu Zhu Yu has a marked warming effect on the body,
helping to relieve headaches and a wide range of digestive problems warms the
middle, lower qi, rids cold of stomach, lower blood pressure. Useful for vomiting,
excess acid of stomach, pain in solar plexus, cold type of hernia, cold and dampness
of swelling of legs.
Acupuncture Points:
Commonly used tonifying acupuncture points include ST36, SP9, SP6, LI10, LIV8, REN6, and
REN4.
5Differentiatiion and Treatment of Acid Reflux in Chinese Medicine
HOT Frequent acid regurgitation with belching of old food, fullness in abdomen, dry mouth,
thirsty, smelly stools, liver Qi stagnation symptoms
Tongue - red, yellow coat
Pulse - Wiry, slippery, rapid
Syndromes
Liver-Heat causing Liver and Stomach disharmony.
Clinical Manifestations could include:
Acid regurgitation Peptic ulcer
Acute gastritis Vomiting
Chronic gastritis Belching
Distension of the epigastrium Bitter taste
Excessive hunger Dry mouth
Hiatus hernia Red tongue, yellow coating
Pain of the hypochondrium (along Rapid-Wiry pulse
the Liver channel)
Principle of Treatment:
Clear heat, sooth liver, descend St. Qi
Herbal Medicine Formula:
Zuo Jin Wan aka Left Metal pill or Coptis & Evodia
Clears Liver-Heat , Drains Liver-Heat, Stops vomiting, Subdues Rebellious Qi
The Formula Treats:
Biomedically defined disorders such as: Gastritis, peptic ulcer, esophageal reflux, hiatal hernia
6Modifications
Acid regurgitation (severe cases) add Wu Zei Gu (Os Sepiae seu Sepiellae) Cuttlefish
Bone, Cuttlebone and Wa Leng Zi (Concha Arcae) Cockle Shell, Ark Shell
Severe distension of the epigastrium add Chuan Lian Zi (Fructus Meliae Toosendan)
Sichuan Pagoda Tree Fruit
Acupuncture Points:
CV 12, PC 6, SP 4, ST 34, ST 36
Common Sense Additions:
Food Therapy:
It is very helpful to ask the patient to keep an honest Food Diary. For approximately two
weeks, ask them to write down what they eat, when they eat and where they eat. Noting any
symptoms they may experience. This will help you decide on any change in eating habits that
may be necessary.
Foods To Avoid
These commonly consumed foods often cause problems:
Orange juice, Cranberry juice, Fried Foods (think of potato chips and donuts too,
tomato, vinegar, garlic, coffee, wine, liquor, cigarettes ( Tobacco inhibits saliva.)
Posture:
Slouching and not keeping the back straight can cause symptoms to worsen.
Sleeping at a 45 degree angle by using a wedge under the mattress seems to help a lot of
people who’s symptoms are worse at night. No eating 2-3 hours before sleep.
7Examination for Acid Reflux in TCM:
1. From a western perspective, acid reflux disease is caused by reflux of ______________
___________________________________________________________________
2. Acid reflux disease is described as heartburn _____________________________
despite treatment and diet change.
3. From a TCM perspective, what would cause acid reflux?
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
4. Differentiation shows a cold pattern , patients tongue would present as:
__________________________________________________________________________
5. The principal treatment for Herbal Formula in the above cold pattern would look to:
__________________________________________________________________________
6. The herbal formula Xiang Sha Liu Jun Zi Tang / Six Gentlemen Decoction with Aucklandia
and Amomum will perform the following:
__________________________________________________________________________
__________________________________________________________________________
87. If you determine the patient has signs of heat, what will present as symptoms?
___________________________________________________________________________
___________________________________________________________________________
8. The herbal formula Zuo Jin Wan / Left Metal pill will perform what actions?
___________________________________________________________________________
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