One thing I love about scientific research is that it constantly challenges and reexamines conventional wisdom and thinking. In doing so, some pretty amazing discoveries can be made, potentially altering how various diseases are treated and managed.
A perfect example of this is gastroesophageal reflux disease (GERD). For 80 years, the medical community thought this digestive condition was caused by stomach acid backing up into the esophagus, causing burning, irritation, and damage. But a new study published in the Journal of the American Medical Association questions this long-held belief. This research suggests that the damage caused by GERD actually occurs as a result of an inflammatory response prompted by inflammatory messenger proteins called cytokines.
The researchers followed 12 men who used proton pump inhibitors (PPIs), medications that reduce the amount of acid made by the stomach, to successfully treat their GERD. They stopped taking their PPIs for two weeks, during which time the researchers assumed the GERD would redevelop. In 11 of the 12 patients, the researchers observed changes in the esophagus. However, those changes were not burns, as would be expected. Rather, they found that the refluxed stomach acid stimulated the esophagus to make cytokines, which in turn set off a cascade of inflammatory processes leading back to the disease.
In their conclusion, the researchers stated that these findings suggest the development of GERD “may be cytokine-mediated rather than the result of chemical injury.” In other words, it’s not the acid that’s causing the problem, but the inflammatory messengers.
Let me tell you why this type of research and shift in thinking is so important. It tells the medical community that they have been focusing on the wrong area to treat a disease that affects millions. And the focus in this case needs to move toward the real underlying cause of the disease—inflammation and cytokine blockers. Current GERD treatments neutralize or reduce stomach acid. But this exciting finding opens the door for innovative GERD therapies that target cytokines and other inflammatory proteins rather than stomach acid.
Cytokines were first discovered in the 1950’s and 1960’s. They are problematic in general because they are signals that drive chronic, low-grade inflammation. And as you know, this inflammation is directly linked to diseases like cancer, heart disease, and diabetes. Of course, the GERD/cytokine link needs further study. But if additional research does prove cytokines to be cause of the damaging effects of GERD, taking steps to lower their presence in your body may be helpful. And, in fact, there are a large family of cytokine blockers currently used to treat several inflammatory diseases such as arthritis, psoriasis, and Crohn’s disease. It is possible that clinical trials will show they can also be used for GERD. This is very exciting!
In the meantime, reduce inflammation with an anti-inflammatory diet that lowers your intake of sugar, which triggers the release of cytokines. At the same time, increase your intake of anti-inflammatory omega-3 fatty acids. A good way to do that is to take an omega-3 supplement every day. However, taking omega-3 capsules can aggravate acid reflux in some people. If you find that to be the case, try eating omega-3-containing fish two to three times a week instead. The best option is salmon, but other omega-3-rich fish include mackerel, sardines, trout, and albacore tuna.
Additionally, you want to avoid spicy and overly acidic foods (like tomatoes, citrus, and coffee), which can aggravate symptoms.
Dunbar KB, et al. JAMA. 2016;315(19):2104-112.