Acupuncture and Electroacupuncture for GERD

Got reflux? You’re not alone. While it’s not unusual to experience heartburn after eating spicy, fatty, or acidic foods, if you’re dealing with heartburn more than twice a week, you may have gastroesophageal reflux disease (GERD). Twenty percent of Americans have this condition, which consists of heartburn and regurgitation (acid in your throat or mouth), as well as symptoms such as dry cough and trouble swallowing. Symptoms are triggered by problem foods, such as chocolate, coffee, alcohol, tomatoes, and vary from person to person.

With GERD, the valve at the base of the esophagus (the tube that connects the mouth to the stomach), doesn't function properly. When it’s not working properly, this valve, called the lower esophageal sphincter, or LES, allows stomach acid to back up into the esophagus, explains Eamonn M.M. Quigley, MD, chief of the division of gastroenterology and hepatology at Houston Methodist Hospital.

Conventional Treatment for GERD

While over-the-counter medications, such as antacids like TUMS and Rolaids, help reduce stomach acid and work for occasional heartburn and stomach upset, people who suffer from chronic reflux, or GERD, usually have two options to treat their condition:

1. Proton Pump Inhibitors (PPIs). These prescription medications reduce the acid in your stomach and help heal damage to the esophagus caused by GERD. PPIs are generally well tolerated, but long-term side effects may include reduced bone density, malabsorption of vitamin B12, and increased risk of gastrointestinal conditions, from run-of-the-mill gastroenteritis to the more serious Clostridium Difficile (C. Diff), a bacterial infection that causes inflammation of the colon.

But not everyone will get heartburn relief on PPIs. Additionally, "Some of these people have large hiatal hernias [when the upper part of the stomach bulges through the opening in the diaphragm], combined with poor function of the lower esophageal sphincter. And while they may not experience heartburn on PPIs, they may still have a lot of regurgitation," says Quigley, adding that these people are great candidates for option two: surgery.

2. Fundoplication. "If your GERD symptoms don’t respond to PPIs, you may be a candidate for laproscopic fundoplication surgery, which is a procedure that wraps the upper part of the stomach around the lower esophageal sphincter to strengthen the sphincter," says Quigley. While it’s effective for some, if the wrap is too tight, you may have continued problems swallowing; if the wrap is too loose, or it begins to loosen over time, PPIs may be prescribed again. Nonetheless, when performed by an experienced surgeon, surgery is effective for carefully selected patients with chronic GERD, according to the American College of Gastroenterology.

Since surgery and long-term medication aren't especially appealing, more and more GERD patients are considering alternative treatments, such as acupuncture.

Acupuncture and Electroacupuncture for GERD

Based on traditional Chinese medicine, acupuncture uses small needles placed on specific points on the body to rebalance qi, or energy flow, and promote healing. "Acupuncture resets the template of the body—the way [the body] works," says Kathleen Lumiere DAOM, L.Ac., Assistant Professor Acupuncture and East Asian Medicine, School of Traditional World Medicines Bastyr University, Seattle.

Research appears to support this idea: A 2006 study showed that the effects of acupuncture on the ST-36 point (a specific acupuncture point, located on the lower leg) may be beneficial to patients with GERD.

What should you expect if you opt for acupuncture?

You'll start with an intake meeting, where your practitioner will take a health history and may look at the color, shape, and coating of your tongue; he or she will also take your pulse to find the location of the qi imbalance in your body. All these techniques allow the practitioner to make a diagnosis from a Chinese medicine perspective. For instance, "Rebellious stomach qi is a common traditional Chinese medicine diagnosis for GERD," says Lumiere.

After the initial assessment, a personalized treatment approach is determined. The practitioner will also do a dietary assessment and prescribe dietary changes and possibly Chinese herbs.

Anatomy of an Acupuncture Session

During acupuncture treatment, for GERD, "We stimulate the acupuncture points to reduce transient lower esophageal sphincter relaxations and help strengthen the muscle so that it works properly," explains Lumiere.

Anywhere from 6 to 20 hair-thin, sterile needles may be used during each session. The points for GERD include the ST-36 point, as well as additional points located on the front and back of the torso, explains Lumiere. In addition, "I do something unique in my practice, and use acupuncture to relax the muscles surrounding the LES so they can close properly, and thus prevent GERD. My patients have had tremendous success with that."

Appointments usually last about 60 minutes; weekly sessions are recommended. Costs range from $50 to $120 per session, but may be covered by your insurance. Preliminary results are usually seen within two to three weeks.

During treatment, your practitioner may also address other conditions, such as stress, which may also help soothe your GERD symptoms. But Lumiere has found that her patients benefit from more than a reduction in GERD symptoms: "I’ve had people say their sleep was fragmented, but now they sleep soundly. Or that they used to have headaches, and now they’re gone."

But, as with PPIs, some GERD patients’ symptoms may not improve with traditional acupuncture. These people may find relief with electroacupuncture, which is basically acupuncture with the use of electrical currents. "Electroacupuncture provides more constant stimulation," says Lumiere. "I love it for a lot of things. In this case I use it for patients with recalcitrant GERD that doesn't respond to a few treatments of manual acupuncture."

And it appears to work, both anecdotally and in some small studies. One study in the Journal of Traditional Chinese Medicine found that electroacupuncture, combined with zhizhukuanzhong capsules (a Chinese herbal preparation), helped alleviate GERD symptoms. But, again, the study was small, so more thorough research is needed.

What You Need to Know

While these unconventional approaches may appeal, "On the basis of current research, it would be difficult to recommend acupuncture or electroacupuncture for GERD," warns Quigley. "We don’t know for sure that it works. And while it may not do any harm, it may cost a lot out of pocket, and there may be no benefit."

Bottom line: It comes down to personal preference. If you are uncomfortable with medications, or having surgery—and you don’t mind needles—acupuncture may be an option for you. You can even use acupuncture in conjunction with your current medication. If you are interested in acupuncture to treat GERD, Lumiere recommends you find a licensed acupuncturist (L.Ac.) with three years of training at the graduate level.

Kathleen Lumiere DAOM, L.Ac., and Eamonn M.M. Quigley, MD, reviewed this article.

Sources

Eamonn M.M. Quigley, MD. Interview March 5, 2015.

Kathleen Lumiere DAOM, L.Ac.. Interview March 9, 2015.

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