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Digestive Disorders: Heartburn, Acid Reflux, and GERD

Digestive Disorders: Heartburn, Acid Reflux, and GERD

Digestive disorders affect millions of individuals and cover a variety of diseases ranging from mild to severe. These conditions involve the digestive tract, also known as the gastrointestinal or GI tract. The digestive disorders of heartburn, acid reflux, and gastroesophageal reflux disease/GERD are related and have similar symptoms but are different. Accurately diagnosing digestive disorders involves a thorough medical history, imaging and lab tests, and physical examination to develop the proper treatment plan.

Digestive Disorders: Heartburn, Acid Reflux, and GERD

Digestive Disorders

The gastrointestinal tract includes the esophagus, liver, gallbladder, stomach, pancreas, and large and small intestines.

Heartburn

Heartburn has nothing to do with the heart but describes a burning sensation in the chest. Individuals experience heartburn when stomach acid flows back into the esophagus. Occasional heartburn after eating spicy foods or foods an individual is not used to is common and is no cause for alarm. Most can manage the discomfort symptoms with lifestyle adjustments and over-the-counter medications. Chronic heartburn that interferes with daily/nightly routines could indicate a more serious condition requiring medical care. Symptoms include:

  • The burning discomfort sensations in the stomach and chest regions are usually worse after eating a meal, bending down, at night, and when lying down.
  • A bitter or acidic taste.

Acid Reflux

The esophagus comprises mainly smooth muscle that extends from the throat down through the chest cavity and past the abdomen, where it connects with the stomach. When swallowing, the esophagus opens and squeezes food down to the bottom, where a valve (lower esophageal sphincter LES) separates it from the stomach. The valve is normally closed. When swallowing, it opens so that food can pass through and then closes up. Acid reflux is a disorder that causes the valve to open when it’s not supposed to. This allows stomach contents like acid, digestive juices, enzymes, and food to flow backward from the stomach into the esophagus, causing heartburn symptoms. This usually happens when the lower esophageal sphincter is under added pressure, weakened, or malfunctioning. Symptoms can be caused by:

  • Overeating.
  • Eating spicy or acidic foods that can trigger symptoms.
  • Eating right before going to bed.
  • Medications.
  • Over alcohol consumption.
  • Exercising after eating.
  • Pregnancy.
  • Smoking.

Acid reflux and heartburn affect everyone, but most can handle the discomfort by taking antacids and avoiding the foods that brought it on. Occasional acid reflux can be treated with over-the-counter medication, including:

GERD

Acid reflux can potentially progress to gastroesophageal reflux disease, a more serious form of acid reflux that lasts longer. GERD is frequent heartburn that happens two or more times a week. Other signs and symptoms can include:

  • Regurgitation of food or sour liquid.
  • Difficulty swallowing.
  • Inflammation of vocal cords.
  • A sensation of a lump in the throat.
  • Coughing to clear throat constantly.
  • Asthma-like symptoms.
  • Chest pain, especially when lying down at night.

Various factors can cause GERD, that include lifestyle and physiological. It can develop as a result of the following:

  • Delayed stomach emptying.
  • Being overweight or obese.
  • Medications.
  • Pregnancy.
  • Hiatal hernias.
  • Smoking.
  • Connective tissue disorders like scleroderma.

Some individuals with digestive disorders may need more extensive diagnostic evaluations, including GI endoscopy, laboratory tests, and imaging.

Chiropractic Treatment

Body misalignments, unhealthy posture, and restrictive positions can contribute to digestive disorders that put pressure on the stomach and chest, triggering symptoms. A chiropractor can realign the body and take the stress off the joints and spine, relieving the pressure on the nerves. They can also strengthen the muscles through adjustments that help alleviate pressure on the stomach. A chiropractor designs a treatment plan that suits the individual’s needs, including stretches and exercises, nutrition, and health coaching to achieve and manage a healthy weight.


Chiropractic Precision


References

Carvalho de Miranda Chaves, Renata, et al. “Respiratory physiotherapy can increase lower esophageal sphincter pressure in GERD patients.” Respiratory medicine vol. 106,12 (2012): 1794-9. doi:10.1016/j.rmed.2012.08.023

Harding, Susan M. “Acid reflux and asthma.” Current opinion in pulmonary medicine vol. 9,1 (2003): 42-5. doi:10.1097/00063198-200301000-00007

Kahrilas, Peter J. “Regurgitation in patients with gastroesophageal reflux disease.” Gastroenterology & hepatology vol. 9,1 (2013): 37-9.

Pope, C E 2nd. “Acid-reflux disorders.” The New England journal of medicine vol. 331,10 (1994): 656-60. doi:10.1056/NEJM199409083311007

Tendons and Ligaments Injuries Chiropractic Back Clinic

Tendons and Ligaments Injuries Chiropractic Back Clinic

Tendons and Ligaments: A tendon is a fibrous flexible, strong tissue similar to a rope that attaches the muscles to the bones. Tendons allow for the movement of the body’s limbs and help prevent muscle injury by absorbing muscles’ impact when running, jumping, or performing other actions. Ligaments are bands of solid elastic tissue that connect bone to bone, hold structures together and keep them stable, support the joints and limit their movement.Tendons and Ligaments Injuries Chiropractic Team

Tendons and Ligaments

  • Tendons are strong and non-flexible.
  • Ligaments are flexible and elastic.
  • Both comprise collagen and living cells, essential in joints and bones and integral to locomotion.
  • Tendons allow body movement by transmitting force from muscle to bone, allowing the body to stand, walk, and jump.
  • Ligaments work by allowing for the full range of motion.
  • Ligaments are around the knees, ankles, elbows, shoulders, and other joints.

Connective Tissue

  • The collagen connective tissue that makes up tendons and ligaments is the same; their patterns are different.
  • Tendon fibers are laid out in a parallel pattern.
  • Tendon connective tissue needs to have more elasticity to help move the muscles.
  • Ligament fibers are laid out in a crisscross pattern. 
  • Ligament connective tissue stabilizes and strengthens the bones’ joint structure.

Tendon Injury

A tendon that gets overstretched or torn is known as a strain. Common areas affected by strains are the:

  • Leg
  • Foot
  • Back

Strains often result from repetitive work movements, intense physical activity, and sports. Individuals who overuse their bodies without proper rest and muscle repair recovery have an increased risk of injury. Symptoms include:

  • Inflammation
  • Swelling
  • Pain
  • Cramping
  • Weakness

Ligament Injury

A ligament that gets overstretched or torn results in a sprain. Sprains can happen suddenly from a fall, awkward movement, or trauma. Sprains commonly occur in the:

  • Ankle
  • Knee
  • Wrist

Examples include:

  • Misstep causing the ankle to twist in an awkward position, snapping a ligament and causing unstableness or wobbliness.
  • There could be a popping sensation or the feeling of a tear when the injury occurs.
  • Wrist sprains often happen when reaching out and extending the hands to break a fall, and the wrist hyperextending back.
  • The hyperextension overstretches the ligament.

Symptoms of a sprained ligament include:

  • Inflammation
  • Swelling
  • Bruising
  • Pain
  • The joint may feel loose or weak and unable to take on weight.

The intensity of symptoms varies depending on whether the ligament is overextended or torn. Sprains are classified by grade:

  • Grade 1 – a mild sprain with slight stretching of the ligament.
  • Grade 2 – a moderate ligament tear, but not a complete tear.
  • Grade 3 – a complete ligament tear, making the joint unstable.

Chiropractic Care

Tendons and ligaments do not receive full blood circulation like other soft tissues. Depending on the severity of the injury, and the slower transfer of oxygen and nutrients, ligament and tendon injuries can take six to twelve weeks to heal, and repeatedly stressing the injured area from overuse can extend recovery. Chiropractic adjustments, and massage therapy, combined with corrective exercises and stretches, will reduce inflammation, decrease pain, improve the range of motion, increase nerve and muscle function, and strengthen the muscles. Chiropractic treatment involves:

  • Soft tissue work
  • Percussive massage
  • Cross friction massage
  • Deep tissue massage
  • Trigger point therapy
  • Rest
  • Ice
  • Compression
  • Elevation
  • Ultrasound
  • Anti-inflammatory nutritional recommendations

Knee Injuries Adjustment


References

Childress, Marc A, and Anthony Beutler. “Management of chronic tendon injuries.” American family physician vol. 87,7 (2013): 486-90.

Fenwick, Steven A et al. “The vasculature and its role in the damaged and healing tendon.” Arthritis research vol. 4,4 (2002): 252-60. doi:10.1186/ar416

Leong, Natalie L et al. “Tendon and Ligament Healing and Current Approaches to Tendon and Ligament Regeneration.” Journal of orthopedic research: official publication of the Orthopaedic Research Society vol. 38,1 (2020): 7-12. doi:10.1002/jor.24475

https://orthoinfo.aaos.org/en/diseases–conditions/sprains-strains-and-other-soft-tissue-injuries

Scalcione, Luke R et al. “The athlete’s hand: ligament and tendon injury.” Seminars in musculoskeletal radiology vol. 16,4 (2012): 338-49. doi:10.1055/s-0032-1327007

Disc Protrusion Back Clinic Chiropractor

Disc Protrusion Back Clinic Chiropractor

Spinal disc deterioration from aging is normal, but health issues or injuries can advance the degenerative process. Disc protrusions are related to herniated discs but are the mildest form of the condition and are a common form of spinal disc deterioration that can cause neck and back issues. However, individuals may have a small protruding disc that can go undetected unless it irritates or compresses the surrounding nerves. Chiropractic care, decompression, and massage therapy can realign the disc back into position, relieving discomfort and pain. 

Disc Protrusion Chiropractor

Disc Protrusion

A disc is like a sturdy soft rubber shock absorber/cushion with added gel inside. The gel acts as a shock absorber. When the gel begins to protrude out slightly, this is a disc protrusion. Once a protruding disc begins to develop, it usually remains in that position. The disc can sometimes reabsorb on its own and realign back into position, but there is no way of knowing that will happen or how long it will take. With age and/or injuries, the body’s parts change. The spine’s discs dehydrate and lose elasticity weakening the discs and making them more vulnerable to herniation stages:

First Stage

  • Following natural weakening can be classified as a disc protrusion when the disc’s core begins pushing into the spinal column.
  • Disc protrusions can be tiny or push out an entire side of the disc.

Second Stage

  • Disc deterioration often consists of a bulging disc when the core pushes out farther around the circumference beyond the disc’s outer layer, called the annulus fibrosus, creating the telltale bulge.
  • A bulging disc involves more than 180 degrees of the disc’s circumference.

Third Stage

  • The third stage is a herniated disc, meaning the disc’s outer wall has torn, allowing the inner gel to leak out, usually irritating the surrounding nerves.

Fourth Stage

  • The fourth stage is sequestration, a herniated disc in which a piece of the nucleus breaks free of the vertebral disc fragments and falls into the spinal canal.

Types

A disc protrusion is one type of disc herniation that pushes out but remains connected. Different types compress and irritate the discs differently and produce various symptoms, including:

Paracentral

  • This is the most common, where the disc protrusion jams the space between the central canal and the foramen.

Central

  • This is where the disc protrusion impinges into the spinal canal, with or without spinal cord compression.

Foraminal

  • The disc intrudes into the foramen, the space through which nerve roots branch off the spinal cord and exit the vertebrae.

Symptoms, Diagnosis, and Chiropractic Care

Individuals with a disc protrusion can have symptoms similar to sciatica, which includes back, buttock, and leg discomfort, numbness, and pain sensations.

  • Treatment for disc protrusion will be based on the individual’s symptoms.
  • A chiropractor will take a detailed medical history and perform a physical examination.
  • A spinal MRI test could be ordered depending on the injury or condition.
  • A customized treatment plan will be developed to fit the individual’s medical needs.

Most disc protrusions improve after a few weeks of rest, avoiding strenuous activities, activity modification, an anti-inflammatory diet, and gentle exercises that the chiropractic team will provide.


True Spinal Decompression


References

Fardon, David F et al. “Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology.” The spine journal: official journal of the North American Spine Society vol. 14,11 (2014): 2525-45. doi:10.1016/j.spinee.2014.04.022

Mysliwiec, Lawrence Walter, et al. “MSU classification for herniated lumbar discs on MRI: toward developing objective criteria for surgical selection.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 19,7 (2010): 1087-93. doi:10.1007/s00586-009-1274-4

https://www.ninds.nih.gov/low-back-pain-fact-sheet#3102_7

Urban, Jill P G, and Sally Roberts. “Degeneration of the intervertebral disc.” Arthritis research & therapy vol. 5,3 (2003): 120-30. doi:10.1186/ar629

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