Gastroesophageal reflux disease or GERD or commonly known as heart burn is very common symptoms in patients with chronic fatigue syndrome or fibromyalgia, many of them suffer from symptoms of irritable bowel syndrome. Few have watery or loose stool and are not constipated. They do get very hot and sweat at night and prefers the cold weather.
Most patients with the chronic fatigue syndrome or fibromyalgia has poor digestion. Either they get heart burn or reflux symptom after eating or at night time. Many of them are on common reflux medication to control which may help but not eliminate the symptoms. It is still a symptomatic relief and difficult to decrease or eliminate it without rebound of the symptoms. This is beacuse the digesion don’t improve with reflux medicaion only it is symptomatic relief. In some patient after 3-5 years of use of protone pump inhibitors the efficacy may further decrease.
The reason of peristent GERD is poor digesion. Medication helps to control the symptoms but may not improve the digestion. So most of the patient need to stay on the medication for long time and after many years the efficacy decreases. The underlying problem still persist.
Our observation with this kind of patients in our chronic fatigue clinic patients is high level of acid in the body. The subset of this group of patinets has inharent genetic tendensy to secrete the high acid. Most of the patient has Type A personality. Analysing at different perspective by Ayurveda which is traditional Indian Medcine method this subset of patients are Pitta type or have Pitta/Vatta. They also have high abdominal gas formation and abdominal discomfort in many patients. Some of them have lose bowel movement after they eat or get abdominal pain. Understanding at two different perspective helps to understand the complex disease process and alleviate the condition. We have seen that analysing at two different perspective helps the treatment process better then one alone.
The factors that are precipiating the GERD are lack of sleep or interuption of sleep, Poor eating and sleeping habit. Many are high temper personality and are obsessed with perfection. That infact goes again their health. It is a vicious cycle difficult to break. Habit of eating food difficult to digest and eat more then stomch can handle is very common. Drinking cold water or ice water or cold drinks worsenes the conditon. They usually eat low fiber diet and lack of fruits and vegatable.
The factors that may help alliviating this are going to bed early by 9-10pm and waking up by 5-6am. doing slow deep breathing exercise and other Pranayma or yoga breathing exercise. Eating 1-3 apples a day helps to neutralize the acid so are pears, resins and sweat graphs useful. Many of the medication they take also has side effect of GERD that need to be evaluated or modeified or eliminated by their physician as clinically appropriate. If they have sleep apnea symptoms then they need to evaluated by their doctors and if sleep study is positive then use CPAP.
The improvment may takes many months to happen and lot more other treatment regimen needs to be modified on individual basis as every chronic fatigue patient is different and indviualizing their treatment. Adding Ayurvedic treatment regimen may further help eliminating toxins and rejuvination of the body.
Again to summarize this article it is improving sleep, food habits, eliminating side effect of drugs and change of life style when appropriate. Ayurveda may further help. Relaxation is a key.