Gastroesophageal reflux disease, or GERD, affects up to 25 percent of Americans and Europeans, according to a 2009 review in "American Family Physician." Heartburn is the most prominent symptom of GERD, but other symptoms, such as chest pain or pressure, abdominal pain and cough, are not uncommon. GERD can lead to injury of the lining in the lower part of your esophagus, which if not addressed can contribute to the development of esophageal cancer.
Cause of GERD
The exact cause of GERD is a matter of some debate, but a 2009 review in "Gastroenterology Research and Practice" suggests that the disorder arises from inappropriate relaxation of the lower esophageal sphincter, which is a narrowed portion at the bottom of your esophagus that normally prevents the backwashing of acidic stomach contents. Physical factors that appear to aggravate GERD include abnormalities in the muscular contractions of the esophagus, a persistent laxity of the lower esophageal sphincter and delayed stomach emptying following meals.
Digestive Enzymes Enhance Stomach Emptying
When you eat a meal, the food that enters your stomach is subjected to a mixture of acid and enzymes that help to break the swallowed material into smaller particles that can eventually leave the stomach and enter the small intestine, where more enzymes continue the digestive process. In conditions in which insufficient gastric acid is present to activate your digestive enzymes, or when digestive enzymes are not produced in sufficient amounts, gastric emptying is delayed. This can occur during treatment with acid-blocking medications or as a result of pancreatic disorders.
Digestive Enzymes: A Two-Edged Sword
Although delayed gastric emptying probably plays a role in GERD, it is only one part of the mechanism that causes this condition. As outlined in a 2009 "Journal of Pharmacy and Pharmacology" review, anything that is present in your stomach during a "reflux event" can potentially come in contact with your esophagus. Thus, if you are taking digestive enzymes to accelerate the emptying of your stomach and some of those enzymes backwash into your esophagus, the enzymes could further irritate the esophageal lining.
GERD is a potentially serious condition that over time can lead to cancerous changes in your esophagus. Intuitively, it might seem that the use of digestive enzymes would hasten gastric emptying and reduce the likelihood of reflux, thereby reducing your symptoms, but there is no convincing evidence to suggest that digestive enzymes are useful for the treatment of GERD, and there is the possibility that digestive enzymes could worsen esophageal injury if they are regurgitated. If you have GERD, talk with your doctor before using digestive enzymes.
Is This an Emergency?
- “American Family Physician”; GERD in Adults; B. Delaney, P. Moayeddi; January 2009
- “Gastroenterology Research and Practice”; Gastroesophageal Reflux Disease: Medical or Surgical Treatment?; T. Liakakos, et al.; December 2009
- “Journal of Pharmacy and Pharmacology”; The Role of an Alginate Suspension on Pepsin and Bile Acids - Key Aggressors in the Gastric Refluxate. Does This Have Implications for the Treatment of Gastro-oesophageal Reflux Disease? V. Strugala, et al.; August 2009