The Cause of Reflux Esophagitis Unresolved by Acid Suppressants (The Link to SIBO) | Incheon Gastroenterology

가슴이 타는 듯한 속쓰림, 목에 무언가 걸린 듯한 이물감, 신물이 올라오는 불쾌감...
Are you trapped in a cycle of recurrence, where reflux esophagitis medication provides temporary relief, only for symptoms to invariably return when you try to stop?

When everyone points to 'excessive stomach acid' as the culprit, have you ever considered that the medication itself might be contributing to the recurrence?

The real problem might not be 'stomach acid', but 'Wei Qi Shang Ni (胃氣上逆)', where the qi that should descend instead rushes upwards.

Hello. I am Choi Yeon-seung, a Doctor of Korean Medicine who, for 15 years, has been identifying the root causes of chronic reflux esophagitis unresolved by acid suppressants and fundamentally treating them from the perspective of 'small intestinal pressure (SIBO)' and 'Wei Qi Shang Ni'.

The Great Misconception of 'Excess Stomach Acid', The Real Problem is 'Pressure'

When diagnosed with reflux esophagitis, we naturally assume 'too much stomach acid is being produced'. This belief is further strengthened because taking acid suppressants actually relieves heartburn.

Of course, it is true that excessive stomach acid secretion irritates the esophageal lining and causes heartburn. However, there is a crucial trap here that many people miss, and that leads to recurrence.

Chronic reflux esophagitis that recurs even with medication is very likely not due to 'excess stomach acid'. In fact, many individuals who have suffered from heartburn for a long time, or are elderly, are often in a state of 'hypochlorhydria', where stomach acid secretion is actually reduced.

The Source of Pressure, The Rebellion of the Lower Floor (feat. SIBO)

The origin of the pressure that constantly compresses the stomach and forcibly opens the lower esophageal sphincter is the 'small intestine (小腸)', the floor below. And the main culprit creating that pressure is 'SIBO (Small Intestinal Bacterial Overgrowth)'.

This situation can be easily understood by comparing it to a 'shaken cola bottle'🥤. A still cola bottle (normal gut) does not overflow when its cap is opened. However, when the bottle is vigorously shaken, activating the internal carbonation and increasing the pressure (a state where gas has built up due to SIBO), even a slight opening of the cap will cause the cola to erupt explosively.

Wei Qi Shang Ni (胃氣上逆)

The phenomenon of stomach contents refluxing due to pressure from the small intestine. In Korean medicine, this condition, where the stomach qi (胃氣) that should descend instead rushes upwards, refluxing into the chest and throat, is called 'Wei Qi Shang Ni (胃氣上逆)'.

The Paradox of Acid Suppressants: Adding Fuel to the Fire

Doctor, if the cause of all these problems is 'pressure', then why do symptoms temporarily improve when taking acid suppressants?

Here lies the most frightening 'paradox' that leads to recurrence. Acid suppressants, quite literally, block the secretion of stomach acid. Since the acidity of the refluxed contents decreases, it is natural that the irritation and pain experienced by the esophagus are reduced.

Conclusion

Ultimately, the reason your reflux esophagitis keeps recurring is because you've only turned off the 'heat (stomach acid)' of the pressure cooker, without addressing the 'pressure (SIBO gas)' itself that causes the internal boiling.

By now, you've likely understood the real cause of the problem and the direction for its solution. However, many of you will probably feel a fear of, 'Should I stop taking my medication right away?'

So, in the next post, I will provide answers to that very practical concern. The next topic is How to Safely Discontinue Acid Suppressants (PPIs) & Key SIBO Treatment Strategies.

The tiresome heartburn and fear of recurrence can now be brought to an end.

#GERD #SIBO