GERD, IBS, Phlegm Accumulation Syndrome?

It is quite common for people to be diagnosed with reflux esophagitis in internal medicine due to symptoms of the upper gastrointestinal tract such as heartburn, indigestion, and chest pain. This is commonly referred to as reflux esophagitis, and in English, it is called Gastroesophageal Reflux Disease, abbreviated as GERD.

It is known to cause symptoms when gastric acid secreted from the stomach refluxes due to the gastroesophageal sphincter not being properly controlled. Drugs such as PPIs (proton pump inhibitors), which suppress gastric acid secretion, are primarily used.

Non-Erosive Reflux Disease (NERD)

Generally, reflux esophagitis refers to cases where erosions and inflammatory findings are observed during gastroscopy due to acid reflux. However, symptoms resembling reflux esophagitis can also appear without such endoscopic abnormalities, and this is classified as Non-Erosive Reflux Disease (NERD).

Particularly in NERD, there is significant interest because symptoms are often not well controlled even with acid-suppressing medications.

Functional Esophageal Disorders

Symptoms of functional esophageal disorders include chest pain, heartburn, chest burning sensation, reflux hypersensitivity, globus sensation, and functional dysphagia.

Reflux hypersensitivity is also known as esophageal hypersensitivity. While PPIs may be prescribed for a chest burning sensation, if there is no therapeutic response to the medication, the condition is differentiated by re-evaluating for acid exposure.

Relation to Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) also exhibits a similar pattern. IBS primarily involves functional symptoms without inflammation, with key symptoms including frequent constipation, diarrhea, and post-meal abdominal pain.

IBS does not show inflammation on endoscopic findings and has a high rate of accompanying mental health issues such as anxiety and depression.

Relation to Damjeokbyeong

Damjeokbyeong refers to cases where an overly sensitive nervous system manifests as digestive symptoms. It is a condition where various neurological symptoms and gastrointestinal disorders appear together. Although Damjeokbyeong is not an official diagnostic term, many people search for information about it and often self-identify with the condition.

Differences between Reflux Esophagitis, Irritable Bowel Syndrome, and Damjeokbyeong

Ultimately, I believe that the dysregulation of the autonomic nervous system caused by various stress responses in the body, leading to digestive symptoms, is captured by terms such as functional gastrointestinal disorders, Irritable Bowel Syndrome, and Damjeokbyeong.

If the main symptoms appear in the upper gastrointestinal tract, they might be described as reflux esophagitis, while symptoms primarily in the lower gastrointestinal tract would be termed irritable bowel syndrome. It seems some individuals perceive it as Damjeokbyeong when symptoms resembling 'Hwabyung' (anger syndrome) predominantly affect the digestive system.

In traditional Korean medicine, these are described as Ganbi-bulhwa (disharmony between Liver and Spleen) or Gan-gi-beomwi (Liver qi invading Spleen/Stomach), primarily indicating a pattern where excessive stress leads to digestive symptoms. Treatment will require conditioning to normalize digestive function and harmonize the autonomic nervous system.

For digestive symptoms, consistent treatment is often necessary because symptoms tend to manifest chronically over a considerably long period.