Is There An Herb That Can Help Acid Reflux?
Answered by: Robert Newman, L.Ac.
Question from: Geri Cobbin
Posted on: July 30, 2004

There are numerous herbs which could be considered for use in the case of acid reflux. In traditional Chinese medicine (TCM), we try to look at the whole person and see each person as an individual, different from anyone else. So different herbs are going to be chosen, depending on what the diagnosis is that describes the causative factor(s) in TCM. There are several causes involving the internal organs that are believed to be associated with acid reflux. Naturally, the Stomach is always the main organ involved, symptomatically. But an imbalance with the Liver is also considered a main factor in one of these situations. I’ll describe the three main factors and some possible herbs below.

One common cause, according to TCM, is said to be from what’s known as Stomach Yin deficiency with heat. This is where the Yin aspect of the Stomach is deficient or insufficient and heat occurs as a result of this material, fluid component being too weak to balance out the warming Yang aspect of the system (the Yin aspect of the body includes the fluids, the Blood, what’s known as the Essence, and just generally, the material and physical components of the body -- as opposed to the Yang, which is that part of the body which is more energetic in nature; the Yang involves the more functional aspect, the active and warming and protective aspect). This situation involves a heat due to a deficiency rather than there being too much of the Yang or warming aspect present. So this is called a "deficient heat" and is milder than what is known as an "excess heat" -- in the case of the excess condition, the Yang is present in excess of what is considered normal. The symptoms and signs are what are used to determine the difference between a Yin deficiency heat versus an excess heat condition. With Yin deficiency, the heat symptoms are less severe and they occur more in the afternoon as the day goes on and particularly more in the evening. So along with the acid regurgitation, there may be Stomach (epigastrium) pain, mild thirst with possible desire for cooler liquids -- but only in small sips, low grade fevers, flushing of the cheeks, a sudden feeling of heat in the upper body (possible "hot flashes"), a feeling of heat in the palms and the soles of the feet and the chest, night sweats, constipation with dry stools, low appetite, dry mouth and throat, fullness feeling after eating; and remember, with Yin deficiency, most or all of these symptoms occur in the later part of the day and/or evening and typically may get worse as it gets closer to evening and into the later part of the night. According to Giovanni Maciocia, in the "Foundations of Chinese Medicine," the causes for this Stomach Yin deficiency heat are irregular eating habits and diet: eating late at night, skipping meals, eating in too much of a hurry and eating while under stress, going back to a stressful job too quickly after having just eaten, (I would add overeating to this list), etc. Primary herbs that could be considered for this are:

* Bei Sha Shen ("bay shah shen," Radix Glehnia littoralis, Coastal Glehnia root)

* Yu Zhu ("yew joo," Radix Polygonatum odoratum, Chinese Solomon’s Seal root)

* Mai Men Dong ("my men dohng," Tuber Ophiopogon japonicus, Mondo Grass/Lilyturf tuber)

* Shi Hu ("shih hoo," Herba Dendrobium nobile, Dendrobium orchid stems)

* Bai Mu Er ("buy moo are," Fructificatio Tremella fuciformis, White Wood Ear Mushroom)

Secondary herbs to consider are:

* Sheng Di Huang ("shung dee hwahng," Radix Rehmannia glutinosa, Chinese Foxglove root)

* Nu Zhen Zi ("noo jen tzih," Semen Ligustrum lucidum, Chinese Privet seed)

* Hei Zhi Ma ("hay jih mah," Semen Sesamum indicum, Sesame seed)

* Tian Men Dong ("tee-en men dohng," Tuber Asparagus cochinchinensis, Chinese Climbing Asparagus Fern)

* Tian Hua Fen ("tee-en hwah fen," Radix Trichosanthes kirilowii, Kirilow’s Snakegourd root)

* Zhu Ru ("joo roo," Caulis Phyllostachys nigra var. henonis in taenis, Bamboo shavings)

Another cause for acid regurgitation is what is known as Stomach fire, an excess heat situation -- this is a stronger heat than a Yin deficiency heat. According to Maciocia, the main causes for this Stomach fire are eating an excessive amount of moderately or extremely spicy-hot foods (food with peppers, cardamon, curry, gingers, garlic, etc.) and/or the smoking of cigarettes (this adds heat into our bodies). In addition to acid regurgitation, there may be a burning sensation and pain in Stomach (epigastrium), strong thirst with a strong desire to drink cold fluids, constant and strong hunger, gum swelling and pain, bleeding gums, constipation with dry and hard stools, nausea, vomiting right after eating, bad breath.

Herbs that could be considered to address Stomach Fire/Excess Heat are:

* Huang Lian ("hwahng lee-en," Rhizoma Coptis chinensis, Chinese Goldthread rhizome)

* Zhu Ru ("joo roo," Caulis Phyllostachys nigra var. henonis in taenis, Bamboo shavings)

* Shi Gao ("shih g’oww," Calcium sulfate, Gypsum)

* Zhi Mu ("jih moo," Rhizoma Anemarrhena asphodeloides, Anemarrhena rhizome)

* Lu Gen ("loo gun," Rhizoma Phragmites communis, Reed rhizome)

The third possible diagnosis in TCM as a cause for this problem is a fairly common one. It is a condition that is said to be largely due to an imbalance of the Liver, according to TCM. In TCM, one of the most important functions of the Liver is to makes sure that the flow of "Qi" is moving and coursing smoothly, evenly and fully in all directions (up, down, inward, outward, etc.), throughout all parts of the body and all the channels (I should clarify what "Qi" is; in the west, most people who have heard of Qi think that it is synonymous with "energy," but it is more than just something that gives you energy or pep; see below at the end of this reply for a further explanation of "Qi"). Stress is one of the main contributors to Liver imbalances: it is a strong factor in creating stagnation in the flow of the Qi in the body and as such is also a common cause of Liver imbalances. It is said to cause a knotting and binding of the Liver Qi -- just think of the tension and knotted feeling you get inside when you are under a great deal of stress: this is your Qi becoming bound and stagnant in its flow. When the Liver Qi develops this knotting and binding, it can begin to affect and disrupt the smooth flow of Qi in other organs or parts of the body -- when this happens, it is said that the Liver is "attacking" these other organs or areas of the body. One of the areas that is often easily affected adversely by this Liver attack is the digestive tract, including the two main organs of digestion in TCM, the Stomach and the "Spleen" (see my answer to the question, also on the Q&A section on Richters website, "Can You Tell Me About Korean Ginseng and Give Me Some Advice About Weight Loss Herbs?" to understand more about the Chinese idea of the "Spleen" organ). This is also known as a disharmony between the Liver and the Stomach. The effect on the Stomach is that it will tend to cause excess heat in the Stomach and also cause rebellious Stomach Qi (see below, near the end of this answer, for a description of rebellious Stomach Qi). When this knotted Liver Qi affects the Stomach, in addition to the symptom of acid regurgitation, there may also be irritability, distention and pain in the Stomach (epigastrium) and flanks/ribs(hypochondrium), fullness and bloating in the Stomach, belching, nausea, vomiting, headaches on the temples; generally, when the Liver Qi is knotted and congested, you will see that the associated symptoms (such as the ones just listed) are worse with stress. So a classic indication with this diagnosis is when the acid regurgitation gets worse with stress. Sometimes, when certain drugs or chemical/environmental toxins cause excessive heat and toxicity build up in the Liver, it can affect the flow of Liver Qi adversely and can also lead to problems with the Liver attacking the Stomach and/or digestive tract. Also, if the Blood becomes weak or deficient, this too can sometimes cause or exacerbate Liver Qi stagnation and knotting.

Herbs that could be considered to address Liver-Stomach Disharmony are:

* Xiang Fu ("shee-ahng fu," Rhizoma/Tuber Cyperus rotundus, Chinese Nutgrass tuber)

* Mu Xiang ("moo shee-ahng," Radix Saussurea/Aucklandia lappa, Costus root)

* Chai Hu ("chigh hoo," Radix Bupleurum chinensis, Chinese Thorowax root)

* Bai Shao ("buy sh’oww," Radix Paeonia lactiflora, Herbaceous/White Peony root)

* Fang Feng ("fawng fung," Radix Siler/Saposhnikovia divaricata, Siler Root)

* Fo Shou ("foe show," Fructus Citrus medica var. sarcodactylis, Buddha’s Hand Citrus fruit)

If excessive heat and toxicity have indeed built up in the Liver, herbs that can clear toxic heat and Blood heat in the Liver are also needed. Likewise, if the Blood has become weak or deficient, herbs that can tonify the Liver Blood are also needed.

There are two additional groups of herbs below which could be used as general adjuncts to the herb choices above within any of the 3 syndromes, to also address any of the 3 above conditions. They are chosen depending on their properties and activities (i.e., depending on their temperature, their other functions, certain contraindications, etc.) and the particular needs of the patient who is being treated. The first of these two additional types of herbs is generally good for situations involving acid regurgitation, because these herbs are known to symptomatically reduce and "absorb" the acidity in the Stomach:

* Mu Li ("moo lee," Concha Ostrea gigas, Oyster shell)

* Hai Piao Xiao ("hi pee-oww shee-oww," Os Sepia esculenta seu Sepiella maindroni, Cuttlefish bone)

* Hai Ge Ke ("hi guh kuh," Concha Cyclina sinensis, Clam shell)

Also generally good for situations involving acid regurgitation, the following second group of adjunct herbs symptomatically brings down the upward rising Stomach contents/acid (the proper direction of movement for the contents of the Stomach is obviously downward -- according to TCM, we say that the Stomach "Qi" should normally descend; if some imbalance is present that adversely impacts the Stomach, it can cause a disruption of the Stomach Qi flow, causing it to go upwards, in the opposite direction of what is normal; this is known as "rebellious Stomach Qi"; so in TCM, these herbs are considered to lower "rebellious Stomach Qi"). Again, the choice of which of these herbs to use depends on the properties and activities of the herbs and the particular needs of the patient who is being treated:

* Pi Pa Ye ("pee pah yay," Folium Eriobotrya japonica, Loquat Tree leaves)

* Zhi Ke ("jih kuh," Fructus Immaturus Citrus aurantium, Bitter Orange unripe fruit)

* Zhi Shi ("jih shih," Fructus Citrus aurantium, Bitter Orange fruit) Shi Di ("shih dee," Calyx Diospyros kaki, Persimmon fruit calyx)

* Sheng Jiang ("shung jee-ahng," Rhizoma Zingiber officinalis recens, fresh Ginger rhizome)

Also possible is for there to be a mixture of the patterns, involving the Liver attacking the Stomach with either the Stomach Yin deficiency or the Stomach fire present as well. In that case, one might use a combination of herbs for both of those issues while trying to also combine herbs to balance out the overall temperature of the formula and the properties of the herbs in conjunction with the patient’s specific constitution and needs.

There are some specific prepared formulas in the form of patent pill medicines available in some Chinese pharmacies and on the internet. You can do a search on Google for the following formulas, listed in order of their importance for treating acid reflux in TCM: Xiang Lian Wan; Shu Gan Wan; Chai Hu Long Gu Mu Li Wan.

Richters has some seeds, plants or dried or prepared herbal material available of some of the above-mentioned single species of herbs:

* Rehmannia: plants are sold (Rehmannia glutinosa, Sheng Di Huang)

* Privet, Chinese: seeds, plants are sold (Ligustrum lucidum, Nu Zhen Zi)

* Sesame: seeds are sold (Sesamum indicum, Hei Zhi Ma)

* Asparagus, Chinese: seeds are sold (Asparagus cochinchinensis, Tian Men Dong)

* Cucumber, Chinese: seeds are sold (Trichosanthes kirilowii, Tian Hua Fen)

* Goldthread: dried herb whole is sold (Coptis trifolia: this is not the Chinese species, this is an American species and may or may not have similar properties and functions)

* Zhi Mu: seeds are sold (Anemarrhena asphodeloides, Zhi Mu)

* Bupleurum: seeds, dried root powder are sold (Bupleurum chinensis, Chai Hu)

* Laserwort: seeds are sold (Saposhnikovia/Siler divaricata, Fang Feng)

* Ginger: plants, dried root cut, dried root powder, fluid extract of root are all sold (Zingiber officinalis, Sheng Jiang)

A Description of What "Qi" Is:

Qi is basically indefinable -- you can’t hold a physical amount of Qi in your hands, you can’t say you’re holding 3 units of Qi or you’re going to put 10 units of Qi into a bottle: what is meant by this is that it is like gravity, known only by its manifestations, effects, and functions. Qi is matter that is about to become (disperse into) energy and energy about to become (condense into) matter; it is both etheric and material, heaven and earth, life and death, etc. Qi is the basis for all things, living and non-living, energetic and physical. In our bodies, Qi is responsible for warming us, protecting us (this includes all aspects of what we would call our "immune system" in western physiology), holding all fluids and the Qi itself inside of us (i.e., Qi prevents losses: when the Qi is weak, there may be losses of fluids from deficiency in such conditions as frequent urination or incontinence, spermatorrhea, leucorrhea, diarrhea, excessive sweats without exertion; possible loss of blood through excessive menses, bleeding with a cough, bleeding with bowel movements, bleeding with urination or through the nose; possible loss of Qi through a chronic, frequent cough, etc.; significant fatigue and weakness are generally always accompanying these symptoms and Qi is always lost along with the loss of these fluids, leading to greater weakness of the Qi and further losses from the increasingly weaker Qi having less ability to hold), transporting all materials throughout the body (transporting Blood, fluids, Essence, and even Qi itself), holding the organs and tissues in place and the muscles in good tone (Qi prevents prolapses such as hemorrhoids, hernias, prolapsed uterus, bladder, stomach, etc. and is responsible for preventing flaccidity and sagging of muscles and skin), moving the body (Qi is not only responsible for the start of a movement of any part of the body, but is also involved with the whole process of movement from start to finish), and is the source for all transformations in the body (e.g., the transformation of: food and fluids into both usable nutrients and into feces and urine; one compound or substance into another: so this involves ALL the chemical and metabolic reactions that take place inside and outside of our cells, such as when our body makes a hormone or enzyme or breaks down ATP for energy, etc.).

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