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Do You Have Any of these Problems?

  1. History of lactose intolerance or gluten intolerance
  2. Craving or thirst for cold liquids or foods
  3. Intolerance of dairy products, grains, or sugar
  4. Sensitive to air pollutants (i.e., perfumes, smoke)
  5. Discomfort or soreness under the left rib cage after eating

They are consistent with carbohydrate digestive problems.

It has several causes, all concerned with digestion, particularly in the duodenum and jejunum. Irritation can be caused by any digestive disturbance and may include the liver and biliary system and especially the pancreas.

If you are interested in solutions to these problems go to www.nevadachiro.com or call (702) 565-7474 for more information.

As an additional resource, go here www.nevadachiro.com/Nutrition.html.

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The Facts about Gastroesophageal Reflux Disorder

I wanted to share this article by one of my mentors, Dr. Howard Loomis. He is the godfather of enzyme replacement therapy.

by Howard Loomis, D.C.

Before beginning this discussion, I wish to point out that current diagnosis of this seemingly pandemic condition is done without physical examination or objective testing. Recommendation of antacids, proton-pump inhibitors, and histamine antagonists, thus canceling normal digestion in the stomach, can only lead to chronic degenerative conditions.

GERD is a condition that is described as occurring when the acidified liquid contents of the stomach back up into the esophagus. This includes not only stomach acid, but pepsin as well and may even include bile that has backed-up into the stomach from the duodenum. The liquid can inflame and damage the lining of the esophagus, if it is not protected by the mucosal lining.  This is in and of itself not a disease.

The symptoms of uncomplicated GERD are heartburn, regurgitation, and nausea, but these symptoms only occur in a minority of patients. This statement requires some explanation.

Reflux of the stomach’s liquid contents into the esophagus occurs in most normal individuals. In fact, one study found that reflux occurs as frequently in normal individuals as in patients with a diagnosis of GERD. There are several mechanisms that prevent the symptoms from occurring:

  • Most reflux occurs during the day when we are upright and refluxed liquid is more likely to flow back down into the stomach due to the effect of gravity.
  • When awake we repeatedly swallow and each swallow carries any refluxed liquid back into the stomach. Also saliva contains bicarbonate and with each swallow it travels down the esophagus and neutralizes the small amount of acid that remains in the esophagus after gravity and swallowing have removed most of the liquid.
  • At night while sleeping, gravity is not in effect, swallowing stops, and the secretion of saliva is reduced. Therefore, reflux that occurs at night is more likely to result in acid remaining in the esophagus longer and can cause damage to the esophagus.

Symptoms of Uncomplicated GERD

Heartburn
When acid refluxes back into the esophagus in patients with GERD, nerve fibers in the esophagus are stimulated. This nerve stimulation results most commonly in heartburn, the pain that is characteristic of GERD. Heartburn usually is described as a burning pain in the middle of the chest. It may start high in the abdomen or may extend up into the neck. In some patients, however, the pain may be sharp or pressure-like, rather than burning. Such pain can mimic heart pain or angina. In other patients, the pain may extend to the back.

Episodes of heartburn tend to happen periodically. This means that the episodes are more frequent or severe for a period of several weeks or months, and then they become less frequent or severe or even absent for several weeks or months. Nevertheless, medicine considers GERD to be a chronic condition and once treatment for GERD is begun it is continued indefinitely.

Regurgitation
Usually only small quantities of liquid reach the esophagus, and the liquid remains in the lower esophagus. At the upper end of the esophagus is the upper esophageal sphincter (UES). The upper esophageal sphincter is a circular ring of muscle that is very similar in its actions to the lower esophageal sphincter (LES). That is, it prevents esophageal contents from backing up into the throat. When small amounts of refluxed liquid and/or foods pass back through the UES and enter the throat, there may be an acid taste in the mouth. If larger quantities breach the UES, patients may suddenly find their mouths filled with the liquid or food.

Nausea
Nausea is uncommon in GERD. In some patients, however, it may be frequent or severe and may result in vomiting. In fact, in patients with unexplained nausea and/or vomiting, GERD is one of the first conditions suspected. It is not clear why some patients with GERD develop mainly heartburn and others develop mainly nausea.

The Causes of GERD

These include an abnormal lower esophageal sphincter, weak or abnormal esophageal contractions, hiatal hernia, and slow emptying of the stomach – BUT NOT EXCESS STOMACH ACID PRODUCTION, except in the rare Zollinger-Ellison Syndrome. A small number of patients with GERD do produce abnormally large amounts of acid, but this is uncommon and not a contributing factor in the vast majority of patients.

Lower esophageal sphincter (C3 to C5 and T4 to T9)
The action of the lower esophageal sphincter (LES) is the most important factor for preventing reflux. The LES is a specialized ring of muscle that surrounds the lower-most end of the esophagus where it joins the stomach. This muscle is active most of the time, contracting and closing off the passage from the esophagus into the stomach. When food or saliva is swallowed, the LES relaxes for a few seconds to allow the food or saliva to pass into the stomach, and then it closes again. Two abnormalities of the LES have been found in patients with GERD:

  • The first is abnormally weak contraction of the LES, which reduces its ability to prevent reflux.
  • The second is abnormal relaxations of the LES that do not accompany swallows and they can last up to several minutes.

These prolonged relaxations allow reflux to occur more easily. The transient LES relaxations occur in patients with GERD most commonly after meals when the stomach is distended with food.

Hiatal hernia
Hiatal hernias may contribute to reflux, but not necessarily. A majority of patients with GERD have hiatal hernias, but many do not AND many people have hiatal hernias but do not have GERD! There appear to be three reasons why a hiatal hernia can contribute to GERD:

  • First, the LES is located at the same level where the esophagus passes from the chest through the diaphragm and into the abdomen. When there is a hiatal hernia, a small part of the upper stomach that attaches to the esophagus pushes up through the diaphragm. As a result, a small part of the stomach and the LES come to lie in the chest, and the LES is no longer at the level of the diaphragm. This means the barrier to reflux is equal to the sum of the pressures generated by the LES and the diaphragm.
  • Second, a hiatal hernia produces a small pouch of stomach above the diaphragm. The sac is pinched off from the esophagus above by the LES and from the stomach below by the diaphragm. The sac traps acid that comes from the stomach and it is easier for the acid to reflux when the LES relaxes with a swallow or a transient relaxation.
  • Finally, the esophagus normally joins the stomach obliquely, not straight on or at a 90-degree angle. Due to this oblique angle of entry, a flap of tissue is formed between the stomach and esophagus. This flap acts like a valve, shutting off the esophagus from the stomach and preventing reflux. When a hiatal hernia allows entry of the esophagus into the stomach the valve-like flap is distorted or disappears and it no longer can help prevent reflux.

Esophageal contractions
Swallowing is important in eliminating acid in the esophagus. Swallowing causes a ring-like wave of contraction of the esophageal muscles, which narrows the lumen of the esophagus. Peristalsis begins in the upper esophagus and travels to the lower esophagus. It pushes food, saliva, and whatever else is in the esophagus into the stomach. If the contraction is weak, refluxed acid cannot be pushed back into the stomach.

Abnormalities of contraction are found frequently in patients with GERD. In fact, they are found most frequently in those patients with the most severe GERD. Note that smoking also substantially reduces the clearance of acid from the esophagus. This effect continues for at least 6 hours after the last cigarette.

Delayed Emptying of the stomach
A minority of patients with GERD, about 20%, have been found to have stomachs that empty more slowly than normal after a meal. This slower emptying of the stomach prolongs the distention of the stomach with food after meals. Therefore, the slower emptying prolongs the period of time during which reflux is more likely to occur.

Hi. Dr. Swolensky again! If you have questions about this information please contact my office at www.nevadachiro.com or call (702) 565-7474.

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Brain Function (Sensorimotor Cortex) Increases with Chiropractic Care

topography of brain cortex
Image via Wikipedia
by Mark Studin DC, FASBE(C), DAAPM, DAAMLP

Chiropractic care improves brain function and the body’s motor or movement ability

Research findings that redefine care for every rehabilitation patient for all motor disorders

According to the Sensory Processing Disorder Foundation (2011), “Sensory processing (sometimes called ‘sensory integration‘ or SI) is a term that refers to the way the nervous system receives messages from the senses and turns them into appropriate motor and behavioral responses. Whether you are biting into a hamburger, riding a bicycle, or reading a book, your successful completion of the activity requires processing sensation or ‘sensory integration'” (http://www.learningrx.com/sensory-motor-integration-faq.htm)

According to Wikipedia (2011), “A motor skill is a learned sequence of movements that combine to produce a smooth, efficient action in order to master a particular task. The development of motor skill occurs in the motor cortex, the region of the cerebral cortex that controls voluntary muscle groups” (http://en.wikipedia.org/wiki/Motor_skill).

According to LearningRX (2010), “Sensory motor integration is the synergistic relationship between the sensory system and the motor system. Since the two communicate and coordinate with each other, if one is problematic, the other can suffer as a result. The two involve receiving and transmitting the stimuli to the central nervous system where the stimulus is then interpreted. The nervous system then determines how to respond and transmits the instructions via nerve impulses to carry out the instructions (e.g. a hand-eye coordination movement)” (http://www.learningrx.com/ sensory-motor-integration-faq.htm).

The synopsis of the above 3 paragraphs is that the human body senses information (sensory processing), processes the information in the brain (sensorimotor cortex), and then sends the information to the part of the body that has to perform a function, such as moving your thumb, walking, talking, picking something up or any other function we do in our lives. As the above paragraph eloquently stated, if any of the 3 areas are not working properly or working not optimally, every part of the system suffers.

In 2010, Taylor and Murphy concluded in their research that chiropractic care improves the functional levels of the motor cortex, premotor areas, and that this improved measurement was maintained after a 20-minute training task, indicating that it wasn’t a transient finding. The authors further offered that the practical applications suggesting that:

1. this alters the way the central nervous system responds to motor training

2. a chiropractic spinal adjustment/manipulation alters the neurological integration at the cortical (brain) level

3. this explains the mechanism responsible for reducing pain levels and increased functional ability after the adjustment/manipulation

4. this explains the mechanism of overuse injuries and chronic pain conditions

The above 4 areas change the way we should approach strategies in rehabilitation for all neurodegenerative and congenital motor and sensory disorders. A list of potential disorders that could benefit in rehabilitation from this research is:

1. muscular dystrophy

2. Duchenne muscular dystrophy

3. myasthenia gravis

4. Parkinson’s disease

5. fibromyalgia

6. multiple sclerosis

7. Huntington’s disease

8. stroke victims

9. all other neuro-muscular diseases

On a clinical note, this author, having cared for muscular dystrophy patients for 30 years, can report that in every instance, the patients were able to ambulate (walk) with greater ease and had significantly more motor control (movement) while under chiropractic care. The goal of rehabilitation in the neurodegenerative patient is to both increase muscle tone and through repetition of activities of daily living, gait training, balance training, speech training and all other motor functions, to help retrain the muscles to maximize the body’s ability to regain those functions. The rehabilitation is essential in most cases and critical to the person regaining an independent life.

The therapist in rehabilitation creates a setting similar to a car or kitchen so that the patient can re-create activities of daily living. In doing these activities with the help of the therapist, the patient is activating stimuli in the sensory nervous system. Touching and movement are senses that the brain has to process and then send impulses back to the muscles to move in order to perform daily tasks. In order for function to be regained maximally, there can be no dysfunction at the spinal level. That dysfunction is defined in chiropractic as subluxation or a vertebrate out of place, negatively affecting the nerve and fixed in the wrong position.

Based upon the research by Taylor and Murphy (2010), if there is a spinal dysfunction (subluxation) it prevents normal impulses from the sensory system and lowers the ability of the brain from functioning at its optimal. Therefore, the most rehabilitation can offer is maximization of the body’s ability at reduced capacity. The implications are staggering as in many cases that could mean no matter the expertise of the therapist or the diligence of the patient, the rehabilitation would not be as successful or could fail if the brain could not function at a higher level.

Through chiropractic care, the patient can have the ability to function at a higher level and live a “more normal life” with neurodegenerative disorders. The implications go well beyond neurodegenerative disorders and cross over to industry, sports and everyday life. However, that will be discussed in another article.

References:

1. Sensory Processing Disorder Foundation (2011). About SPD. Retrieved from http://spdfoundation.net/about-sensory-processing-disorder.html

2. Wikipedia (2011). Motor skill. Retrieved from http://en.wikipedia.org/wiki/Motor_skill

3. LearningRX (2010). Sensory motor integration. Retrieved from http://www.learningrx.com/sensory-motor-integration-faq.htm

4. Taylor, H. H., & Murphy, B. (2010). The effects of spinal manipulation on central integration of dual somatosensory input observed after motor training: A crossover study. Journal of Manipulative and Physiological Therapeutics,　33(4), 261-272.

If you have any further questions. call or contact us at www.nevadachiro.com


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