GERD stands for Gastroesophageal reflux disease. It is a very common problem in western countries these days. Around 10-20% of the world population is affected by this disease.

GERD is a chronic and progressive disorder including various drastic symptoms like: esophageal ulcer, esophageal cancer, Barrett’s disease (damage to lower cells of esophagus), respiratory problems, heart burn, chest pain, and angina.

It is caused due to the abnormal reflux of gastric juice and other content in to the esophagus and oral cavity or lungs which may cause damage to the mucosal lining of the area which get affected.

GERD can be classified further on the basis of the presence or absence of mucosal damage of esophagus as seen on endoscopy:

  • Non-erosive reflux disease (NERD)
  • Erosive reflux disease (ERD)

GERD symptoms not only cause a condition of disease but adversely affect the day to day activities and quality of life of the patient. These symptoms are sometimes quite similar to irritable bowel syndrome and dyspepsia (indigestion).

Due to its similarity with other disease like chronic cough, asthma, dental erosion, etc. it is difficult to diagnose this disorder or differentiate this disorder from other diseases which make it more deadly.

Three hypotheses are given Stephen J. Sontag in his research paper to explain why GERD is affecting human population:

  • Hypothesis 1: CONGENITAL. Due to incomplete gestation period some people can’t develop proper anti-reflux barriers like- lower esophageal sphincter, phreno-esophageal ligaments(ligament by which esophagus is attached to the diaphragm), and right crural(a structure extend below diaphragm to vertebral column)diaphragm.
  • Hypothesis 2: ACUTE TRAUMA. Due to acute traumatic injury anti reflux barriers in adult get easily disrupted which may even create a condition called hiatal hernia which renders every possibility to prevent GERD.
  • Hypothesis 3: CHRONIC TRAUMA. This is mainly due to western life style. The use of high seated toilets and low fibre diet result in strain to defecate which gradually weakened the anti-reflux barriers.

Causes of GERD include:

  • The barrier between stomach and food pipe is ruptured or doesn’t work.
  • It can also be cause by a condition called Hiatal hernia (a part of stomach pushes up through the diaphragm).
  • Obesity, smoking, drinking alcohol, and being in stress can also trigger GERD symptoms.
  • Bad life style and bad eating habits can also induce symptoms of GERD.
  • Drugs against high blood pressure and birth control pills are also one of the causes of GERD.

GERD has a recurrent nature hence a long term and continuous treatment is required to get rid of this disorder completely.

Hydrogen receptor blockers and proton pump inhibitors are most commonly used drugs for the treatment of this disease.

But these drugs have adverse side effects on the body. They may cause hypochlorhydria (low production of hydrochloric acid in stomach), cardiac events and increased risk of hip fractures which can make the problem worse for the patient suffering from GERD.

Hence there is a need to find natural remedy for this disease with least side effects and no further complications.

This study on aloe vera demonstrates the efficacy of this medicinal plant in treating GERD.

What happened in the study?

This study was conducted to analyse the effect of aloe vera juice on the patients with gastroesophageal reflux disease and also compare its effects with other antacids like omeprazole and ranitidine.

The study included 79 patients age between 18-65 years. These patients were randomly given different treatments with Aloe vera syrup, omeprazole capsule or ranitidine tablet. The dosage of each medicine was defined:

  • Aloe vera syrup was given 10ml per day. The syrup was standardized to 5.0mg polysaccharide per ml of syrup.
  • Omeprazole capsule was given 20mg per day.
  • Ranitidine tablet was given 150mg in morning and then 150 mg before sleep.

The study lasted for 4 weeks. After 2nd and 4th weeks patients were check for eight main symptoms of GERD (heart burn, food expulsion, intestinal gas, burping, dysphagia (discomfort in swallowing), nausea, vomiting and acid expulsion).

The goal was to analyse the effect of aloe vera on patients showing various symptom of GERD. How efficient aloe vera syrup is in fighting those symptoms and what relief could this cause to the patient suffering from GERD.

What were the results of the study?

The result of the study shows a significant reduction in the GERD symptoms at interval of both 2 and 4 weeks of treatment in all the groups.

The aloe vera group showed a reduction in all the GERD symptoms at both 2 week and 4 week as compared with the baseline or untreated patients.

In the omeprazole and ranitidine group the frequency of all assessed symptoms of GERD was also reduced significantly compared with the data recorded at the start.

A trend in increased frequency of heart burn was seen in all the groups at 4th week as compared to that at 2nd week.

Adverse events result in two drop-outs each from omeprazole and ranitidine groups while no drop-out took place from aloe vera group.

This indicates that the side effects from the omeprazole and ranitidine were intolerable to the patients as compared to the relief these chemicals give. While aloe vera show least side effects and these few side effects were comparably tolerable.

How does this occur?

It has been believed that GERD is a result of inflammation and oxidative stress. Hence aloe vera reducing the symptoms of GERD is due to its anti-oxidant and anti-inflammatory properties.

Aloe vera inhibits the activity of cyclooxygenase (enzyme involved in stabilizing superoxide in the cell), has ability to scavenge superoxide anions, reduce lipid peroxidation and up regulates antioxidant enzymes; hence it acts as a potent antioxidant.

In a study it was found that aloe vera reduces oxidative damage to liver due to various toxins like Carbon tetrachloride which can lead to hepatotoxicity.

Also aloe vera suppress the expression of lipid producing genes so insulin resistance improves and toxic effect of lipid on liver get reduced. Since liver is the most vital organ for digestion, so this hepatoprotectant nature of aloe vera can improve digestion and prevent heart burn (major symptom of GERD).

It was also found out that aloe vera reduce the chances of leukocyte infiltration (movement of white blood cells outside the blood to infected area) and TNF-alpha concentration in infection with Helicobater pylori.

This is the indication of strong antimicrobial effect of aloe vera against H.pylori (bacteria which has the tendency to damage the gastroesophageal lining) and hence the effect of gastric acid secretion on stomach lining gets reduced.

Aloe vera contains lectins which inhibit the aminopyrin uptake by acid secreting cells of stomach so acid secretion is reduced. Hence, damage to oesophageal lining can be prevented.

Aloe vera leaf extracts contain a glycoprotein called aloctin A, which reduces the volume of gastric juice, acid and pepsin production in stomach. It also inhibits the appearance of gastric lesions.

Also polymer fraction of aloe vera protects the gastric mucosa (outer layer of stomach) against erosion.

Phytosterols (plant steroids) present in the aloe vera help in lowering blood glucose concentrations; hence digestion is improved and GERD symptoms gets reduced.

What does this mean?

This implies that aloe vera syrup provide easy, safe and effective treatment and reduce the frequency of GERD symptoms significantly. So aloe vera should be given to the patients suffering from GERD on daily basis to get relief from this disease naturally.

Also because aloe vera is less expensive, easily available and has many therapeutic activities other than treating GERD for example: peptic ulcers, diabetes etc. and also it does not cause any side effect. Aloe vera syrup can be very beneficial for health if taken regularly.

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