V. Gastroesophageal Reflux Gastritis Esophagitis

V. Gastroesophageal Reflux Gastritis (Esophagitis)

Normal bile flows from the common bile duct into the duodenum, then moves through the duodenum and into the jejunum along with gastric contents. However, when gastrointestinal function is disrupted, or when there are abnormalities in the gastrointestinal and pancreatic endocrine functions, bile can reflux into the stomach and lower esophagus, stimulating increased gastric acid production and causing congestion, edema, and ulcers in the gastric and esophageal mucosa. Clinically, there are three main characteristics: ① burning pain in the epigastric region or lower chest; ② nausea and vomiting, with bile present in vomitus; ③ acid reflux. The pain caused by esophageal reflux often radiates downward from the xiphoid process toward the chest. What causes bile reflux? There are three possible scenarios: ① post-gastric surgery (gastric resection or gastric bypass); ② chronic gastritis or ulcers; ③ autonomic nervous system disorders of the gastrointestinal tract. Western medicine often uses H2-receptor blockers to reduce gastric acid production—such as Meclozine, Ranitidine, Losec, and Omeprazole—but these medications are often combined with drugs that increase gastric emptying, such as Gastimun, Metoclopramide. Overall, these treatments are merely symptomatic therapies. Traditional Chinese medicine views this condition as involving liver wood overcoming earth, stomach qi rising upward, and stomach fire being too intense; the treatment principles focus on soothing the liver and stomach, reversing upward qi, and relieving vomiting and acid reflux while clearing fire and drying dampness. Commonly used formulas include Si Ni San, Xiao Yao San, Xuan Fu Dai He, Ban Xia Xie Xin, and Xiao Xian Xiong, among others; I often use a specific formula that often yields remarkable clinical effects. Gu An San Yi Tang: 10g Chai Hu, 10g Zhi Ru, 15g Bai Shao, 6g Gan Cao, 10g Dang Shen, 3g Mu Xiang, 3g Cao Kou, 10g Huang Lian, 3g Wu Yu, 10g Gua Lou, 6g Ban Xia, 15g Sheng He Shi Tao, 6g Chuan Xiong, 6g Yuan Hu, 10g Shan Zhi, 6g Cang Zhu, 6g Shen Qu, decocted and taken once daily. For chest tightness, add 6g Hou Pu and 10g Zhi Ru; for severe stomach pain, add 10g Huang Qin, 6g Gan Jiang, 10g Yuan Hu, 15g Luowaleng, 3g Ming Fang; for constipation, add 6g Da Huang; for difficulty swallowing, add 10g Zhe Bei Mu, 10g San Ling, 10g E Zhu; for red tongue with bruising, add 10g Tao Ren and 3g Hong Hua.