A qualitative study on the treatment practices of complementary and alternative medicine practitioners in the treatment and management of Gastro Oesophageal reflux disease

Abstract

Background Gastro Oesophageal Reflux Disease is a digestive disorder that occurs when stomach acid frequently flows up into the oesophagus and irritates the oesophageal cell lining and damages the lower oesophageal sphincter. This condition is commonly known as Acid Reflux or Regurgitation, encompassing a range of different disorders such as dyspepsia and pyrosis and in some cases may cause difficulty swallowing. There may be a sour or bitter taste at the back of the mouth due to reflux of acid. Gastro Oesophageal Reflux Disease is difficult to treat successfully. Prolonged Gastro Oesophageal Reflux Disease leads to injury and inflammation of the oesophageal lining resulting in a condition known as Barrett’s Oesophagus, with complications such as oesophageal cancer, ulceration and stricture of the oesophagus. Gastro Oesophageal Reflux Disease is commonly seen in pregnant women and individuals with hiatal hernias that suffer from dyspepsia and pyrosis, it is also commonly seen as a side effect of medication and, more commonly, stress and anxiety related effects. Gastro Oesophageal Reflux Disease and other gastrointestinal disorders are caused due to stress related inflammation which occurs in patients with stressful lifestyles. Aim of study This study aimed to identify the possible therapeutic practices and management of Gastro Oesophageal Reflux Disease from diagnosis to treatment plans by various Complementary and Alternative Medicine protocols within the context of their philosophical backgrounds. Furthermore, this research study would document valuable information of six different Complementary and Alternative Medicine modalities. These modalities are Traditional Chinese Medicine, Ayurveda, UnaniTibb, Homoeopathy and Reflexology. Methodology The research methodology has utilized a qualitative design incorporating semistructured interviews of twelve Complementary and Alternate Medicine practitioners in the eThekwini area on their treatment of Gastro Oesophageal Reflux Disease. Interviews were done with each Complementary and Alternative Medicine practitioner at a place that was convenient to each practitioner. The interviews were recorded on a Dictaphone and a mobile audio recorder. Each interview was 30 minutes long and was guided by research questions. A stratified purposive sampling was implemented in order to select practitioners according to their modality in the provinces of South Africa exclusively. A pilot study was conducted to ensure trustworthiness and Ethics approval was sort from the Durban University of Technology Institutional Research Ethics Committee (IREC) Analysis of data utilized qualitative design methods that would produce themes and concepts from the information collected. Results The findings of this study showed that Gastro-oesophageal Reflux Disease can be interpreted by many Complementary and Alternative Medicine modalities according to different philosophies such as Miasms, Temperaments, Systemic Meridians and Doshas. Each Complementary and Alternative Medicine philosophy is governed by a set of factors that requires homeostasis to produce optimal health. Despite the various philosophical theories, all modalities were underpinned by the same principle that Gastro Oesophageal Reflux Disease is caused by a constitutional imbalance. This is characterized, in modern times, by inflammation, acidic build up, emotional and mental health and physical conditions, being understood as contributing factors of Gastro Oesophageal Reflux Disease, thus the theme of individualization was the key understanding in the treatment and management protocols. Each Complementary and Alternative Medicine modality prescribed well indicated herbal medicine in conjunction with lifestyle modification best suited for each patient individually. Management included therapies such as acupuncture, yoga, cupping and calming exercises. Furthermore, each modality “borrowed” medicines or therapies from other modalities in order to enhance the efficacy of the treatment and management of Gastro Oesophageal Reflux Disease. Conclusion It was concluded that Gastro Oesophageal Reflux Disease needs a multidimensional approach of treatment and management. Lifestyle changes, medication (herbs and remedies), stress management and dietary changes are needed to correct and manage Gastro Oesophageal Reflux Disease along with reducing or preventing the risk of complications that can manifest. Overall, the treatment and management through Complementary and Alternative Medicine modalities can improve the quality of life of patients with Gastro Oesophageal Reflux Disease. 7