Acid Reflux May Respond Better to Foods Than Prescribed Pills by Dr. Mercola
Acid Reflux May Respond Better to Foods Than Prescribed Pills
January 03, 2018 • 27,311views
Story at-a-glance
Americans
spend $13 billion a year on over-the-counter and prescription proton
pump inhibitors (PPIs), the most popular anti-reflux medications on the
market
Acid
reflux, also known as gastroesophageal reflux disease (GERD), is a
condition affecting about 20 percent of the U.S. population
Consuming
a Mediterranean diet may be as effective as PPIs in treating acid
reflux symptoms; a Mediterranean-style diet focuses on fruits, healthy
fats, lean meats, nuts and vegetables
Often,
you can restore your body’s acid balance simply by avoiding processed
foods and sugar, eating real food and infusing your gut microbiome with
beneficial bacteria from fermented foods or a high-quality probiotic
A
number of natural remedies, including apple cider vinegar, baking soda,
ginger and slippery elm, can be useful to address occasional reflux
problems and, in conjunction with diet changes, may eliminate the need
for PPIs and other medications
By Dr. Mercola
Americans spend a whopping $13 billion a year on over-the-counter and prescription proton pump inhibitors (PPIs), which are the most popular anti-reflux medications on the market.1
Because they inhibit acid production, prescription PPI drugs like
Nexium, Prevacid and Prilosec are used to treat acid reflux, also known
as gastroesophageal reflux disease (GERD), a condition affecting about
20 percent of the U.S. population.2
Once prescribed, your doctor may keep you on a PPI drug for years,
despite label warnings suggesting they be used only for short periods.
If you regularly suffer from heartburn or acid reflux, you'll want to
take note of research suggesting dietary changes are as or more
effective than drugs in addressing acid reflux.
In many cases, you can begin to restore your body's proper gastric balance and function simply by avoiding processed foods and sugar. By eating real food and infusing your gut microbiome with beneficial bacteria — from traditionally fermented foods
or a high-quality probiotic supplement — you can rebalance your
digestive system and eliminate the need for PPIs and other medications.
In addition, there are several natural remedies available to help you
address this condition.
What Is Reflux?
Reflux, or GERD, occurs when contents from your stomach back up into
your esophagus, causing stomach acid to irritate the lining of your
esophagus. Other common names for this condition include:
If you experience acid reflux symptoms more than twice a week, you
very likely have reflux disease or GERD, which involves bloating,
burning pain in your chest and gut discomfort.
GERD sufferers who experience pronounced reflux symptoms concentrated
in the upper throat area, including the pharynx and voice box, may have
a more serious condition called laryngopharyngeal reflux (LPR). LPR
occurs when pepsin, a digestive enzyme from your stomach, damages the
sensitive tissues in the back of your throat, resulting in symptoms such
as:3
A "lump" in your throat that doesn't go away
Excessive throat clearing or throat mucus
Hoarseness
Persistent cough or sore throat
Trouble breathing or swallowing
Research Shows Diet Plays a Crucial Role in Addressing Acid Reflux
A study published in the Journal of the American Medical Association Otolaryngology, Head & Neck Surgery4 involving 184 participants, suggests a Mediterranean diet — one focused on fruits, healthy fats, lean meats, nuts and vegetables — may be as effective as PPIs in treating acid reflux symptoms.
The type of reflux addressed in the research was LPR, the kind in
which stomach acid affects sensitive tissues at the back of your throat.
"You're not supposed to have acid up in the throat," says lead study
author Dr. Craig Zalvan, chief of otolaryngology and medical director of
the Phelps Institute for Voice and Swallowing Disorders at Phelps
Hospital in New York. "The tissues there have poor protection against
acid and pepsin."
All the study participants were advised to avoid reflux triggers such
as alcohol, chocolate, coffee, greasy and fatty foods, spicy foods and
tea. The research compared outcomes involving two groups:
85 LPR sufferers who were treated with PPIs
99 LPR sufferers who were put on a Mediterranean diet and told to drink alkaline water
After six weeks, outcomes were measured using a standardized reflux
scale. Notably, those who changed their diet and those who used PPI
medications both reported a similar lessening of reflux symptoms, with
the diet group indicating a slightly higher level of improvement. Given
the outcomes, Zalvan believes diet is the better of the two options for
addressing LPR symptoms. He states:
"These results really show you can treat people with a diet-based
approach using a plant-based diet. If you take all patients with LPR
and put them on a plant-based diet … the majority do get better. And
they stop their drugs, which overall leads to much better health."
The Benefits of a Mediterranean Diet on Reflux
Even though it was not clear from the research why this particular
choice of diet evidently helped relieve reflux symptoms, a number of
studies have confirmed the overall health benefits of a
Mediterranean-style diet. As you may imagine, eating a healthy diet will
naturally contribute to your body's proper acid balance.
Even if you do not have reflux issues, a Mediterranean-style diet is a
good choice if you are interested in optimizing your health, since it's
low in sugar,
moderate in protein and high in fresh fruits and vegetables, as well as
healthy fats. The Mediterranean-style of eating has been shown to
improve cardiovascular health and significantly reduce your risk of
stroke. It has also been shown to lower your risk of Alzheimer's disease,5,6 cancer, Parkinson's and rheumatoid arthritis.
Overall, the Mediterranean diet is one of the best conventional diets
to support your brain and heart health. Research indicates diets rich
in healthy fats from avocados, nuts and olive oil may boost memory and cognition in older adults.7,8
About the research, Samantha Heller, certified dietitian/nutritionist
at New York University's Langone Orthopedic Center, stated:
"These healthy fats have been shown to improve cognitive function
and brain health. Conversely, research suggests eating unhealthy fats
like trans fats found in processed foods, and saturated fats in animal
foods accelerated cognitive decline and poor memory, and is linked to an
increased risk of dementia."
While I agree with most of what Heller said, I disagree with her
assertion that saturated fats from animal foods are bad for you.
Saturated fat found in meats and other animal products is actually quite
good for you, but only if you choose high-quality sources such as grass fed beef and pastured chicken or healthy fish such as wild Alaskan salmon, anchovies or sardines.
Alkaline Water Is a Short-Term Fix, Not a Long-Term Solution for Reflux
While there's no doubt you need water to survive, the type of water
you drink will have a significant impact on your well-being. Because
alkaline water was paired with a Mediterranean-style diet in the
featured reflux study, I want to address it. Most importantly, if you
suffer from GERD or another serious reflux disease, I want to dispel any
notions you may have about consuming alkaline water on a regular basis.
Your body simply will not be able to handle the pH change that will
come about if you make that switch.
For occasional relief from burning reflux symptoms, alkaline water,
due to its higher pH level than regular drinking water, may deliver
soothing relief by neutralizing the acid in your body.
Whereas normal drinking water has a neutral pH of 7, alkaline water's
pH is about 8 or 9. On those "emergency" occasions, you can make
alkaline water easily and quickly at home simply by adding a squeeze of
lemon or lime juice, or one-half to 1 teaspoon of baking soda, to a
glass of filtered water. Authors of a 2012 study indicating the
beneficial effects of alkaline water on reflux disease noted:9
"Unlike conventional drinking water, pH 8.8 alkaline water
instantly denatures pepsin, rendering it permanently inactive. In
addition, it has good acid-buffering capacity. Thus, the consumption of
alkaline water may have therapeutic benefits for patients with reflux
disease."
Again, I would underscore the importance of alkaline water as a
temporary solution — and only if your reflux is actually caused by
excess stomach acid. More often than not, heartburn is the cause of
insufficient amounts of acid. Your body is naturally designed to achieve
balance and it needs acid to digest food. If you have low stomach acid
and your digestion is impaired, you will not only absorb less nutrients
from your food, but also open the door for potential bacterial
infections. (More on that below.)
The bottom line is daily consumption of water that is either too
acidic or too alkaline will be problematic. What you want is pure water —
water that is clean and balanced. Ideally, the pH of your water should
be somewhere between 6 and 8.
To that end, the most economical and environmentally sound choice you
can make is to purchase and install a water filter for your home. Even
better, you may be able to obtain your drinking water from a natural
gravity-fed spring — check out FindaSpring.com10
to see if there is one near your home. Not only will spring water tend
to be naturally filtered and pH balanced, it is "alive," or
"structured," meaning it is believed to have significant health benefits
beyond mere hydration.
PPIs Interfere With Your Body's Natural Processes Involving Acid Production
Even if your doctor tells you they are perfectly safe, PPI drugs have
been linked to serious health problems and early death. Zalvan asserts
PPI medications are not necessarily effective in treating all reflux
conditions, noting some studies find the drugs inappropriate for as many
as 40 to 80 percent of the people taking them.11
The main problem is PPIs inhibit the proton pump in your body that
produces hydrochloric acid. Contrary to popular belief, excess stomach
acid is rarely the primary trigger of heartburn and indigestion. In
fact, heartburn is typically an indicator you have too little
hydrochloric acid, which means if you add a PPI medication, you are only
going to exacerbate the problem by decreasing your acid level even
further.
Because hydrochloric acid (and pepsin) are necessary to break down
protein in your intestinal tract, reduced acid levels affect your body's
ability to absorb nutrients. Without adequate protein breakdown, you
also increase your risk of dysbiosis,12 an imbalance in gut microbiome
between harmful and friendly bacteria. As these undigested protein
molecules ferment in your intestines, they become food for pathogens
such as Candida, C. difficile and Helicobacter pylori (H. pylori).
Use of PPIs May Put You at Risk for Bacterial Infections
A study published in the British Journal of Clinical Pharmacology13,14
indicates the use of PPIs, as well as H2 blockers like Pepcid, Tagamet
and Zantac, may put you at increased risk for gut infections. The study,
which involved about 565,000 adults, discovered participants taking
certain heartburn drugs had a 1.7 to 3.7 times increased risk of
developing C. difficile and Campylobacter bacterial infections due to
the suppression of stomach-acid production.
Both bacteria are potentially serious and cause inflammation in your
intestines and stomach. Some of the symptoms associated with these
infections include diarrhea, severe abdominal cramps and vomiting. Both
bugs can become even more serious and potentially life threatening —
especially C. difficile. According to the U.S. Centers for Disease
Control and Prevention, nearly 500,000 Americans were sickened by the
infection in 2011, and 29,000 of them died less than a month after the
initial diagnosis of C. difficile.15
Clearly, there are grave risks to getting hooked on PPIs. It seems
the ready availability and popularity of PPIs has given us the false
sense they are "100 percent safe," says Dr. F. Paul Buckley, surgical
director of the Heartburn and Acid Reflux Center at the Baylor Scott
& White Clinic in Round Rock, Texas. "There's still a myth that
these drugs are benign. It's not true."16
PPIs Also Associated With Increased Dementia Risk
Beyond infections, research has linked PPIs to dementia,
and even short-term use of them can contribute to cognitive changes.
One study involving 60 participants suggested PPIs caused clinically and
statistically significant impairments in attention, executive
functions, visual memory and working and planning functions after just
one week of use.17
According to research published in the JAMA Neurology,18,19,20
seniors over the age of 75 who use PPIs on a regular basis had a 44
percent increased risk of dementia compared to nonusers. Men using PPIs
were at greater risk, raising their dementia risk on average by 52
percent, compared to 42 percent for women.
One characteristic of dementia is the accumulation of beta-amyloid
plaques in the brain that provoke inflammation and ultimately kill brain
cells. There is now strong scientific evidence suggesting PPIs not only
increase production of beta-amyloid plaques in the brain, but also slow
your body's ability to eliminate them.21,22
PPIs Indicated for Heart Attacks and Other Serious Conditions
Long-term use of PPIs has been linked to heart attacks and other
serious health conditions. If you have been taking PPIs for any length
of time, you will want to ask your doctor about your potential risk
related to the following serious health conditions:
• Chronic kidney disease: More than 10,000 participants were tracked in a nearly 12-year study23 that concluded PPI use is associated with higher risk of chronic kidney disease. • Death from any cause:
Research involving nearly 350,000 U.S. veterans over six years indicated
PPI users were nearly 20 percent more likely than nonusers to suffer
death from any cause; the longer you use them, the greater your risk of
premature death.24,25,26,27 • Heart disease and heart attacks: Research gathered through a data-mining study 28
including nearly 3 million people linked long-term PPI use to an
increased risk for heart disease and heart attacks — even if you have no
prior history of cardiovascular disease.29,30
In one study, patients with GERD who took PPIs had a 16-percent
increased risk of heart attack, and a twofold increased risk of
cardiovascular mortality.31
The reason for this effect is thought to be due to the drug reducing
nitric oxide in the walls of your blood vessel. Nitric oxide relaxes
your blood vessels, so by reducing the amount of nitic oxide, PPIs may
thereby raise your risk of a heart attack. • Increased risk of bone fractures:32
A multiyear study that tracked nearly 80,000 postmenopausal women noted
the risk of hip fracture among those who regularly used PPIs for at
least two years, as compared to nonusers, was 35 percent higher. Longer
use of PPIs was associated with increasing risk of hip fractures. • Vitamin B12 deficiency: According to a 2011 study published in the Journal of the American Medical Association,33,34
use of acid-inhibiting medications for two or more years may lead to
vitamin B12 deficiency, particularly among women and younger individuals
who take stronger doses. When left untreated, the study authors
indicated a vitamin B12 deficiency can lead to "dementia, neurologic
damage, anemia and other complications, which may be irreversible."35
10 Natural Remedies for Treating Occasional Reflux Problems
Because PPIs can have serious damaging effects on your health, you
would be wise to consider nondrug alternatives first. Below are 10
natural remedies that may help you manage occasional bouts of heartburn,
indigestion and other minor reflux symptoms:36,37
Aloe juice
The juice of the aloe plant naturally helps reduce inflammation,
which may ease symptoms of acid reflux. Drink about one-half cup of aloe
juice before meals. To avoid its laxative effect, look for a brand in
which the laxative component has been removed.
Apple cider vinegar (raw, unfiltered)
Acid reflux typically results from having too little acid in your
stomach. You can easily improve the acid content of your stomach by
consuming 1 tablespoon of raw unfiltered apple cider vinegar in a large glass of water.
Astaxanthin
When compared to a placebo, this potent antioxidant was found to
reduce symptoms of acid reflux, especially for individuals with
pronounced H. pylori infection.38 Researchers concluded a daily dose of 40 mg of astaxanthin was effective for reflux reduction.
Baking soda
One-half to 1 teaspoon of baking soda (sodium bicarbonate) in an
8-ounce glass of water will help neutralize your stomach acid and ease
the burn of acid reflux. While I do not advise this as an ongoing
remedy, it is effective on an "emergency" basis when you are in
excruciating pain.
Deglycyrrhizinated licorice root
Deglycyrrhizinated licorice (DGL) may also be helpful because it
helps block inflammatory prostaglandins. Licorice must be approached
cautiously, however, because it contains the active metabolite
glycyrrhiza, which at high doses can affect your adrenal glands, cause
muscle weakness or numbness and raise your blood pressure.
Licorice is contraindicated if you're on diuretics or stimulant
laxatives. Women on hormone therapy, who have estrogen-dependent cancers
or reproductive conditions like endometriosis should also avoid it.
Ginger root
Ginger has
been found to have a gastroprotective effect by suppressing H. pylori.
Add two or three slices of fresh ginger root to 2 cups of hot water and
let it steep for several minutes. Drink it about 20 minutes prior to
eating a meal.
Glutamine
The amino acid glutamine has been shown to address gastrointestinal
damage caused by H. pylori. Glutamine is found in many foods, including
beef, chicken, dairy products, eggs, fish and selected fruits and
vegetables. L-glutamine is widely available as a supplement.
Papaya (papain supplement) or Pineapple (bromelain supplement)
Papaya contains papain, an enzyme useful for breaking down both
protein and carbohydrates. Bromelain is a proteolytic enzyme found in
pineapple, and like papain, helps digest proteins. Bromelain also
promotes anti-inflammatory activity and helps you maintain regular bowel
movements.
Slippery elm
Slippery elm coats and soothes your mouth, throat, stomach and
intestines, and contains antioxidants that may help address inflammatory
bowel conditions. Because it stimulates nerve endings in your
gastrointestinal tract, it is useful for increasing mucus secretion,
which has a protective effect against ulcers and excess acidity.
Vitamin D
Vitamin D
is critically important for your gut health. Once your vitamin D levels
are optimized, you will benefit from your body's production of about
200 antimicrobial peptides that will help eradicate gut infections.
Talk to Your Doctor About Getting Off PPIs
If you are currently taking a PPI for reflux, this article should be a
wake-up call for you to consider the damage it may be doing to your
body and your health. The risks are real, especially if you plan on
taking PPIs for the long term. At the very least, I hope this
information has given you encouragement to consider making changes to
your diet to heal your gut and restore your body's natural acid balance.
Beyond helping yourself, you may want to share this article with
friends or family members who also suffer from reflux problems. Once you
commit to making changes, talk to your doctor about weaning off your
PPI medication. Because your body has very likely become dependent on
the drug, you will need to back down from it very carefully.
Quitting cold turkey can result in severe rebound effects known as
rebound acid hypersecretion. To avoid it, you must wean yourself off the
PPI gradually. Start by lowering the dose you're taking while
simultaneously implementing the recommended lifestyle modifications
suggested. Once you get down to the lowest dose of the PPI, you can
start substituting with an over-the-counter H2 blocker like Tagamet,
Cimetidine, Zantac or Ranitidine. Then gradually wean off the H2 blocker
over the next several weeks.
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