Gastroesophageal Reflux Disease (GERD), otherwise known as acid reflux, affects an extraordinary number of adults worldwide. According to the journal Gut, between 18 and 28 percent of the adults in North America suffer from the disease, as do 9 to 26 percent of Europeans and up to 33 percent in the Middle East.1 Locke, G. Richard III. “The Prevalence and Impact of Gastroesophageal Reflux Disease.” 3 November 2017. Iffgd. 31 August 2018. http://www.aboutgerd.org/what-is-gerd/prevalence.html Those numbers appear to be rising.
Acid reflux occurs when stomach acid flows back into the tube that connects your esophagus to your mouth, leaving you with a bitter or sour taste. The acid causes heartburn and indigestion. While most of us have had an occasional bout of acid indigestion after a particularly indulgent meal, full-blown GERD means having such bouts at least twice a week. In healthy digestion, food and liquid pass from the esophagus to the stomach and then a sphincter at the base of the esophagus closes, preventing backwash. But when you develop GERD, that sphincter has weakened, allowing partially digested food and stomach acid to come back into your throat.
Symptoms of GERD include burning in the throat and chest after eating (heartburn) –particularly when lying down at night –spitting up sour liquid or food, feeling like there’s a lump in your throat, and difficulty swallowing.2 “Gastroesophageal reflux disease (GERD).” Mayo Clinic. 31 August 2018. http://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940 Victims might also experience coughing, laryngitis, nausea, tooth decay, exacerbated asthma, and insomnia. To be constantly sick after eating wears people out as does fatigue from being unable to sleep because of GERD distress. As the disease progresses, the constant exposure to stomach acid causes the esophagus to become inflamed, and that can cause narrowing of the esophagus so that it’s hard to swallow. It can also lead to esophageal ulcers, and there’s some evidence that it can eventually trigger cancer.
The first line of defense when GERD symptoms appear, at least according to the medical community, is to avoid certain triggering foods, including anything with caffeine, tomato products, alcohol, citrus, peppermint, or fatty and fried foods.3 “Esophageal Reflux Disease.” WebMD. 31 August 2018. http://www.webmd.com/heartburn-gerd/guide/reflux-disease-gerd-1#2 Also, excess weight seems to trigger GERD, so losing weight is recommended, as is eating smaller meals, walking around after eating, and sleeping with the head raised. If symptoms don’t abate, your doctor will probably prescribe medications that block acid production. These include what are known as H-2-receptor-blockers, like Pepcid, and proton pump inhibitors like Nexium. There are also medications to strengthen the sphincter in the esophagus. All these drugs come with undesirable side effects, including increased risk of bone fractures, osteoporosis, diarrhea, fatigue, and B-12 deficiency. Since medications for GERD are often taken long-term, it’s important to know that more serious side effects of proton pump inhibitors include increased risk of dementia, heart attacks, kidney disease, stomach cancer, and strokes.4 Kaechele, Bruce. “Are long-term PPIs the right choice for treating acid reflux?” 13 January 2018. Reflux MD. 31 August 2018. http://www.refluxmd.com/long-term-ppis-right-choice-treating-acid-reflux/ Plus, medications don’t always work, so surgical options such as wrapping the upper stomach to strengthen the sphincter may be considered.
Here are a few treatment options to consider before rushing to fill that prescription.
Melatonin. The digestive system naturally produces melatonin, especially in response to tryptophan-rich foods. This melatonin reduces stomach acid production while increasing pressure from the esophageal sphincter. In fact, a 2006 study of 300 heartburn patients found that patients achieved better relief using six milligrams of melatonin plus vitamins (B6, folic acid, vitamin B12, methionine and betaine) at bedtime compared to those using 20 milligrams of a proton pump inhibitor.5 Hume, Anne L. “Melatonin eases GERD symptoms, studies show.” August 2016. Pharmacy Today. 31 August 2018. file:///C:/Users/hiyag/AppData/Local/Temp/PIIS1042099116306879-1.pdf Of the 175 patients using the melatonin and vitamin mix, 100 percent achieved a complete eradication of symptoms within 40 days.6 Pereira, Ricardo de Souza. “Regression of esophageal reflux disease symptoms using dietary supplementation with melatonin, vitamins, and amino acids: comparison with omeprazole.” Journal of Pineal Research. 31 August 2018. file:///C:/Users/hiyag/AppData/Local/Temp/JPinealRes2-publicado-PB.pdf But of the 175 on the proton pump inhibitor, only 67 percent realized such a result in the same time period. Other studies have shown that a combination of melatonin plus a proton pump inhibitor yielded faster and better relief than using either product alone—but again being cognizant of the side effects associated with proton pump inhibitors.
Even so, the medical establishment hasn’t embraced the idea of using melatonin in lieu of or in addition to prescription medications. In fact, the Mayo Clinic website says, “No alternative medicine therapies have been proved to treat GERD or reverse damage to the esophagus,” a rather odd statement given the existence of studies showing otherwise. Perhaps that’s in part because the studies to date have focused on younger people so there isn’t concrete evidence that melatonin will help elderly GERD sufferers, but given that melatonin levels drop as we age, it’s a good bet.
Probiotics. There are only a few studies exploring the effect of probiotics on GERD, but the evidence to date looks promising.7 http://www.livestrong.com/article/531210-the-best-probiotic-for-gerd/ One theory postulates that GERD occurs because when food doesn’t flow properly from the esophagus into the stomach, “bad” bacteria build up and cause fermentation, which causes gas that in turn forces food back up the esophagus. Probiotics work to overrun “bad” bacteria with “good” bacteria, and thus can alleviate related distress. Evidence also indicates that probiotics help the stomach empty its contents faster, so GERD symptoms related to eating too much may be alleviated. Plus, there’s clinical evidence that probiotics may help reduce inflammation, which can help reduce pain related to GERD. And, studies show that probiotics may help with weight loss, which again indirectly may benefit GERD sufferers. Since there are so many different probiotic formulations, make sure you try a high quality formula with a balanced spectrum of healthy bacteria.
In summary, if you find yourself having heartburn episodes, losing some weight and adding some probiotic and melatonin supplementation to your routine would be a wise step to get the condition under control before it becomes a major problem. Also, to better understand GERD, the mechanisms underlying it, the different alternatives for dealing with it, and the problems associated with most medical treatments for it, check out Jon Barron’s article on the physiology of The Stomach.
References
↑1 | Locke, G. Richard III. “The Prevalence and Impact of Gastroesophageal Reflux Disease.” 3 November 2017. Iffgd. 31 August 2018. http://www.aboutgerd.org/what-is-gerd/prevalence.html |
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↑2 | “Gastroesophageal reflux disease (GERD).” Mayo Clinic. 31 August 2018. http://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940 |
↑3 | “Esophageal Reflux Disease.” WebMD. 31 August 2018. http://www.webmd.com/heartburn-gerd/guide/reflux-disease-gerd-1#2 |
↑4 | Kaechele, Bruce. “Are long-term PPIs the right choice for treating acid reflux?” 13 January 2018. Reflux MD. 31 August 2018. http://www.refluxmd.com/long-term-ppis-right-choice-treating-acid-reflux/ |
↑5 | Hume, Anne L. “Melatonin eases GERD symptoms, studies show.” August 2016. Pharmacy Today. 31 August 2018. file:///C:/Users/hiyag/AppData/Local/Temp/PIIS1042099116306879-1.pdf |
↑6 | Pereira, Ricardo de Souza. “Regression of esophageal reflux disease symptoms using dietary supplementation with melatonin, vitamins, and amino acids: comparison with omeprazole.” Journal of Pineal Research. 31 August 2018. file:///C:/Users/hiyag/AppData/Local/Temp/JPinealRes2-publicado-PB.pdf |
↑7 | http://www.livestrong.com/article/531210-the-best-probiotic-for-gerd/ |
Unfortunately, melatonin can
Unfortunately, melatonin can give people nightmares. I suggest serapaptase for acid reflux and also sinuses. No nightmares.
You could also try eating
You could also try eating either plain popcorn or plain low sodium rice cakes just before bed. (1-2 cups of popcorn or 1-2 rice cakes depending on body size and amount of acid). These foods will absorb the acid in your stomach.
Then lie down on your RIGHT side for about 30 minutes when you go to bed. Your stomach empties out to the right and gravity will help the stomach contents drain out rather than go up the esophagus. If you notice acid reflux during the night, turn back over on your right side. (Most people with reflux sleep on their back or left side)
I’m curious about the
I’m curious about the probiotic mode of relief. Do the beneficial bacteria aid in digestion within the stomach its self?
To learn more, check out this
To learn more, check out this article: healthy bacteria.
Just finished reading your
Just finished reading your article on GURD. Recomendation was to take Melatonin with some vitamins. I have been taking Nexum 20mg 24hr formula. Been taking it for approximately 20 yrs with no obvious or known side effects. I do know this. If I forget to take it first thing upon arising in the morning – before eating breakfast, I WILL have gurd effects by 6pm or so – no matter what I eat. If I take as usual – upon rising, I can eat anything I want. Anything. What I’m concerned about is what you say in the article about long term use causing serious medical problems. I am more that willing to try the Melatonin and vitamins mix.. It is a bit of a hassel to get all that together to have them on hand each morning. (But your article says to take em at night before bed.
My question is – do you, can you put together that formula in a convenient pkg of daily doses? I would much prefer take that that continue on with Nexium. What say ye?> Or does your Probiotics formula do the same thing? If so, send me some. P.S. I already am a customer and get your newsletters.
Hi Chuck, to learn more about
Hi Chuck, to learn more about how probiotics work, did you see this article? Healthy Bacteria.
Hi John,
Hi John,
The best treatment for acid reflux I have found is to take 1000mg a day of d-Limonene when you get up in the morning for about 14 days. It generally stops acid reflux for about six months by tightening the stomach sphincter and increasing peristalsis. I learned about this from several similar writeups from various alternative doctors, and it has worked for myself and about a half dozen other people I have told about it over 20 years or so.
My best to you,
Don Meyer