Turn on the TV anytime of day and you’re likely to see one of those ads promoting a particular pill for heartburn relief. It is after all a multi-billion dollar industry and they are counting on your suffering. Chances are heartburn or acid reflux will likely affect most of us at some time in of our lives. It can be annoying, but it can also have serious health consequences if it is recurrent and left untreated. Diet and lifestyle changes, as well as natural remedies can be very effective in providing relief and can be a vital part of the total treatment program.
Diet and Lifestyle Changes
The danger with recurrent reflux or “GERD” (gastroesophageal reflux disease) is that the acid from the stomach can damage esophageal tissue and may eventually lead to cancer. Common risk factors for heartburn include mental stress, obesity, pregnancy, smoking, and alcohol consumption. Eating large, fatty meals and lying down after a meal can induce heart burn. Some common medications can cause heartburn like aspirin, ibuprofen, and certain blood pressure drugs. Chocolate, caffeine, spearmint, peppermint and alcohol can relax the muscle at the end of the esophagus, allowing reflux to occur. Undiagnosed celiac disease, food sensitivities, and bacterial or candida (yeast) overgrowth may also be to blame.
In general adopting a healthy lifestyle can be of great help. If you are overweight, lose weight. Avoid large, heavy, high fat meals that make you feel “stuffed”. Instead, eat smaller, lighter meals more frequently. Some people find relief at night by raising the head of their bed or pillow by six inches.
Medications
Over the counter and prescription H2 blockers (Zantac, Pepcid) and proton pump inhibitors (Nexium, Prilosec) are effective at reducing the amount of acid produced by the stomach. In acute cases where ulcers are present they may be indicated to allow the tissue of the esophagus to heal. They are not without side effects however, especially with long term use. People find it is extremely hard to get off of these medicines, so they just stay on them for years and years.
Stomach acid is actually very important and necessary-as long as it stays in the stomach. Too little acid from long term acid-suppressing treatment can lead to poor digestion of nutrients, especially vitamin B12. Anyone who has been taking these medications long term should have their vitamin B12 levels checked and replenished if low. Long term use of proton pump inhibitors (Nexium, Prilosec) is associated with an increased risk of bone fractures. Instead of covering up the symptom of heartburn, ideally one should try to get to the root cause of why it is recurring to avoid these medication side effects from long term use.
Alternatives
There are natural alternatives to drugs that can help alleviate symptoms. One of the most common remedies for occasional heartburn is calcium carbonate which helps to neutralize acid in the stomach. Pure calcium citrate powder is a different form of calcium that dissolves quickly and can help tighten the lower esophageal sphincter muscle. 250 mg of pure calcium citrate powder mixed in water after meals and before bed is commonly recommended.
Several studies have found deglycyrrhizinated licorice (DGL) can help heal ulcers. In head to head studies, DGL was found to be as good or better than Tagamet and Zantac in the treatment and maintenance of gastric ulcers. (Gut. 1985;26:599-602 and Gut. 1982;23:545-551.) It has soothing properties that aid in healing ulcers and may help heal damage in the esophagus caused by heartburn while also easing reflux symptoms. It is important to mix the DGL with saliva to activate it. It can be found in powdered form or in convenient lozenges. DGL does not contain the compound responsible for raising blood pressure that is found in regular licorice. The most common dose is 760 mg DGL about 20 min before meals and bedtime.
Other herbs and supplements that have long been used for easing digestive problems include aloe vera and slippery elm. Gamma-oryzanol, derived from rice bran oil, appears to help control digestion and is especially helpful for chronic heartburn or ulcer sufferers. Digestive enzymes such as bromelain, found in pineapples, may help digestion by breaking down proteins which may ease heartburn and upset stomach.
Melatonin is most well known for helping those with sleeping problems or jet lag, but emerging research suggests it may play an important role in digestive health. Cells in the GI tract secrete 400 times the amount of melatonin that’s secreted in the pineal gland in the brain. A study published in a 2006 issue of the Journal of Pineal Research found 100% regression of GERD symptoms after 40 days in the group taking a supplement of melatonin (6mg), L-tryptophan, vitamin B6, folic acid, vitamin B12, methionine and betaine. The other group was taking 20 mg of omeprazole (Prilosec) and had a 65.7% regression of symptoms. In a 2010 study published in BMC Gastroenterology researchers stated that melatonin shows promise as a therapeutic agent in the treatment of GERD. They do note that further studies are warranted to determine long term safety with continued use.
Side effects of melatonin can include grogginess. It also stimulates the immune system so those with autoimmune conditions should not use unless under the advice of their healthcare professional.
References:
http://jama.ama-assn.org/cgi/content/abstract/296/24/2947
Natural Medicines Comprehensive Database, 2011
Alternative Therapies in Health and Medicine, Melatonin for the Treatment of Gastroesophageal Reflux Disease. July 2008-Vol 14, No. 4.