What Is It?

Acid reflux, also called gastroesophageal reflux (GER), is a common condition that features an accompanying pain called heartburn. It occurs when acid from the stomach flows back up into the esophagus. In addition to heartburn, some people experience a bitter, sour taste of acid in the back of the throat. Gastroesophageal reflux disease (GERD) is a long-lasting, more serious form of GER. GERD has more severe symptoms in addition to frequent heartburn, including food sticking and blood or weight loss.  

If GERD goes untreated, people can experience intense chest pain, narrowing of the esophagus, bleeding, or Barrett’s esophagus. Other symptoms include difficulty swallowing, feeling like food is trapped, vomiting blood, tarry bowel movements, choking, and weight loss. 

Acid reflux has been observed since the 1900s, at least that we know of. There are even depictions of it as early as the 18th century. In 1934, Winkelstein first correlated symptoms of heartburn with acid reflux. The first medical treatment, a proton pump inhibitor, came out in 1989. More management strategies were developed throughout the 20th century. Since, the number of people diagnosed with GERD has been on the rise, just as awareness has.

GERD is one of the most common gastrointestinal disorders, with a prevalence of approximately 20 percent of adults in the United States. One review estimated the prevalence to be between 18.1 percent to 27.8 percent of U.S. adults. 

Anyone can develop GERD. You are more likely to have GERD if you are:

• Overweight or obese
• A pregnant woman
• Taking certain medicines
• A smoker or regularly exposed to secondhand smoke

Causes

The American College of Gastroenterology (ACG) explains that some experience heartburn if the esophagus lining comes into contact with too much stomach juice for a prolonged time. 

Within this juice is acid, which can damage the esophagus’s lining and create a burning discomfort. Usually, a sphincter would keep the acid out of the esophagus, but, if you have GERD, that sphincter relaxes too frequently. 

In addition, in your gut you have a whole ecosystem of bacteria, that ecosystem isn’t the same as in other parts of the body. Bacteria that belong in the gut, don’t necessarily belong in the esophagus too. If this goes on, overtime of course there will be damage.   

People with chronic, untreated heartburn for a long period of time have been shown to have a greater risk of developing esophageal cancer. It doesn’t have to be that way though!

GERD develops if you continue to let acid reflux occur, but there are many things you can do to prevent it. 

Being overweight and having a poor lifestyle and eating habits contribute to the development of acid reflux and GERD. If you’re often experiencing acid reflux or have GERD, it means there is something wrong with your gut’s ecosystem! Perhaps you have too much bad bacteria, bacteria that doesn’t belong there, or not enough good bacteria. This can be corrected!

Conventional Treatments 

Treatment and medications for GERD are mostly focused on eradicating symptoms. Treatments are meant to decrease the amount of acid that travels up from the stomach into the esophagus or to make the reflux substances less irritating to the esophagus lining. 

The two types of medications that are often prescribed are H2 receptor antagonists and proton pump inhibitors. H2 receptor antagonists suppress acid and improve symptoms of heartburn and regurgitation. Symptoms go away in 50 percent of people who use this medication twice a day. That’s twice too many times if you ask me!  These can have side effects like headache, diarrhea, dizziness, and rash.

Proton pump inhibitors can heal a type of severe GERD called erosive esophagitis. They don’t only provide relief, but may eliminate symptoms completely. Some believe these to be the most effective in eliminating symptoms, healing esophagitis, preventing complications, and maintaining remission. Side effects of proton pump inhibitors include risk of fractures, higher risk of pneumonia and dementia, hypomagnesemia, diarrhea, vitamin B12 deficiency, acute interstitial nephritis, and lupus erythematosus. 

There are also promotility agents. These are used to treat mild to moderate GERD. They increase lower esophageal sphincter pressure to help reduce acid reflux and heartburn symptoms. However, one agent called cisapride has caused complications in some patients such as cardiac arrhythmias and sudden death. Another called domperidone has been related to hyperprolactinemia (having higher-than-normal levels of the hormone prolactin in the blood), which can cause gynecomastia, galactorrhea, amenorrhea, and impotence. Metoclopramide’s side effects are drowsiness, agitation, irritability, fatigue, and dystonic reactions. Others have been associated with Parkinson’s-like symptoms, abdominal cramps, nausea, and more. Surgery could also be an option.

However, medications are really only short-term solutions and only treat symptoms. Unless you treat the cause, you’d keep experiencing GER and have GERD if you were to stop medicating. Having to take a bunch of medications everyday doesn’t allow for the best quality of life. If you were to treat the cause, you can eventually get to a place where you don’t need medications, or at least need a lot less of it. Plus, there are plenty of treatments other than medication! 

Natural Treatments

In terms of lifestyle modifications, changing your eating and sleeping habits could help. You can try to sleep sitting upright or try raising the head of your bed a little. The ACG recommends using an under-mattress foam wedge. Avoid eating for at least two hours before bedtime to reduce stomach acid, tight clothing, and foods and medications that lower the sphincter tone or irritate the esophagus lining.  

Harvard Women’s Health Watch provides nine ways you can relieve acid reflux without medication:  

• Eat sparingly and slowly—This will reduce reflux from the stomach up into the esophagus.

• Avoid certain foods—Some foods are more likely to trigger reflux such as mint, fatty foods, garlic, coffee, tea, chocolate, and alcohol. Try to avoid eating these foods regularly to help control reflux.

• Avoid carbonated drinks—Carbonated beverages may make you burp and send acid into the esophagus. 

• Stay upright after eating—Stand or sit after eating. Staying upright will help keep acid down. 

• Don’t move too fast—Vigorous movement, especially if you’re bending over, can send acid into the esophagus. 

• Sleep inclined—As mentioned, keeping your head higher than your feet when you sleep may also help. 

• Lose weight—Being overweight can also increase chances of reflux because more weight decreases pressure on and spreads the muscular structure that supports the lower esophageal sphincter. 

• Don’t smoke—Nicotine can relax the lower esophageal sphincter.

• Check your medicine—Some medications like postmenopausal estrogen, tricyclic antidepressants, and anti-inflammatory painkillers can relax the sphincter as well. Bisphosphonates that are used to increase bone density can irritate the esophagus.

The International Foundation for Gastrointestinal Disorders says that determining the appropriate diet and lifestyle changes involves discovering what works best for you—noting that triggers and treatments may affect people differently.  

Knowing that something is off with the bacteria in the gut, a doctor may prescribe antibiotics for acid reflux or gut issues. Not so fast though! Antibiotics kill all the bacteria, including the good bacteria that is needed! 

Anything you eat can affect the gut microbiota (microorganisms of the gastrointestinal tract) and the balance between good and bad gut bacteria. According to Healthline writer Sarah Lewis, RD, antibiotics have been shown to change in certain kinds of bacteria and may cause health problems later in life. Prebiotics and probiotics are a better solution. 

Think of probiotics like the seeds you plant in a garden to make the good stuff grow, and prebiotics would be the soil needed for those seeds to grow. You couldn’t throw seeds on a desert floor and expect them to grow. And, not to mention, if you kill off your garden, what grows back? Weeds. That’s what happens when you take antibiotics. It kills all of the bacteria, including the good stuff, and then weeds grow. So, avoid antibiotics and opt for prebiotics and probiotics instead. 

Prebiotics are a group of nutrients broken down by the gut bacteria or gut microbiota. The intestinal microbiota can feed off them, and the short-chain fatty acids they produce are released into the blood circulation, affecting other organs. 

Fructo-oligosaccharides, galacto-oligosaccharides, and trans-galacto-oligosaccharides are the most common prebiotics, all having effects on human health. They stimulate growth or activity of certain bacteria in the colon, improving health. 

Prebiotics naturally exist in different fibrous foods, such as asparagus, sugar beet, garlic, chicory, onion, wheat, honey, banana, barley, tomato, soybean, milk, peas, beans, and more!

Prebiotics provide a source of energy from the gut microbiota, so they can influence the composition and function of the microorganisms. In this way, they can modify the environment of the gut. For instance, their products can decrease gut pH and alter the population of the gut microbiota, including acid-sensitive species. 

Fiber and many spices are loaded with those health-helping prebiotics! There are tons of fiber supplements out there that provide these. They are meant to fertilize and prepare the “soil” where that bacteria is going to land so the good bacteria will thrive. When the good bacteria thrive, they kill the bad bacteria.

Probiotics are actual live bacteria found in certain foods that also have numerous health benefits. Both are necessary and make each other more effective. Probiotics are good bacteria that help protect against harmful bacteria and fungi. These can improve immune system function, symptoms of depression, and more. 

Unpasteurized yogurt and fermented foods are good sources of this beneficial bacteria. Some common ones include lactobacillus and bifidobacterium.

Probiotics eat soluble fiber. That’s what feeds the good bacteria. Whole plant foods provide lots of soluble fiber. Fiber, spices, fruits, vegetables, and other plant foods help restore the natural flora or microbiota and beat out those weeds or the bad bacteria that cause acid, gas, and yeast. 

Alive & Well Founder J.R. Martin MS, MMS, PA-C, similarly explains that having more “good guys in the neighborhood” can carry off the bad guys. This is much better than dropping a bomb (aka antibiotics) to wipe out the whole neighborhood and starting over again, which is the theory of most medicines. This applies to gut health too! 

Use prebiotics and probiotics to support those “good guys.” 

What You Should Know

GERD may not always appear as such; it can be mistaken for other diseases. Irritation and damage to the esophagus can come with heartburn, chest pain, chronic cough, hoarseness, and asthma-like symptoms. People can think the heart is responsible for chest pain or that cough and hoarseness could be due to a problem with their ears, nose, or throat. It could be GERD.

If GERD persists over a long period of time, it can lead to peptic stricture, Barrett’s esophagus, or esophageal cancer. Peptic stricture is when acid scars the lower esophagus. Barrett’s esophagus is a condition where the lining of the esophagus changes to that of the intestine’s. 

One study showed that those who experience weekly episodes of acid reflux were associated with increased risk of Barrett’s esophagus. Although people with it may experience less heartburn, it is a precancerous condition. Esophageal cancer can occur if GERD is left untreated for many years, so don’t just dismiss symptoms like frequent heartburn, for it could lead to something more serious. 

What You Can Do To Take Control of Your Health

Remember, diet can help prevent and relieve symptoms of GER or GERD! The National Institute of Diabetes and Digestive and Kidney Diseases says to avoid consuming chocolate, coffee, peppermint, greasy foods, and alcohol if you suffer from GER or GERD. Eating healthy and balanced amounts of different foods is good for your overall health. 

For example, foods rich in fiber can help you feel full, making you less likely to overeat. Fibrous foods include whole grains, oatmeal, brown rice, couscous, sweet potatoes, carrots, beets, root vegetables, asparagus, broccoli, and green beans. 

According to John Hopkins Medicine, foods with higher pH are less acidic, such as bananas, melons, cauliflower, fennel, ginger, and nuts. Watery foods such as celery, cucumber, lettuce, watermelon, broth-based soups, and herbal tea may also help dilute stomach acid. Generally speaking, you can’t go wrong eating a wide variety of whole fruits and vegetables.

Set health goals to get the quality of life you want. Take responsibility for your health, do what you can to achieve optimal health, and know you’re not alone. 

Takeaways

GER and GERD is when acid frequently travels up into the esophagus from the stomach. Many things play a role in this occurrence. It could have to do with the lower esophageal sphincter, your gut’s ecosystem, and/or your lifestyle habits. Medications are used to treat GER and GERD, but may merely treat symptoms. What, when, and how you eat may all encourage acid reflux and heartburn. Avoid fatty, greasy, sugary, or carbonated foods and drinks. A diet rich in fruits and vegetables can all help reduce acid reflux. Fibrous foods, prebiotics, and probiotics can balance your gut’s ecosystem and get you the good bacteria it needs to function properly.