Treating Heartburn And Hyperacidity.docx

14 Home Remedies for Heartburn and Acid Reflux Millions of people suffer from acid reflux and heartburn. The most frequently used treatment involves commercial medications, such as omeprazole. However, lifestyle modifications may be effective as well. Simply changing your dietary habits or the way you sleep may significantly reduce your symptoms of heartburn and acid reflux, improving your quality of life.

What Is Acid Reflux and What Are the Symptoms? Acid reflux is when stomach acid gets pushed up into the esophagus, which is the tube that carries food and drink from the mouth to the stomach. Some reflux is totally normal and harmless, usually causing no symptoms. But when it happens too often, it burns the inside of the esophagus. An estimated 14–20% of all adults in the US have reflux in some form or another (1). The most common symptom of acid reflux is known as heartburn, which is a painful, burning feeling in the chest or throat. Researchers estimate that around 7% of Americans suffer from heartburn daily (2). Of those who regularly experience heartburn, 20–40% are diagnosed with gastroesophageal reflux disease (GERD), which is the most serious form of acid reflux. GERD is the most common digestive disorder in the US (3). In addition to heartburn, common symptoms of reflux include an acidic taste at the back of the mouth and difficulty swallowing. Other symptoms include a cough, asthma, tooth erosion and inflammation in the sinuses (4). So here are 14 natural ways to reduce your acid reflux and heartburn, all backed by scientific research.

1. Don't Overeat Where the esophagus opens into the stomach, there is a ring-like muscle known as the lower esophageal sphincter. It acts as a valve and is supposed to prevent the acidic contents of the stomach from going up into the esophagus. It naturally opens when you swallow, belch or vomit. Otherwise, it should stay closed. In people with acid reflux, this muscle is weakened or dysfunctional. Acid reflux can also occur when there is too much pressure on the muscle, causing acid to squeeze through the opening. Unsurprisingly, most reflux symptoms take place after a meal. It also seems that larger meals may worsen reflux symptoms (5, 6). One step that will help minimize acid reflux is to avoid eating large meals. SUMMARY: Avoid eating large meals. Acid reflux usually increases after meals, and larger meals seem to make the problem worse.

2. Lose Weight The diaphragm is a muscle located above your stomach. In healthy people, the diaphragm naturally strengthens the lower esophageal sphincter. As mentioned earlier, this muscle prevents excessive amounts of stomach acid from leaking up into the esophagus.

However, if you have too much belly fat, the pressure in your abdomen may become so high that the lower esophageal sphincter gets pushed upward, away from the diaphragm's support. This condition is known as hiatus hernia. Hiatus hernia is the main reason obese people and pregnant women are at an increased risk of reflux and heartburn (7, 8). Several observational studies show that extra pounds in the abdominal area increase the risk of reflux and GERD (9). Controlled studies support this, showing that weight loss may relieve reflux symptoms (10). Losing weight should be one of your priorities if you suffer from acid reflux. SUMMARY: Excessive pressure inside the abdomen is one of the reasons for acid reflux. Losing belly fat might relieve some of your symptoms.

3. Follow a Low-Carb Diet Growing evidence suggests that low-carb diets may relieve acid reflux symptoms. Scientists suspect that undigested carbs may be causing bacterial overgrowth and elevated pressure inside the abdomen. Some even speculate this may be one of the most common causes of acid reflux. Studies indicate that bacterial overgrowth is caused by impaired carb digestion and absorption. Having too many undigested carbs in your digestive system makes you gassy and bloated. It also tends to make you belch more often (11, 12, 13, 14). Supporting this idea, a few small studies indicate that low-carb diets improve reflux symptoms (15, 16, 17). Additionally, an antibiotic treatment may significantly reduce acid reflux, possibly by decreasing the numbers of gasproducing bacteria (18, 19). In one study, researchers gave participants with GERD prebiotic fiber supplements that promoted the growth of gasproducing bacteria. The participants' reflux symptoms worsened as a result (20). SUMMARY: Acid reflux might be caused by poor carb digestion and bacterial overgrowth in the small intestine. Low-carb diets appear to be an effective treatment, but further studies are needed.

4. Limit Your Alcohol Intake Drinking alcohol may increase the severity of acid reflux and heartburn. It aggravates symptoms by increasing stomach acid, relaxing the lower esophageal sphincter and impairing the ability of the esophagus to clear itself of acid (21, 22). Studies have shown that moderate alcohol intake may even cause reflux symptoms in healthy individuals (23, 24). Controlled studies also show that drinking wine or beer increases reflux symptoms, compared to drinking plain water (25, 26). SUMMARY: Excessive alcohol intake can worsen acid reflux symptoms. If you suffer from heartburn, limiting your alcohol intake might help ease some of your pain.

5. Don't Drink Too Much Coffee Studies show that coffee temporarily weakens the lower esophageal sphincter, increasing the risk of acid reflux (27). Some evidence points towards caffeine as a possible culprit. Similar to coffee, caffeine weakens the lower esophageal sphincter (28).

Additionally, drinking decaffeinated coffee has been shown to reduce reflux compared to regular coffee (29, 30). However, one study that gave participants caffeine in water was unable to detect any effects of caffeine on reflux, even though coffee itself worsened the symptoms. These findings indicate that compounds other than caffeine may play a role in coffee's effects on acid reflux. The processing and preparation of coffee might also be involved (29). Nevertheless, although several studies suggest that coffee may worsen acid reflux, the evidence is not entirely conclusive. One study found no adverse effects when acid reflux patients consumed coffee right after meals, compared to an equal amount of warm water. However, coffee increased the duration of reflux episodes between meals (31). Additionally, an analysis of observational studies found no significant effects of coffee intake on the self-reported symptoms of GERD. Yet, when the signs of acid reflux were investigated with a small camera, coffee consumption was linked with greater acid damage in the esophagus (32). Whether coffee intake worsens acid reflux may depend on the individual. If coffee gives you heartburn, simply avoid it or limit your intake. SUMMARY: Evidence suggests that coffee makes acid reflux and heartburn worse. If you feel like coffee increases your symptoms, you should consider limiting your intake.

6. Chew Gum A few studies show that chewing gum reduces acidity in the esophagus (33, 34, 35). Gum that contains bicarbonate appears to be especially effective (36). These findings indicate that chewing gum — and the associated increase in saliva production — may help clear the esophagus of acid. However, it probably doesn't reduce the reflux itself. SUMMARY: Chewing gum increases the formation of saliva and helps clear the esophagus of stomach acid.

7. Avoid Raw Onion One study in people suffering from acid reflux showed that eating a meal containing raw onion significantly increased heartburn, acid reflux and belching compared with an identical meal that didn't contain onion (37). More frequent belching might suggest that more gas is being produced due to the high amounts of fermentable fiber in onions (20, 38). Raw onions might also irritate the lining of the esophagus, causing worsened heartburn. Whatever the reason, if you feel like eating raw onion makes your symptoms worse, you should avoid it. SUMMARY: Some people experience worsened heartburn and other reflux symptoms after eating raw onion.

8. Limit Your Intake of Carbonated Beverages Patients with GERD are sometimes advised to limit their intake of carbonated beverages.

One observational study found that carbonated soft drinks were associated with increased acid reflux symptoms (39). Also, controlled studies show that drinking carbonated water or cola temporarily weakens the lower esophageal sphincter, compared to drinking plain water (40, 41). The main reason is the carbon dioxide gas in carbonated beverages, which causes people to belch more often — an effect that can increase the amount of acid escaping into the esophagus (14). SUMMARY: Carbonated beverages temporarily increase the frequency of belching, which may promote acid reflux. If they worsen your symptoms, try drinking less or avoiding them altogether.

9. Don't Drink Too Much Citrus Juice In a study of 400 GERD patients, 72% reported that orange or grapefruit juice worsened their acid reflux symptoms (42). The acidity of citrus fruits doesn't appear to be the only factor contributing to these effects. Orange juice with a neutral pH also appears to aggravate symptoms (43). Since citrus juice doesn't weaken the lower esophageal sphincter, it is likely that some of its constituents irritate the lining of the esophagus (44). While citrus juice probably doesn't cause acid reflux, it can make your heartburn temporarily worse. SUMMARY: Most patients with acid reflux report that drinking citrus juice makes their symptoms worse. Researchers believe citrus juice irritates the lining of the esophagus.

10. Consider Eating Less Chocolate GERD patients are sometimes advised to avoid or limit their consumption of chocolate. However, the evidence for this recommendation is weak. One small, uncontrolled study showed that consuming 4 ounces (120 ml) of chocolate syrup weakened the lower esophageal sphincter (45). Another controlled study found that drinking a chocolate beverage increased the amount of acid in the esophagus, compared to a placebo (46). Nevertheless, further studies are needed before any strong conclusions can be made about the effects of chocolate on reflux symptoms. SUMMARY: There is limited evidence that chocolate worsens reflux symptoms. A few studies suggest it might, but more research is needed.

11. Avoid Mint, If Needed Peppermint and spearmint are common herbs used to flavor foods, candy, chewing gum, mouthwash and toothpaste. They are also popular ingredients in herbal teas. One controlled study of patients with GERD found no evidence for the effects of spearmint on the lower esophageal sphincter. Yet, the study showed that high doses of spearmint may worsen acid reflux symptoms, presumably by irritating the inside of the esophagus (47). If you feel like mint makes your heartburn worse, then avoid it.

SUMMARY: A few studies indicate that mint may aggravate heartburn and other reflux symptoms, but the evidence is limited.

12. Elevate the Head of Your Bed Some people suffer from reflux symptoms during the night (48). This may disrupt their sleep quality and make it difficult for them to fall asleep. One study showed that patients who raised the head of their bed had significantly fewer reflux episodes and symptoms, compared to those who slept without any elevation (49). Additionally, an analysis of controlled studies concluded that elevating the head of the bed is an effective strategy to reduce acid reflux symptoms and heartburn at night (10). SUMMARY: Elevating the head of your bed may reduce your reflux symptoms at night.

13. Don't Eat Within Three Hours of Going to Bed People with acid reflux are generally advised to avoid eating within the three hours before they go to sleep. Although this recommendation makes sense, there is limited evidence to back it up. One study in GERD patients showed that having a late evening meal had no effects on acid reflux, compared to having a meal before 7 p.m. (50). However, an observational study found that eating close to bedtime was associated with significantly greater reflux symptoms when people were going to sleep (51). More studies are needed before solid conclusions can be made about the effect of late evening meals on GERD. It may also depend on the individual. SUMMARY: Observational studies suggest that eating close to bedtime may worsen acid reflux symptoms at night. Yet, the evidence is inconclusive and more studies are needed.

14. Don't Sleep on Your Right Side Several studies show that sleeping on your right side may worsen reflux symptoms at night (52, 53, 54). The reason is not entirely clear, but is possibly explained by anatomy. The esophagus enters the right side of the stomach. As a result, the lower esophageal sphincter sits above the level of stomach acid when you sleep on your left side (55). When you lay on your right side, stomach acid covers the lower esophageal sphincter. This increases the risk of acid leaking through it and causing reflux. Obviously, this recommendation may not be practical, since most people change their position while they sleep. Yet resting on your left side might make you more comfortable as you fall asleep. SUMMARY: If you suffer from acid reflux at night, avoid sleeping on the right side of your body.

The Bottom Line Some scientists claim that dietary factors are a major underlying cause of acid reflux. While this might be true, more research is needed to substantiate these claims.

Nevertheless, studies show that simple dietary and lifestyle changes can significantly ease heartburn and other acid reflux symptoms.