In the previous post- Five Reasons Why You Need Stomach Acid, we discussed why stomach acid is vitally necessary and that gastroesophageal reflux disease (GERD) is usually due to having too little stomach acid rather than not enough. The physiological problem behind GERD is due to the lower esophageal sphincter (LES) relaxing at the wrong times, thus allowing stomach acid to reflux into your soft, unprotected esophagus. You can positively influence LES valve function by utilizing the following natural treatments. Before you take matters into your own hands, have your heartburn and indigestion problems evaluated medically, to make sure that they are not a sign of a more serious problem, like gallbladder disease, an ulcer, Barrett’s esophagus, erosive esophagitis or hiatal hernia. With that being said, here is how you can treat GERD naturally:
Reduce/Modify your Carbohydrates
The first thing that you can do to take control of GERD is to adjust your carbohydrates. Low stomach acid causes bacterial overgrowth and the improper digestion of carbohydrates-which can produce copious amounts of gas. This increases intra-abdominal pressure (IAP) which in turn pushes stomach acid through the LES (18). In addition, dysbiosis is an imbalance of the microbial community in the stomach and esophagus. The wrong microorganisms can increase inflammation, leading to relaxation of the lower esophageal sphincter (LES). Dysbiosis has been found in individuals with GERD (19). A low carbohydrate diet can decrease the growth of these microorganisms. One study found that obese individuals with GERD who adopted a very low carbohydrate diet found significant improvement in GERD symptoms after just 6 days (20). A case report in 5 individuals observed symptom resolution after adopting a low-carbohydrate diet in addition to reducing other exacerbating foods, like caffeine (21). There are other diets that are not necessarily considered low carbohydrate, but modify the type of carbohydrates you eat. The FODMAPS diet and the specific carbohydrate diet restrict certain carbohydrates that are known to increase bacterial fermentation. One study found that eating a carbohydrate that is fermentable by the miccorganisms in the colon caused a significant increase in LES relaxation, exposure of the esophagus to acid and GERD symptoms, compared to a placebo (22). You, with the help of your practitioner, will need to determine the type of carbohydrate restriction that will work best for you and your lifestyle.
Adjust Your Diet and Lifestyle
Besides modifying your carbohydrates, it is helpful to eliminate the following foods due to the impact these foods have on your LES (can cause relaxation allowing for more reflux of stomach acid):
Coffee, mint, sugar, alcohol, spicy foods, fried foods, food allergies/intolerances (dairy, gluten, citrus, tomatoes, etc). Finding a practitioner to help you work on a diet plan so that you can identify food allergies/intolerances and/or test you for these conditions is important.
Also, making the following lifestyle changes can help:
Eat smaller meals, wear looser clothing, limit food intake 2-3 hours prior to lying down, lose weight, stop smoking and minimize liquids with meals, which will dilute digestive juices.
Correcting micronutrient deficiencies, such as magnesium, are accepted therapies despite lack of scientific evidence, for the treatment of GERD and may prove helpful.
Practice mindful eating. It is common knowledge that stress disrupts gastrointestinal function. Stress can cause delayed gastric emptying, meaning that food remains in the stomach for a longer period of time (23) and delayed gastric emptying is associated with GERD (24). A great way to reduce stress, especially when eating a meal is to practice mindful eating. Mindful eating focuses on awareness of your natural sensations for hunger and satiety. It is about being “in the moment” while you are eating, to slow down and enjoy every bite-thus promoting optimum digestion. Check out these websites to help get you started:
• www.tcme.org (The Center for Mindful Eating)
The following supplements will aid your digestive processes and help heal your digestive lining. These are the supplements that I recommend:
• Digestive Enzymes. Digestive enzymes aid with the breakdown of food and low stomach acid can impair their function. Symptoms that may indicate the need for digestive enzymes are gas and bloating, a heavy feeling after meals, undigested food in the stool, and oily stools.
• Swedish Bitters. Bitters have been used for thousands of years to stimulate the flow of digestive juices to improve digestion (25). They will help eliminate gas, bloating and indigestion. They are taken 15-20 minutes before a meal to get your juices flowing.
• Deglycyrrhizinated Licorice Root. This is a substance that relieves inflammation by protecting mucus membranes, thus aiding in the treatment of peptic ulcers, canker sores, and irritated mucus membranes caused by GERD (26, 27).
• Zinc-Carnosine aids in the treatment of gastric ulcers (28, 29). Zinc is a significant trace mineral that helps with tissue repair, growth, and wound healing in the body. L-carnosine helps transport the zinc-carnosine to the site of ulceration, where it adheres to gastric mucosa and provides its protective effects against damaging agents (30). If you have any kind of damage-including esophagitis (inflammation of the esophagus) this supplement will help protect and heal damaged tissue (31).
• L-Glutamine is a vital nutrient for the intestines to rebuild and repair and for maintaining the barrier of the intestinal lining (32, 33).
• Aloe Leaf Extract has been shown to have antioxidant properties in some studies (34, 35) and is also used to aid in the treatment of digestive disorders (36). It is included in some combination supplements for added support.
• Probiotics. Numerous studies have documented the importance of probiotics to restore gastrointestinal function. There are thousands of different brands of probiotics, all ranging in different types and strains of microorganisms, as well as quality. Different people respond differently to probiotics. You can start with a probiotic that has multiple strains of microorganisms, like UltraFlora Spectrum, VSL#3, Ther-biotic Complete or BioKult.
Lifestyle changes and supplements will go a long way to helping you feel better, but in order to restore your digestion, you will need to discuss with your healthcare practitioner if you are a candidate for weaning off of your PPI. In the next post How To Wean Off Of Your Acid Suppressing Drug, I will walk you through how to do just that.
(Special thanks to Amanda Connolly, dietetic intern, for her research assistance)
References (see part 3)