treatment options for GERD
Acid reflux is also known as indigestion or gastroesophageal reflux disease (GERD). It occurs when the valve between the esophagus and stomach doesn’t function properly. When the valve (lower esophageal sphincter, LES, or cardiac sphincter) malfunctions, food and stomach acid can travel back up the esophagus and cause a burning sensation.
Other symptoms of GERD include:
- sore throat
- sour taste in the back of the mouth
- asthma symptoms
- dry cough
- trouble swallowing
Talk to your doctor if these symptoms are causing discomfort. If left untreated, GERD can cause bleeding, damage, and even esophageal cancer.
Doctors can prescribe several different treatments for GERD to reduce acid production in the stomach. And there are quite a few over-the-counter medications (OTC) available. There are also some complementary and alternative medicine (CAM) options that may provide relief.
Complementary methods work alongside traditional treatments, while alternative therapies replace them. But there is limited scientific evidence supporting alternative treatments as replacements. Always talk to a doctor before trying CAM. Some herbs and supplements may negatively interact with medications you’re already taking.
Acupuncture is a type of traditional Chinese medicine that’s been around for at least 4,000 years. It uses small needles to rebalance energy flow and stimulate healing. Only recently are there clinical trials studying the effectiveness of acupuncture for GERD.
One clinical trial reported that acupuncture significantly decreased the symptoms of GERD. Participants scored their results based on 38 symptoms, including issues that involved:
- digestive system problems
- back pain
Another study found positive effects on decreasing stomach acid as well as LES regulation.
Electroacupuncture (EA), another form of acupuncture, uses electrical current along with the needles. Studies are still new, but one found that using needleless EA increased LES pressure and reduced acid reflux. The combination of electroacupuncture and proton pump inhibitors resulted in significant improvement.
Melatonin is usually thought of as the sleep hormone made in the pineal gland. But your intestinal tract makes nearly 500 times more melatonin. The intestinal tract includes the stomach, small intestine, colon, and esophagus.
Melatonin can reduce:
- incidence of epigastric pain
- LES pressure
- pH level of your stomach (how acidic your stomach is)
One study compared the effectiveness of taking omeprazole (a common medication used to treat GERD), melatonin, and a combination of melatonin and omeprazole. The study suggested that using melatonin alongside omeprazole shortens the duration of treatment and lessens side effects.
Stress often makes GERD symptoms worse. Your body’s stress response can increase the amount of acid in the stomach, as well as slow digestion. Learning how to manage stress can help with these triggers. Massage, deep breathing, meditation, and yoga may help reduce symptoms of GERD.
Yoga in particular encourages the relaxation response. One study suggested that practicing yoga along with taking your medication treats GERD symptoms.
Hypnotherapy, or clinical hypnosis, is the practice of helping a person reach a concentrated, focused state. For digestive health, hypnotherapy is shown to reduce:
- abdominal pain
- unhealthy bowel patterns
Current studies on hypnotherapy are still limited. However, in small trials, it’s been shown to be effective for functional heartburn and reflux symptoms. Some people with acid reflux may show increased sensitivity toward normal esophageal stimulation. Hypnotherapy may help people to release fear of pain by promoting a deep state of relaxation.
Herbalists may recommend different types of herbs in the treatment of GERD. Examples include:
- ginger root
- marshmallow root
- slippery elm
At this time, there is little clinical research to back up the effectiveness of these herbs in treating GERD. Researchers don’t recommend using traditional Chinese medicine to treat GERD. Current studies on herbal medications are poor and not well-controlled.
Always check with your doctor before you take herbal supplements. Even natural herbs can cause unintended side effects.
As an antacid, baking soda can help temporarily neutralize stomach acid and provide relief. For adults and teenagers, dissolve 1/2 teaspoon in a 4-ounce glass of water. Talk to your doctor about the dosage for children.
Lifestyle changes for GERD
Some of the best treatments for GERD are lifestyle changes. These changes include:
- Quitting smoking: Smoking affects LES tone and increases reflux. Not only will quitting smoking reduce GERD, but it can also reduce your risk for other health complications.
- Losing weight, if you are overweight: Excess weight can put extra pressure on the stomach, which can cause acid to reflux into the stomach.
- Refraining from wearing tight-fitting clothes: Clothes that are tight around the waist can put extra pressure on your stomach. This added pressure can then affect the LES, increasing reflux.
- Elevating your head: Elevating your head when sleeping, anywhere from 6 to 9 inches, ensures that stomach contents flow downward instead of upward. You can do this by placing wooden or cement blocks underneath the head of your bed.
The good news is that you no longer need to eliminate food to treat GERD. A review of over 2,000 studies found no evidence that food elimination works. But some foods like chocolate and carbonated drinks may reduce LES pressure and allow food and stomach acid to reverse.
When to see a doctor
You should seek medical treatment if:
- you have difficulty swallowing
- your heartburn is causing nausea or vomiting
- you use OTC medications more than two times per week
- your GERD symptoms are causing chest pain
- you are experiencing diarrhea or black bowel movements
Your doctor will prescribe medications such as:
- H2 receptor blockers
- proton pump inhibitors
All three types of medication are available over the counter and by prescription. Note that these medications can be expensive and may cost hundreds of dollars each month. In extreme cases, your doctor may recommend surgery to alter your stomach or esophagus.
Seek treatment for GERD symptoms if at-home methods aren’t proving effective, or your symptoms are worsening.