Everything You Need To Know About GERD and Acid Reflux

At AskDoctor.ai, we have created this content to provide you with valuable knowledge about GERD and acid reflux. Our goal is to offer both information and inspiration—helping you understand the causes, symptoms, and management options of the conditions. You are not alone; through knowledge and community, we believe you can confidently navigate this journey. 

Gastroesophageal reflux disease (GERD) and acid reflux are common conditions that affect millions of people worldwide. These conditions occur when stomach acid or bile irritates the food pipe (esophagus), leading to symptoms like heartburn, regurgitation, chest pain, and difficulty swallowing. While both medical and natural treatments exist for managing GERD and acid reflux, patients often find themselves confused about the best course of action. Should they rely on medications or opt for natural remedies? 

In this blog, we will explore the symptoms, causes, medical treatments, natural treatments, and their effectiveness to help you make a well-informed decision.

What is GERD and Acid Reflux?

Acid reflux is a condition where stomach acid flows back into the esophagus. This happens when the lower esophageal sphincter (LES), a ring of muscle at the bottom of the esophagus, weakens or relaxes at the wrong time, allowing stomach acid to escape. Occasional acid reflux is normal, especially after eating a large meal, but when it happens frequently, it can lead to GERD.

GERD (Gastroesophageal Reflux Disease) is a more severe, chronic form of acid reflux. In GERD, acid reflux occurs more than twice a week and can cause significant discomfort and potential complications. Some common symptoms of GERD and acid reflux include:

• Heartburn (a burning sensation in the chest)
  
• Regurgitation of food or sour liquid
  
• Difficulty swallowing
  
• Chronic cough
  
• Sore throat
  
• Chest pain
  
• Bloating and nausea
  

Causes of GERD and Acid Reflux

Several factors contribute to GERD and acid reflux. Some of the most common causes include:

1. Weak LES (Lower Esophageal Sphincter): 

The LES normally acts as a barrier to prevent stomach acid from backing up into the esophagus. When the LES weakens or relaxes inappropriately, acid reflux can occur. Studies have found that 60-70% of people with GERD have a weak or relaxed LES that fails to effectively prevent acid reflux.

2. Obesity: 

Excess weight can put pressure on the stomach, pushing stomach contents upward into the esophagus.

3. Hiatal Hernia: 

This occurs when part of the stomach pushes through the diaphragm into the chest, which can interfere with the LES and increase the likelihood of acid reflux.

4. Pregnancy: 

Hormonal changes and pressure from the growing fetus can relax the LES and lead to acid reflux.

5. Diet and Lifestyle: 

Foods like spicy dishes, fatty foods, chocolate, caffeine, citrus, alcohol, and peppermint can trigger acid reflux. Smoking and overeating can also contribute to the condition.  In fact, a study in the Journal of Clinical Gastroenterology found that 55% of individuals with GERD experienced worsened symptoms after eating high-fat foods.

6. Medications: 

Certain medications, such as antihistamines, calcium channel blockers, and pain relievers like aspirin or ibuprofen, can relax the LES and promote reflux.

Medical Treatments for GERD and Acid Reflux

The medical treatment for GERD and acid reflux typically revolves around medications and, in some cases, surgery. The goal is to reduce the frequency and severity of symptoms, promote healing of the esophagus, and prevent complications such as esophageal ulcers, bleeding, or narrowing.

1. Antacids

Antacids are the most commonly used over-the-counter (OTC) medications for quick relief from heartburn. They work by neutralizing stomach acid. Common examples include Tums, Rolaids, and Maalox.

• Pros: Fast relief, easily accessible.
  
• Cons: Not suitable for long-term use. Overuse can lead to side effects such as kidney stones or increased calcium levels.
  

2. H2 Receptor Antagonists (H2 Blockers)

H2 blockers, such as ranitidine (Zantac) and famotidine (Pepcid), work by blocking histamine receptors in the stomach that trigger acid production. This reduces the amount of acid produced in the stomach, which can help manage GERD symptoms.

• Pros: Longer-lasting than antacids, available in both OTC and prescription forms.
  
• Cons: May take longer to work than antacids, and can interact with certain medications.
  

3. Proton Pump Inhibitors (PPIs)

Proton pump inhibitors, such as omeprazole (Prilosec) and esomeprazole (Nexium), are the most powerful medications for reducing stomach acid. They work by blocking the proton pumps in the stomach lining that produce acid. PPIs are typically used to treat GERD and to promote healing of the esophagus. 

Around 60-70% of GERD patients experience significant symptom relief when using H2 blockers. They reduce acid production, leading to reduced reflux episodes and lessening the severity of symptoms like heartburn and regurgitation.

• Pros: Highly effective at reducing stomach acid, long-lasting.
  
• Cons: Long-term use may lead to nutrient deficiencies (e.g., vitamin B12, calcium), increased risk of bone fractures, and gut infections.
  

4. Prokinetics

Prokinetics, such as metoclopramide (Reglan), help strengthen the LES and promote the movement of food through the stomach and intestines. This can reduce acid reflux episodes.

• Pros: Can improve gastric motility, may be useful for those with delayed stomach emptying.
  
• Cons: Side effects include drowsiness, diarrhea, and in rare cases, movement disorders.
  

5. Surgery

In severe cases of GERD that do not respond to medication, surgical options may be considered. The most common procedure is fundoplication, where the top of the stomach is wrapped around the LES to prevent acid reflux. In some cases, a device known as the LINX device may be implanted around the LES to help it stay closed.

• Pros: Can provide long-term relief.
  
• Cons: Involves risks associated with surgery, including infection and difficulty swallowing.
  

Natural Treatments for GERD and Acid Reflux

In addition to medical treatments, many people turn to natural remedies to manage GERD and acid reflux. While these remedies are not a substitute for professional medical care, they can help alleviate symptoms and support overall digestive health.

1. Dietary Changes

One of the most important natural approaches to managing acid reflux is adjusting your diet. Certain foods trigger reflux symptoms, while others can help reduce acid production.

• Avoid Trigger Foods: Common reflux triggers include spicy foods, citrus, tomatoes, chocolate, caffeine, alcohol, peppermint, and fatty foods.
  
• Eat Smaller, More Frequent Meals: Larger meals put pressure on the LES, which can lead to acid reflux. Eating smaller meals throughout the day can reduce this pressure.
  
• Avoid Eating Late: Eating a large meal right before bedtime can exacerbate reflux. Try to finish eating at least 2-3 hours before lying down. Around 48% of GERD patients reported that consuming a large meal, particularly late in the evening, significantly worsened their symptoms, especially when they went to bed shortly after eating.
  

2. Herbal Remedies

Several herbs have been traditionally used to soothe the digestive system and reduce acid reflux symptoms:

• Ginger: Ginger has natural anti-inflammatory properties that may help reduce irritation in the esophagus. Drinking ginger tea or adding fresh ginger to meals can provide relief.
  
• Chamomile: Chamomile tea has calming properties that may help relax the digestive tract and reduce acid reflux.
  
• Licorice Root: Deglycyrrhizinated licorice (DGL) may help increase the production of mucus in the stomach, providing a protective barrier against stomach acid.
  

3. Aloe Vera

Aloe vera juice is known for its soothing properties. It can help calm the lining of the esophagus and stomach, reducing irritation caused by acid reflux. Drinking a small amount of aloe vera juice before meals may help alleviate symptoms.

4. Apple Cider Vinegar

Despite being acidic, apple cider vinegar may help some people by increasing the acidity in the stomach, which may improve digestion and prevent the LES from relaxing. Mix a teaspoon of apple cider vinegar in a glass of water and drink it before meals.

5. Chewing Gum

Chewing gum stimulates saliva production, which can help neutralize stomach acid. Sugar-free gum, in particular, may be beneficial for people with acid reflux. The act of chewing also helps keep the LES tightly closed, reducing the chance of acid escaping into the esophagus.

6. Lifestyle Changes

Certain lifestyle changes can help prevent or reduce the frequency of GERD symptoms:

• Lose Weight: Excess weight can put pressure on the stomach, promoting acid reflux. Losing even a small amount of weight can significantly improve symptoms.
  
• Quit Smoking: Smoking weakens the LES, making acid reflux more likely. Quitting smoking can greatly improve symptoms.
  
• Elevate Your Head While Sleeping: Sleeping with your head elevated by about 6 inches can help prevent acid from flowing back into the esophagus during sleep.
  

Which Treatment is Right for You?

The choice between medical treatments and natural remedies depends on the severity of your GERD or acid reflux, your lifestyle, and your overall health. For some people, natural treatments such as dietary changes and herbal remedies may provide sufficient relief. Others may need medications or even surgery to manage their condition.

In many cases, a combination of both approaches works best. It’s important to consult with your healthcare provider before making any significant changes to your treatment plan, whether you’re considering medication or natural alternatives.

The TIF Procedure

A Reddit User struggled with GERD for years. After a long time of agony, he sought the advice of a nutritionist, who recommended finding a doctor specializing in fundoplication. He learned about various procedures that address the root cause of GERD, but discovered that not all gastroenterologists perform them or suggest them as options. 

While not everyone is a candidate for these procedures, it turned out to be life-changing for him. He underwent the TIF (Transoral Incisionless Fundoplication) procedure, which significantly improved his quality of life. Fortunately, the procedure was also covered by their insurance.

Diet Makes A Massive Difference

For Reddit User Kerry, diet and lifestyle changes helped a lot in managing GERD. Initially, she eliminated dairy from their diet for a couple of months to avoid anything that might upset her digestion, even beyond GERD. After that, she slowly reintroduced dairy and found she could tolerate cheese (even high-fat varieties) and a little butter, though they never consumed much milk. Almonds were well-tolerated, and she ate a lot of them. 

For fruits, bananas and melons were safe to eat, with a particular fondness for bananas. Most vegetables were fine as long as they were cooked, though she avoided gassy vegetables like broccoli, Brussels sprouts, and cabbage in the first few weeks to allow her digestion to settle. After a couple of months, she gradually added in fruits like apples, mangoes, and grapes, as well as raw vegetables, taking it slow to see how each food affected them.

Wayne’s Success Story

You can check out Wayne’s story of overcoming GERD and its debilitating symptoms on this video. 

Wrapping It Up

GERD and acid reflux are common but manageable conditions. Medical treatments like antacids, H2 blockers, and PPIs are effective at controlling symptoms, but they come with potential side effects, especially when used long-term. On the other hand, natural remedies such as dietary changes, herbal treatments, and lifestyle modifications can provide significant relief without the risks associated with medications. Finding the right treatment for you will depend on your specific symptoms, preferences, and overall health. Always consult with a healthcare professional before making decisions about your treatment plan, and remember that managing GERD is often an ongoing process that requires both medical and lifestyle interventions.