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Acid Reflux
 

Acid Reflux

Acid reflux or heartburn are commonly used names for the medical condition, gastroesophageal reflux disease (GERD). Acid reflux occurs when acidic juices from the stomach flow back up into the esophagus, causing irritation and inflammation (esophagitis). The function of the esophagus is to allow food to flow down into the stomach.

During digestion, the lower esophageal sphincter (the valve that separates the esophagus and stomach) opens to allow food to pass into the stomach, and then closes to prevent the stomach contents from flowing back up.

However, acid reflux occurs when the lower esophageal sphincter inappropriately opens, allowing the gastric contents to back up. This leads to a burning pain or discomfort in the upper abdomen and chest, known as heartburn. Acid reflux can be caused by the following dietary sources and conditions:

  • overeating
  • pregnancy
  • smoking
  • consuming fried, fatty or spicy foods
  • chocolate
  • carbonated beverages
  • alcohol
  • coffee

Other causes may include hiatal hernia (an outpouching of the stomach above the diaphragm), ulcer disease, and gastritis (inflammation of the stomach). These factors either increase abdominal pressure or cause the esophageal sphincter to inappropriately relax, allowing the stomach contents to back up.

If acid reflux remains untreated over time, it can cause scarring and precancerous changes of the esophagus (Barrett’s syndrome), and an increased risk for the development of esophageal cancer.

Acid Reflux Statistics

According to the US Department of Health and Human Services, National Institutes of Health (NIH): [1, 2]

  • About 7 million people in the United States have some degree of acid reflux.
  • About 60 million people a month have heartburn.
  • Twenty-five million people suffer from heartburn once a day.
  • Twenty-five percent of pregnant women get heartburn every day and 50 percent occasionally.

Acid Reflux Symptoms

Acid reflux usually occurs after eating, from bending over or lying down. The most common symptom is heartburn, which feels like a burning sensation beginning in the stomach or lower breastbone, and then may move up into the chest and throat. Heartburn can last from a few minutes to a few hours. Belching is also a common occurrence. Esophageal inflammation symptoms may include painful swallowing and/or a sharp, stabbing pain in the center of the chest.

Heartburn Treatment and Relief

The most common lifestyle modifications that people can make to reduce the symptoms of acid reflux and heartburn include:

  • Avoid consuming fried, fatty or spicy foods, chocolate, carbonated beverages, alcohol, or coffee.
  • Avoid lying down within 3 hours of eating.
  • Avoid eating food for 2-3 hours before bedtime. Elevate the head of the bed about 6 inches to help keep the acid contents in the stomach.
  • Maintain a healthy weight.

In addition to lifestyle recommendations, over the counter medications such as H2 antagonists (Tagamet, Pepcid, Zantac) and antacids (Maalox, Tums) may be prescribed for mild to moderate symptoms. For more severe symptoms, prescription proton-pump inhibiting drugs (Prilosec, Prevacid) may be recommended. These medications effectively reduce acid reflux symptoms but with long-term use may have an increased risk of digestive cancers. The drug, Baclofen, a skeletal relaxant, may be a preferred long-term alternative to proton-pump inhibitors.

Supplements helpful for Heartburn

Multivitamins and Heartburn

Studies show that multivitamin/mineral supplementation may reduce esophageal cancer risk (3-5). A good high potency multivitamin/mineral supplement including vitamin A, vitamin C, vitamin B2, vitamin B6, folic acid, zinc, selenium, and other nutrients helps the immune system function optimally and may reduce the risk of gastric and esophageal cancers associated with chronic acid reflux.

Antioxidants and Heartburn (Beta-Carotene, Vitamin E, Vitamin C)

According to studies, antioxidants including beta-carotene, vitamin E, and vitamin C, can protect against esophageal inflammation and reduce the risk of gastric and esophageal cancers associated with chronic acid reflux (6-9). One study found that antioxidant supplementation decreased the risk of developing esophageal cancer by nearly 50% (8).

Digestive Enzymes and Heartburn

Digestive enzymes aid digestion (10) and help the body to absorb and completely utilize the food. Digestive enzymes can help to prevent heartburn by promoting faster movement of food out of the stomach so it doesn’t flow back up into the esophagus. Digestive aids contain pancreatic enzymes including protease, lipase, and amylase, and should be taken at the beginning of each meal.

Deglycyrrhizinated Licorice (DGL)

Deglycyrrhinizinated licorice (DGL), a licorice root extract, has been shown to help prevent acid reflux and heartburn, protect the lining of the stomach and intestinal tract, and heal the esophagus (11, 12). Glycyrrhinizic acid, a component of licorice that’s been linked with high blood pressure, is removed from DGL, which has no known side effects.

References

1. GERD Information Resource Center, “How many people are afflicted with GERD?”, http://www.pdrhealth.com/drug_info/nmdrugprofiles/herbaldrugs/101840.shtml

2. CARITAS, “GERD”, http://www.pdrhealth.com/drug_info/nmdrugprofiles/herbaldrugs/101840.shtml

3. Chen H et al., “Nutrient intakes and adenocarcinoma of the esophagus and distal stomach.” Nutr Cancer. 2002;42(1): 33-40.

4. Mayne ST, Risch HA, Dubrow R, et al. Nutrient intake and risk of subtypes of esophageal and gastric cancer. Cancer Epidemiol Biomarkers Prev. 2001 Oct;10(10):1055-62.

5. Mark SD, Qiao YL, Dawsey SM, et al. Prospective study of serum selenium levels and incident esophageal cancers. J Natl Cancer Inst. 2000 Nov 1;92(21):1753-63.

6. Taylor PR, Li B, Dawsey SM, et al. Prevention of esophageal cancer: the nutrition intervention trials in Linxian, China. Linxian Nutrition Intervention Trials Study Group. Cancer Res. 1994 Apr 1;54(7 Suppl):2029s-31s.

7. Zhang YH, Kramer TR, Taylor PR, et al. Possible immunologic involvement of antioxidants in cancer prevention. Am J Clin Nutr. 1995 Dec;62(6 Suppl):1477S-82S.

8. Terry P, Lagergren J, Ye W, et al. Antioxidants and cancers of the esophagus and gastric cardia. Int J Cancer. 2000 Sep 1;87(5):750-4.

9. Bollschweiler E et al., “Vitamin intake and risk of subtypes of esophageal cancer in Germany,” J Cancer Res Clin Oncol 2002 Oct; 128(10):575-80

10. Suarez F et al., “Pancreatic supplements reduce symptomatic response of healthy subjects to a high fat meal,” Dig Dis Sci Jul 44 (7) (1999): 1317-21.

11. van Marle J et al., “Deglycyrhizinised Liquorice (DGL) and the Renewal of Rat Stomach Epithelium,” Eur J Pharmacol 72 (1981): 219-25.

12. J.E. Pizzorno and M.T. Murray, eds., Encyclopedia of Natural Medicine, revised 2nd edition, (Rocklin, CA: Prima Publishing, 1998): 137

13. Life Extension eds., Disease Prevention and Treatment, 4th ed. (Hollywood, Florida: Life Extension Media, 2003).

14. Miriam Stoppard, MD., Family Health Guide, (New York, NY: DK Publishing, 2002).

15. James F. Balch and Phyllis A. Balch, Prescription for Nutritional Healing, 3rd ed. (New York, NY: Penguin Putnam Avery, 2000).