Wednesday, September 18, 2013

What are natural treatments for gastroesophageal reflux disease (GERD)?


Introduction

In gastroesophageal reflux disease (GERD), acid from the
stomach splashes upward, or refluxes, and burns the esophagus (the tube connecting
the mouth and throat to the stomach). Normally, a type of sphincter muscle keeps
the upper part of the stomach closed, but various factors may loosen it, allowing
acid to rise more easily. The result is pain in the chest, commonly known as
heartburn. GERD is generally made worse by lying down
because gravity no longer restrains the upward movement of stomach contents. In
infants, the major issue with GERD is not pain but the spitting up (vomiting) of
food or milk.




Certain foods may worsen GERD, and these include alcohol, carbonated beverages, caffeine, chocolate, citrus juices, milk, and peppermint. Cigarette smoking may also increase symptoms. Contrary to earlier beliefs, it does not appear that people with GERD need to cut down on fat intake to help control the disease.


Pregnant women frequently develop GERD because of changes in muscle tone. Also, the connection between obesity and GERD remains unclear.


Treatment for GERD involves elevating the head of one’s bed and using
medications that reduce the acidity of the stomach. In general, more powerful
antacid medications are required for GERD than for ulcers or
gastritis. Drugs in the proton pump category are most
effective. Surgery may be recommended in certain cases.


If left untreated, GERD causes precancerous alterations in the lower part of
the esophagus (a condition called Barrett’s esophagus), which can develop
into esophageal
cancer. Thus, people with GERD are often tested to evaluate
the condition of the esophagus.




Proposed Natural Treatments

Natural antacids, such as calcium carbonate (Tums) or hydrotalcite, may provide short-term relief from GERD. Drugs used to treat GERD tend to deplete the body of certain nutrients, especially vitamin B12
but also folate and various minerals. The use of a multivitamin-multimineral supplement should correct this problem.


Deglycyrrhizinated licorice, a special form of the herb licorice, has shown some promise for the treatment of ulcers. A drug (carbenoxolone) that is similar to ingredients in licorice has been studied for the treatment of GERD, with good results.


However, in these studies carbenoxolone was combined with other ingredients, including antacids and alginic acid. It is not clear that carbenoxolone alone will help GERD, and it is even less clear that licorice itself offers any benefit.


A popular over-the-counter drug for GERD, Gaviscon, contains a substance called
alginic acid. Alginic acid is thought to form a kind of protective seal at the top
of the stomach, reducing reflux. The seaweed bladderwrack
is high in alginic acid. However, there is no evidence that whole bladderwrack can
reduce heartburn symptoms.


Several other natural supplements are often recommended for the treatment of GERD, including aloe vera, antioxidants, artemesia, fresh garlic, marshmallow, and slippery elm, but there is no scientific evidence to support their use. Milk allergy is thought to contribute to GERD in infants. Whether food allergies play a significant role in adult cases remains unclear. The herb carob may be helpful for infant GERD.


Many naturopathic physicians believe that the supplement betaine
hydrochloride can aid GERD by increasing stomach acid. This
sounds paradoxical, because conventional treatment involves reducing stomach acid.
However, according to one theory, lack of stomach acid leads to incomplete
digestion of proteins; these proteins cause allergic reactions and other responses
that lead to an increase in reflux. Again, scientific evidence is lacking.




Bibliography


Holtmeier, W., et al. “On-Demand Treatment of Acute Heartburn with the Antacid Hydrotalcite Compared with Famotidine and Placebo.” Journal of Clinical Gastroenterology 41 (2007): 564–70. Print.



“GERD.” MedlinePlus. US Natl. Lib. of Medicine, 15 Sept. 2014. Web. 28 Jan. 2016.



Givens, Shirley. “Health Risks of Common Acid Reflux Medications.” Life Extension (2016): 41–50. Alt HealthWatch. Web. 28 Jan. 2016.



Pehl, C., et al. “Effect of Low- and High-Fat Meals on Lower Esophageal Sphincter Motility and Gastroesophageal Reflux in Healthy Subjects.” American Journal of Gastroenterology 94 (1999): 1192–96. Print.



Salvatore, S., and Y. Vandenplas. “Gastroesophageal Reflux and Cow Milk Allergy: Is There a Link?” Pediatrics 110 (2002): 972–84. Print.



Wenzl, T. G., et al. “Effects of Thickened Feeding on Gastroesophageal Reflux in Infants: A Placebo-Controlled Crossover Study Using Intraluminal Impedance.” Pediatrics 111 (2003): e355–59. Print.

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