Acid reflux disease or gastroesophageal reflux disease (GERD) is a disease caused by excessive amounts of stomach acid. The excess acid seeps into the esophagus and causes pain and various other health problems that can be dangerous. If you have frequent stomach pains (more than once per week), you may have this disease. Therefore, you must treat it to prevent more acute problems from occurring. Here are ways to treat it.
Part 1 of 4: Understanding Stomach Acid Disease
Step 1. Study the role of stomach acid in digestion
Stomach acid is naturally produced by the stomach to help your body break down and digest food. Gastric acid is secreted by the parietal cells in the stomach in response to stimulation from gastrin. The acid also kills pathogens in the gastrointestinal tract to prevent infection. It is absolutely impossible to get rid of stomach acid completely.
If you feel pain or inflammation, find out if the cause is excess stomach acid
Step 2. Control the symptoms of GERD
Watch for symptoms of GERD, such as:
- Pain or burning in the chest below the sternum. This sensation can radiate to the back, neck, and jaw, and can last for hours. Many people mistake this symptom for a heart problem (such as heart disease or angina). If you have pain in your jaw, arm, or chest, seek medical attention.
- Rise of stomach contents into the esophagus and mouth (which will taste like a bitter, burning liquid). This will increase the production of saliva and cause the tongue to taste bad. You will also feel that something is stuck in your throat.
- Reduced hunger or easy satiety.
- Nausea or a stabbing pain in the middle or top of the stomach.
- Chronic cough due to irritation of the esophagus.
Step 3. Learn what causes GERD
Your body has a ring of muscle called the lower esophageal sphincter (LES) that tightens and closes the part of your esophagus where it meets your stomach. The LES prevents stomach contents from leaving the stomach and ensures the stomach will only open when you swallow or burp. Sometimes, the LES can stop functioning so stomach acid flows out of the stomach into the esophagus. This can happen when:
- Your stomach is too full from eating too much or after eating foods that can expand and increase gas production such as cabbage, broccoli, milk, and foods high in fat.
- Your body tenses up, such as when you lift heavy weights or exercise intensely right after eating.
- You have a hiatal hernia. This occurs when the upper part of the stomach moves up through the opening in the diaphragm (where the esophagus connects from the chest to the stomach).
- You are overweight, you are obese, or you are pregnant. Additional weight on the stomach can increase pressure on the stomach, LES, and esophagus.
- You lie down immediately after eating food. Normally, gravity assists the LES in keeping stomach contents in the stomach. If you lie down immediately after eating, the stomach contents can be pushed up and through the LES.
- You eat foods that irritate your esophagus and throat, causing inflammation and relaxing the LES. Examples of substances that can cause irritation are caffeine, alcohol, spicy foods, acids, and nicotine, which can increase acid production.
Part 2 of 4: Adjusting Your Lifestyle
Step 1. Improve your diet
Diet and weight management are the first steps in treating acid reflux. Develop a balanced diet that includes lots of fruits, vegetables, whole grains, and low- or fat-free milk (avoid dairy products that contain added sugar and are high in calories). Also add low-fat proteins like chicken, fish, and whole grains. Reduce consumption of fat, cholesterol, and foods that contain high sodium salt and added sugar.
The Ministry of Health of the Republic of Indonesia provides various diet brochures that can be downloaded for free
Step 2. Avoid foods that can trigger stomach acid
Although there is no specific diet that has been scientifically proven to cure GERD, you can try to treat the symptoms through natural remedies by avoiding foods that can trigger stomach acid. These foods include:
- Caffeine: coffee, tea, soda
- Caffeine-like chemicals like chocolate and candy
- Spicy food like chili and curry
- Acidic foods such as lemons, tomatoes, sauces, and vinegar
Step 3. Change the way you eat
Avoid swallowing large portions of food. Large, poorly chewed food can fill the stomach because it will take longer for the stomach to break it down. Instead, swallow the food little by little, chewing it well in the mouth. This will make the digestive process run more efficiently and prevent air that can cause swelling from being digested.
Eat slowly. The stomach takes approximately 20 minutes to signal to the brain that your stomach is full. Therefore, people who eat quickly tend to feel full more easily
Step 4. Reach a healthy weight
Use your body mass index (BMI) to determine a healthy weight for your height and gender. To lose or maintain weight, calculate your calorie count by estimating your daily caloric needs and keeping track of the number of calories you consume. You can estimate your calorie needs by multiplying your weight (in pounds) by 10. This number can change according to your age, gender, and activity level. To more accurately estimate your daily calorie needs, use an online counter or smartphone app.
- A normal BMI ranges between 18.5 and 24.9. A BMI below 18.5 indicates underweight, 25.0-29.0 indicates overweight, and above 30.0 is classified as obese.
- The healthiest rate for weight loss is 0.45 kg per week. 0.45 kg of fat equals 3500 calories. If you reduce your daily calorie count by 500 calories, you will lose approximately 0.45 kg per week (500 cal x 7 days/week = 3500 cal/7 days = 0.45 kg/week).
Step 5. Perform regular physical exercise to lose or maintain a healthy weight
Adults need at least 30 minutes of moderate-intensity physical activity at least 5 days per week (total = 150 minutes per week) or 25 minutes of aerobic activity, at least 3 days per week, and at least two moderate-to-high-intensity muscle strengthening times per week. Try to do as much physical activity as possible, including walking.
- If the exercise you do exceeds the amount of daily activity, you will burn calories that can be added to your daily caloric intake. Don't forget, you can follow these activities on the fitness app you use.
- Don't exercise too hard, especially after you eat. Give your body time to digest food (approximately 3 to 5 hours), or, eat a light meal before exercising.
Part 3 of 4: Using Natural and Alternative Therapies
Step 1. Use baking soda
Baking soda or sodium bicarbonate can act as an anti-acid that can neutralize stomach acid. To use baking soda as a remedy, mix 1/2 to 1 teaspoon of baking soda in a glass of water and drink it. You can do it once every two hours to reduce stomach acid.
Baking soda is also available in capsule or pill form at pharmacies by prescription. If you want to treat your child with baking soda, talk to your doctor about the correct dosage
Step 2. Drink ginger or chamomile tea
Grind two or three ginger roots and boil them in water for 5 minutes. Drinking ginger or chamomile tea can reduce stress, relieve nausea, and aid digestion. Try drinking 1 or 2 cups of ginger tea 20 minutes before a meal to soothe the stomach.
If you notice that your GERD feels worse when you lie down, try drinking a cup of chamomile tea about 30 to 60 minutes before bed. This is thought to reduce stomach inflammation and balance acidity levels
Step 3. Consume cinnamon
Cinnamon is a plant that is thought to help cure the symptoms of acid reflux disease. Look for liquorice extract (deglycyrrhizinated licorice or DGL) which is available in powder or tablet form. Chew 2 tablets slowly or take 1/2 teaspoon of liquorice powder 15 minutes before you eat. Research has found that consuming liquorice products that also contain mint leaf oil, chamomile, karawai, lemon ointment, mustard greens, and tistel 3 times a day for 4 weeks can reduce symptoms of acid reflux disease.
Cinnamon can have reactions with other medicines you are currently taking. Therefore, consult your doctor before starting to take it
Step 4. Chew gum
Chewing gum after eating can help your body digest food. Your mouth will produce more saliva, which helps neutralize stomach acid. Opt for sugar-free gum to avoid consuming extra calories.
Avoid chewing gum that contains sugar as it can damage teeth and cause cavities
Step 5. Drink aloe vera juice
Although there is not much research on this subject, some studies claim that drinking 1/2 cup of aloe vera juice can reduce inflammation in the esophagus. Make sure you drink it cold or at room temperature before you eat.
Aloe vera also has laxative properties. Therefore, prepare yourself before drinking it
Step 6. Try acupuncture treatment
Acupuncture is an ancient therapy that uses strategically placed needles on the body to stimulate specific points. Research has shown that acupuncture therapy can cure regurgitation and acid reflux. Specifically, acupuncture can change your stomach's acid secretion, aid digestion, and reduce pain.
Make sure you only see a trained and certified acupuncturist. You can ask your local doctor or clinic to look for it
Part 4 of 4: Treating Stomach Acid Disease with Medicine or Surgery
Step 1. Know when you should see a doctor
If you have made changes to your lifestyle and diet without seeing any improvement in your symptoms, see your doctor. Treatment of stomach acid is important to prevent serious health problems such as ulcers or inflammation of the esophagus. The longer your esophagus remains inflamed or repeatedly injured, the higher your risk of developing esophageal cancer.
- Although the lining of the esophagus is usually able to protect itself from stomach acid, continued GERD can erode it.
- You may have a stomach bacterial infection called Helicobacter pylori (H. pylori) which can contribute to acid reflux symptoms. You can ask your doctor to do tests to detect it and give you the right treatment. If left unchecked, these bacteria can cause stomach cancer.
Step 2. Understand acid reflux disease testing
Usually, acid reflux disease is diagnosed based on the clinical symptoms you describe. However, if the disease has been receding in your body for a long time, or if medical therapy is not responding, you may need an upper endoscopy scan. This procedure uses a camera connected to a flexible tube that is inserted through the mouth to observe the throat, esophagus, and stomach. Several biopsies, or tissue samples, are usually taken to determine how severe the inflammation is in the stomach and esophagus. Then, the doctor will suggest a treatment method.
During the endoscopy, the doctor will check for the presence of H. pylori, or the bacteria that can cause GERD symptoms. If your doctor finds one, you will usually be placed in a triple therapy regimen that includes a proton pump inhibitor (for excess stomach acid), amoxicillin, and clarithromycin (an antibiotic), all of which will be administered twice daily for 7 to 14 days
Step 3. Take antacids
To treat mild to moderate acid reflux disease, an antacid will be recommended by a doctor along with suggestions for lifestyle changes and diet monitoring. Antacids, such as calcium carbonate, Tums, or Maalox, are over-the-counter medications that neutralize the acid. These drugs can also be taken as much as needed according to the instructions on the package. Although antacids work quickly, their effects should wear off after about an hour. Take antacids only if you experience GERD symptoms once or twice per week.
If you overdose on antacids, you will develop milk-alkaline syndrome which includes nausea, vomiting, weakness, psychosis, and kidney failure/injury. This happens because the consumption of too much calcium causes the body to be too alkaline
Step 4. Consumption of surfactants
Surfactants, or surface agents, such as sucralfate/carafat, will adhere to the surface of the esophagus and stomach to protect and heal them. Usually, you can take it in pill or liquid form 2 to 4 days per day for 4 to 8 weeks to treat mild to moderate GERD. Unless you take it wrong for a long time, the side effects are minimal.
Many surfactants contain aluminum so you can suffer from aluminum poisoning if the surfactant is not taken properly. Symptoms of aluminum poisoning include: bone or muscle pain, weakness, anemia, and dizziness
Step 5. Try taking Histamine 2 receptor antagonists (H2RAs)
H2RAs such as cimetidine, ranitidine/Zantac/famotidine/Pepiz nizatidine can block signaling pathways in stomach cells to reduce acid secretion. Take H2RAs pills twice daily for 2 to 6 weeks to treat mild to moderate GERD. Several types of H2RAs can be purchased directly at pharmacies and are known to be safe.
Unusual and rare side effects of H2RAs include: gynecomastia (increased breast size in men), impotence, liver dysfunction, dizziness, restlessness, low blood pressure and heart rate, and anemia
Step 6. Consumption of Proton Pump Inhibitor (P3)
P3 drugs such as omeprazole, lansoprazole, esomeprazole, pantoprazole, dexlansoprazole, and rabeprazole are the strongest medications to prevent acid secretion in the stomach. If you have severe acid reflux with 2 or more episodes of reflux per week, take P3 (some of which are available over-the-counter at pharmacies). In general, you should take 1 pill per day, 30 minutes before the first meal of the day, for 8 weeks. Side effects that can occur include:
- Bacterial infections of the digestive system that can cause diarrhea (such as C. difficile, Campylobacter spp., Salmonella spp.) and pneumonia. Because your stomach acid is reduced, the number of bacteria that can be killed is reduced, so bacterial infections can occur.
- Malabsorption: P3 can reduce your body's absorption of iron, vitamin B12, magnesium, and calcium. Although this one side effect is rare, if it occurs, your body can experience anemia and osteoporosis. This can happen if you take P3 for a very long period of time.
- Drug interactions: P3 consumption can affect the amount of absorption and metabolism of other drugs. A common example is interactions with a drug called clopidogrel which is used to prevent blood clots.
Step 7. Run the operation
Although this is rare, if your GERD symptoms are not relieved by medical therapy, you may need surgery. For people who are young, surgery can also be the only option other than undergoing therapy for a very long time. One type of surgery called fundoplication is aimed at strengthening the circular muscle at the bottom of the esophagus called the lower esophageal sphincter (LES) by wrapping and sewing the stomach around the esophagus.
Another type of surgery that can be done is to close the lower part of the esophagus by wrapping a series of magnetized beads around the stomach, esophagus, and LES. The beads will expand to allow food to enter
- Avoid eating too late at night. Sleep with the head of the mattress raised approximately 15 to 20 cm, and do not lie down immediately after eating.
- Avoid caffeine, alcohol, and tobacco.
- The number of studies on the effect of natural medicines, herbal supplements, or alternative therapies for acid reflux disease is not sufficient. Example: You may have heard the news that fennel mint can help with treatment; However, in reality, fennel leaf oil can actually aggravate acid reflux disease. Milk is also generally known to reduce these symptoms. However, although milk can temporarily neutralize stomach acid, the fatty and lactic acids present in milk can stimulate the production of larger amounts of acid.
- Many medicines that can be purchased over the counter at pharmacies can also be obtained through a doctor's prescription, so you can get insurance coverage to buy them.
- If you are trying to treat acid reflux at home and you notice that your symptoms are not improving, consult your doctor immediately and get a prescription for medication.
- Many drugs for stomach acid disease that can be purchased over the counter at pharmacies. However, you should still consult a doctor to get the right treatment.