Acid remedies

Almonds

It has been suggested that 3 or 4 almonds eaten after a meal may help prevent reflux.

N.B. Some may experience an adverse reaction to almonds which can produce migraine attacks in some people.

Aloe Vera

There are many claims made for Aloe Vera. It's main use as a balm is to soothe abrasions. This may explain its popularity for those with acid reflux or oesophagitis.

Cancer Research UK has carried out research into the healing properties of Aloe and the claims made for it. They found there was no evidence to suggest that aloe vera works but many patients say that they have found aloe helpful. Some early research seems to suggest that it may help wounds to heal. Early studies of aloe substances in laboratory animals seem to suggest that some of the chemicals found in aloe may have helpful effects on the immune system and can shrink some cancers. Cancer Research UK provides this page of evidence regarding therapeutic use and warnings for aloe vera.

Some users of Aloe may experience side effects of diarrhoea, nausea and stomach pain.

Aloe vera may interact with other drugs or herbs so always talk to your doctor before you begin taking it.

"Once people begin taking aloe supplements regularly, they tend to develop a tolerance, requiring increased doses to maintain the effect. As the dose increases, safety is of increasing concern: case reports of fatalities and severe kidney dysfunction have been reported with high doses." [U.S.News - Health & Wellness]

A 2014 study, found "clear evidence of carcinogenic activity in rats, and was classified by the International Agency for Research on Cancer as a possible human carcinogen" leading to a 2019 publication, "Aloe vera: A review of toxicity and adverse clinical effects"

Apples, Bananas

Eating an apple or a banana a day are also suggested. Many fruits have been shown to be beneficial to health.

Books on how to cure your acid reflux may be found being sold as downloads on the internet extolling the values of different fruits for curing acid reflux. Most of these appear to exist primarily as a source of income for their authors who usually have no medical qualification.

Apple Cider Vinegar (ACV)

Proponents of apple cider vinegar suggest two to three teaspoonfuls should be stirred into a small glass of water to be consumed before every meal and offer two alternative theories as to why it may work.

1. By providing acid to the stomach before food, the stomach may be fooled into expecting more acid and therefore doesn't need to produce so much.

2. The Lower Oesophageal Sphincter muscles are activated to tighten by acid; drinking ACV before a meal "wakes up" the LOS.

Both of these claims, however, fail to recognise the comparative strengths of stomach acid, which can dissolve metal and would produce scarring if spilled on the skin, and ACV whose only effect on the skin would be to make it feel wet.

A paper "Is Apple Cider Vinegar Effective for Reducing Heartburn?" published in 2015 [a-xxiii] found, "compared to the placebo trial, the vinegar trials do not show significant alleviation of the heartburn sensation and an article published in "Foods 4 Better Heath" in February 2017 [a-xxiv] warned about side effects of drinking too much ACV.

A 2023 article in US News Health, Apple Cider Vinegar: Myths vs. Facts, detailed, "One of the first books was written by the late Paul C. Bragg, a naturopath who began selling raw, unpasteurized ACV at his Hollywood health store in 1912. That’s where he first distributed his book “Apple Cider Vinegar: Miracle Health System.”

"Even though many of the claims are overstated or flat out wrong, some scientific studies have been conducted on ACV, and the results show some promise. Yet it isn’t clear whether these benefits are specific to ACV or are due to acetic acid, which is found in any vinegar."

The article looks at some of the myths of ACV but ends with this warning: Risks of Apple Cider Vinegar
"In addition to unproven benefits, regular vinegar consumption may carry some risks. The high acidity of apple cider vinegar could damage tooth enamel if ingested undiluted in large amounts, says Dr. Edmond R. Hewlett, professor at the UCLA School of Dentistry and consumer advisor to the American Dental Association.
“We recommend diluting 1 to 2 tablespoons in 8 to 12 ounces of water and drinking with the first bites of a meal,” says Johnston. “This allows the food matrix to mix with the vinegar and reduce the contact of the acid with the lining of the esophagus as it is ingested.” In her research, they have also limited the dosage to 4 tablespoons or less daily per participant.  

Baking Soda

This age old remedy is the basis of many antacids which are immediate acting by neutralising the stomach acid. Baking Soda is the chemical Sodium Bicarbonate, NaHCO3. (Some antacids like Tums or Rennie may use other similar compounds such as calcium carbonate or magnesium carbonate but they have a similar effect.)

Chemically, this reaction takes place:

NaHCO3 + HCl → NaCl + H2O + CO2 

(Sodium Bicarbonate + Hydrochloric acid gives Sodium Chloride (table salt) plus water and carbon dioxide)

Warning. Too much sodium in the diet can lead to high blood pressure, heart disease, and stroke 

Chalk

As Baking Soda above, chalk is a good antacid neutralising acid in the oesophagus. Many OTC antacids, like Tums, are just chalk, refined to remove toxins and a little flavouring to make it more palatable, but you could dig up a lump of the rock and gnaw it if you prefer.

Chemically, this reaction takes place:

CaCO3 + 2HCl → CaCl2 + H2O + CO2

(Calcium Carbonate (chalk) + Hydrochloric acid gives Calcium Chloride (a harmless salt) plus water and carbon dioxide)

Warning. Excess calcium is filtered out of the blood by the kidneys where it may accumulate to form kidney stones. Excess calcium can also lead to calcification of the arteries which can cause myocardial infarction, heart attack.

Chewing Gum

By chewing gum, more saliva is produced which can help neutralise excess acid.

Deglycerised Liquorice (DGL)

As with Aloe Vera and Slippery Elm above, liquorice is a demulcent forming a soothing layer over inflammation and possibly increasing production of mucous thus possibly providing symptom relief.

"However, while licorice contains beneficial phytochemicals, it also contains glycyrrhizic acid, which is associated with side effects. To counter this, a modified form of the botanical medicine, known as deglycyrrhizinated licorice, or DGL licorice, is available. Although considered safer, DGL licorice may still pose certain health risks." [Livestrong] 

A report in New England Journal of Medicine in 2020, "A 54-Year-Old Man with Sudden Cardiac Arrest", concluded, "Pseudohyperaldosteronism suggestive of excessive licorice consumption."

This August 2023 article in Medical News Today, Does deglycyrrhizinated licorice (DGL) help with acid reflux? reviewed the current evidence:

One 2017 study involved 58 people, some of whom had GERD. It investigated whether a formula containing DGL could improve symptoms of the condition. According to self-reports over 2 years, the researchers suggested DGL could positively affect GERD.

However, the sample size was small, and further studies are yet to replicate these results. Additionally, the study did not compare DGL with a placebo or investigate the effects of licorice in isolation. For this reason, scientists cannot attribute these improvements to DGL.

Additionally, the NIH notes that studies into the health effects of DGL have yet to provide high quality evidence.

Ginger

Some people swear by ginger root tea as a preparation for the stomach before food. It is made by steeping cut pieces of ginger root in simmering water for half an hour and proponents say to drink a cupful half an hour before you eat claiming it acts as some sort of buffer to acid production.

Green Tea

"Green tea is a drink made from the dried leaves of the Asian plant Camellia sinensis. This tea is drunk widely across Asia. The rates of many cancers are much lower in Asia than other parts of the world. Some people believe this is because of the high intake of green tea. The substance in green tea that researchers think is most helpful is called epigallocatechin-3-gallate (EGCG). EGCG is available as green tea extract which some people take as a supplement in liquid or capsules." [Cancer Research UK]

"Fifty-one studies with more than 1.6 million participants, mainly of observational nature were included in this systematic review. Studies looked for an association between green tea consumption and cancer of the digestive tract, ... The evidence that the consumption of green tea might reduce the risk of cancer was conflicting. This means, that drinking green tea remains unproven in cancer prevention, but appears to be safe at moderate, regular and habitual use." [Cochrane review]

From the 2012 review "Green tea and prevention of esophageal and lung cancers": "Although results from animal models support a protective effect of green tea extract and green tea polyphenols against tumorigenesis, the epidemiological studies have produced inconclusive results for green tea consumption in relation to risk of esophageal and lung cancers overall." and "previous clinical trials demonstrated a protective effect of vitamin–mineral supplementation on esophageal and gastric cancer in a Chinese population with marginally deficient antioxidant nutrients, but vitamin supplementation did not provide any cancer protection or even increased risk of certain cancer in Western populations "

Note that oesophageal cancers in China are mostly Squamous Cell Carcinomas (OSCC) mainly related to smoking, and oesophageal cancers in Western populations are mostly adenocarcinomas (OAC) mainly related to acid reflux. 

Japanese Apricot

Japanese Apricot has recently been found to be a possible aid to motility. In 2010, GORD-related symptoms were examined in 1303 Japanese individuals using a validated questionnaire. Those who consumed Japanese Apricot daily (either dried or pickled) showed significantly improved scores compared with subjects who did not. [r-xlviii]

Kombucha

Kombucha tea is brewed using kombucha which is a type of yeast, black tea and sugar. The resulting alcoholic vinegary drink has many health claims attributed to it. However none have been substantiated and no explanation has been provided why it should benefit acid reflux sufferers.

There have, however, been reports of adverse effects, such as stomach upset, infections and allergic reactions in kombucha tea drinkers.

The Mayo Clinic in America says "there isn't good evidence that kombucha tea delivers on its health claims. At the same time, several cases of harm have been reported. Therefore, the prudent approach is to avoid kombucha tea until more definitive information is available."

Lemon Water

One recipe suggests: "To neutralize stomach acids, add more alkalinity to your stomach. Mix a squeeze of lemon (about 1-2 tsp) in a cup of warm water. This will raise your alkaline level." [Philippine Daily Enquirer magazine]

However there is no evidence to suggest or support the theory and no explanation is presented as to why acid lemon juice should increase alkalinity.

Manuka honey

There are a number of medicinal properties for honey, the main ones being its anti-bacterial and anti-inflammatory properties. Sterilised medical grade honey may be used as a wound dressing.

Honey is sometimes used in cough medication or for sore throats. Along with the properties noted above, it's texture and mucous inducing properties have a soothing influence.

This 2023 paper, "Application of Manuka honey in treatment patients with GERD," declared. "According to our research results, the application of Manuka honey may improve treatment of gastro-esophageal reflux disease." The paper also  stated, "To the best of authors knowledge, there is no other study concerning the use of Manuka honey in GERD." but quoted some other studies particularly, "Efficacy and safety of honey based formulation of Nigella sativa seed oil in functional dyspepsia: A double blind randomized controlled clinical trial" published in 2015. It found "supplementation of honey based formulation of N. sativa can cause significant symptomatic improvement of patients with functional dyspepsia."

Both papers concluded with caveats: "This requires confirmation by further studies." and "The results should be investigated further in studies."

Marijuana

There have been many studies into the medicinal properties of cannabinoids (eg marijuana) with many on-going around the world presently. Beneficial properties are being found particularly in areas of pain relief. Like Peppermint, the benefits of the drug are as a muscle relaxant.

There are many claims made for benefits of the drug on gastric problems. MedicalMarijuana.com claims, "Research suggests that cannabis is effective in treating the symptoms of these GI disorders in part because it interacts with the endogenous cannabinoid receptors in the digestive tract, which can result in calming spasms, assuaging pain, and improving motility.  Cannabis has also been shown to have anti-inflammatory properties and recent research shows crucial neuromodulatory roles in controlling the operation of the gastrointestinal system, with synthetic and natural cannabinoids acting powerfully to control gastrointestinal motility and inflammation." but, although a list of references is published on the site, it hasn't been possible to find the paper this quotes.

The concern is, like Peppermint above, the "calming" and "improving motility" may also exacerbate reflux.

Cancer Research UK issue this advice: "Although centuries of human experimentation tells us that naturally-occurring cannabinoids are broadly safe, they are not without risks. They can increase the heart rate, which may cause problems for patients with pre-existing or undiagnosed heart conditions. They can also interact with other drugs in the body, including antidepressants and antihistamines. And they may also affect how the body processes certain chemotherapy drugs, which could cause serious side effects."

Mustard

Some claim that a teaspoon of made mustard eaten straight can help neutralise acid reflux if taken immediately it is noticed. Proponents assert it to be alkaline and thus neutralises stomach acid.

Peppermint

Peppermint is often used as an aid for digestion problems.  "Peppermint water can relieve trapped wind and so relieve pain. Put a few drops of peppermint oil in hot water and sip it slowly." [Cancer Research UK]

Clinical trials have proved it beneficial for lower gastric tract problems such as irritable bowel.

However, it works by relaxing the pyloric sphincter muscles which helps the egress of bile to assist digestion and relieving pressure building up at the stomach exit. By relaxing the Lower Oesophageal also, it helps release trapped gas from the stomach but also exacerbates gastro-oesophageal reflux so those with acid reflux should avoid it.

Slippery Elm

The active ingredient of Slippery elm is a polysaccharide called mucilage that makes a slippery gel when wet. 

As with Aloe Vera, Slippery Elm is a soothing balm and may help digestive motility by stimulating the secretion of mucous in the digestive tract. 

It is not recommended in people who have kidney or liver problems the plants contain chemicals called oxalates which can damage the liver and kidneys.

Turmeric

The active component of Turmeric is curcumin. Currently there is no research evidence to show that turmeric or curcumin can prevent or treat cancer but early trials have shown some promising results.

A number of studies have shown curcumin can kill some cancer cells and prevent more from growing.

In an American study reported in 2008, "25 patients had curcumin treatment and 21 had tumours that could be measured. In 2 patients their tumours shrank or remained stable. In some patients their levels of particular immune system chemicals that destroy cancer cells went up. But the researchers found that blood levels of curcumin were very low because it is not well absorbed from the gut. Scientists have since developed injectable, fat soluble forms of curcumin which may improve the results." [r-xlvii]

A Thai study published in September 2023, "Curcumin and proton pump inhibitors for functional dyspepsia" compared the reflux pain relief effect of curcumin with omeprazole over a month concluding "Curcumin and omeprazole had comparable efficacy for functional dyspepsia with no obvious synergistic effect." Though it was s small scale study.

Dietary Supplements

An increasing number of people are turning to dietary or herbal supplements instead of proper medicine for various reasons. Typically they do not trust "Big Pharma" who make vast sums of money from over-priced drugs.

However, these are not regulated like drugs and have not been subjected to the same trialing and testing to ensure safety.

This 2023 article from the American Council on Science and Health, Death By Dietary Supplement, warns, "Many herbal products are complex, highly variable, and impure. Not unlike the nineteenth-century snake-oil preparations that were dangerous but had little (if any) efficacy, many are toxic, carcinogenic, or otherwise unsafe. Known side effects include blood-clotting abnormalities, hypertension, deadly allergic reactions, irregular heart rhythms, kidney and liver failure, exacerbation of autoimmune diseases, and interference with conventional prescription drugs."

See also the chapter on Vitamin Supplements.

Others

Uncategorised: 

Poliprotect

Described as "a natural mucosal protective agent for gastroesophageal reflux disease and dyspepsia", the contents of the sachets sold contain "a synergistic molecular complex with polysaccharides (obtained from Aloe vera, Malva sylvestris and Althea officinalis), and the minerals Limestone and Nahcolite", begging the question, 'What does "natural" actually mean?'

This 2022 study, "Effectiveness and tolerability of Poliprotect, a natural mucosal protective agent for gastroesophageal reflux disease and dyspepsia: Surveys from patients, physicians, and pharmacists", funded by the manufacturer and using patient self completion surveys, concluded "Poliprotect can be considered safe and effective in the treatment of a variety of upper GI symptoms and in a large array of subjects."

This July 2023 study published in The American Journal of gastroenterology, "Poliprotect vs Omeprazole in the Relief of Heartburn, Epigastric Pain, and Burning in Patients Without Erosive Esophagitis and Gastroduodenal Lesions: A Randomized, Controlled Trial" also funded by the manufacturer and using patient self completion surveys, was found to be "noninferior to omeprazole (20 mg daily) in relieving moderately severe symptoms of heartburn" and suggested, "Poliprotect, an MPA [Mucosal Protective Agent] made of natural substances, could be a valuable alternative to PPI in the treatment of heartburn."

Page updated 21 May 2024