M illions of Americans take drugs to relieve excess stomach acid. In fact, acid-suppressing drugs are among the most frequently prescribed medications in the US. Although these drugs can relieve symptoms, such as heartburn and abdominal pain, they can have serious long-term side effects. The good news is that there are natural remedies that work even better than drugs, without the side effects.
The drugs
Acid-suppressing drugs fall into two categories...
Proton-pump inhibitors (PPIs), such as Prilosec, Prevacid, Nexium, Aciphex and Protonix, inhibit the enzymes that transport acid from acid-secreting cells into the stomach cavity.
Histamine-2 (H2) blockers, such as Zantac, Pepcid, Axid and Tagamet, inhibit the activity of histamine in the stomach. Histamine stimulates stomach cells to secrete more acid.
The dangers
Regular use of acid-suppressing drugs is associated with increased risk of hip fractures, probably because these drugs hinder calcium absorption.
Taking acid suppressors also increases your risk of acquiring a foodborne intestinal infection or experiencing the overgrowth of bacteria in the stomach and small intestine. Bacteria overgrowth in the stomach probably explains some other risks associated with regular use of acid suppressors, including pneumonia, stomach cancer and vitamin B12 deficiency.
Acid-suppressing therapy is primarily used to treat two kinds of problems -- gastroesophageal reflux disease (GERD) and gastritis (inflammation of the stomach lining). Here are the natural remedies...
Gerd
In GERD, the contents of the stomach flow backward up the esophagus and may reach all the way to the mouth. Symptoms include heartburn, chest pain, regurgitation of food, sore throat, hoarse voice and cough.
Although acid suppressors are commonly prescribed, GERD isn’t caused by excess production of acid. It is caused by failure of the muscle (called the lower esophageal sphincter, or LES) that acts like a valve and separates the esophagus from the stomach. This muscle valve usually is closed and opens only for swallowing so that it keeps the stomach contents out of the esophagus. Because acid is among the most irritating components of stomach juice, reducing acid may reduce irritation. But acid suppression doesn’t prevent reflux -- it merely converts acid reflux into nonacid reflux. To prevent reflux itself...
Don’t stuff yourself. Eating a lot at one time causes stomach distension, which triggers relaxation of the LES.
Avoid high-fat foods, including fried foods and creamy sauces. These weaken the LES.
Don’t smoke. It weakens the LES.
Don’t eat for three hours before lying down. When you’re upright, gravity helps to keep food down.
Maintain a normal weight.
Being overweight increases your risk of GERD. Excess pounds put
pressure on the abdomen, pushing up the stomach and causing acid to
back up.
Don’t eat immediately before strenuous exercise. Strenuous activity increases the likelihood of GERD.
Avoid foods that cause discomfort until you’re better. So-called “acidic” foods, such as oranges and tomatoes, may irritate an already inflamed esophagus.
Try supplements.
The simple steps above prevent symptoms of GERD in the majority of
people and may allow you to avoid the use of acid-suppressing drugs. If not, try the following...
Calcium. Calcium tightens the LES. This is not an antacid effect. In fact, the best type of calcium -- because it is the most soluble -- is calcium citrate, which is itself mildly acidic. The most effective preparation is calcium citrate powder. Take 250 milligrams (mg), dissolved in water, after every meal and at bedtime (for a total daily dose of 1,000 mg). Nutricology (800-545-9960, www.nutricology.com) makes calcium citrate capsules that can be opened and mixed in water. Swallowing calcium pills does not prevent reflux, because the calcium is not instantly dissolved.
Digestive enzymes. These appear to work by decreasing distension of the stomach. The enzymes should be acid-resistant so that they work in the stomach itself, not in the small intestine. A powdered enzyme preparation (one-half teaspoon) can be mixed together with the calcium powder above and taken after each meal. Digestive enzymes are available in health-food stores and pharmacies. I use AbsorbAid powder from Nature’s Sources (to find retailers in your area, call 800-827-7656 or go to www.naturessources.com).
Gastritis
The leading cause of gastritis (inflamed stomach lining) in the US is the regular use of aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve). Other causes include other medications, especially antibiotics... cigarette smoking... and regular use of alcohol.
For some people, infection of the stomach is the underlying cause of gastritis. Anyone with gastritis should be tested for Helicobacter pylori, the most common cause of bacterial gastritis. If H. pylori is found, treatment with antibiotics is necessary.
Whatever the cause of the gastritis, when the stomach is inflamed, it becomes sensitive to its own acid. The usual symptom is burning pain in the middle part of the upper abdomen, above the belly button. This pain is often affected by food (food can ease the pain or make it worse) and may be associated with nausea and changes in appetite. Antacids, such as Maalox and Mylanta, and acid-suppressing drugs may relieve symptoms by buffering or decreasing acidity, but they do not address the underlying cause of gastritis. To prevent gastritis...
Eat anti-inflammatory foods. The diet I developed, called the Fat Resistance Diet (“Dr. Leo Galland’s Lose Weight Forever Diet,” Bottom Line/Personal, January 1, 2006) is helpful in preventing or relieving gastritis. The diet is rich in anti-inflammatory fruits, vegetables and spices.
Try supplements.
Scientific studies have shown benefits from the following. If your
symptoms are severe, you might want to try them all. If not, use one at
a time in the order listed until you get relief. If you want to use
only one, choose the deglycyrrhizinated licorice (DGL).
Carrot juice and/or cabbage juice, one cup per day. The addition of aloe vera liquid, up to four ounces a day, also can help, although aloe has a laxative effect. If you can’t find cabbage juice, sauerkraut juice is a suitable substitute.
DGL. This herbal extract -- 600 mg taken twice a day with meals -- helps the stomach lining to heal and can be combined with other soothing herbs, such as slippery elm (200 mg twice a day) and marshmallow root (400 mg twice a day).
L-glutamine powder. L-glutamine is an amino acid. One teaspoon of L-glutamine powder in four ounces of water taken with each meal can help heal gastritis and even stomach ulcers.
Mastic gum. The sap of the Mediterranean plant Pistacia lentiscus, mastic gum has been used to treat stomach problems for centuries and now is available in capsule form. Take 500 mg of mastic gum twice a day after meals (for a total of 1,000 mg a day).
Go slowly
People who have been taking acid-suppressing drugs daily for several weeks or more may have difficulty discontinuing them. When the stomach is deprived of acid, it compensates by producing more acid-secreting cells. The result is that even though the initial symptoms are not due to hyperacidity, attempting to stop the drug creates hyperacidity. The solution is to taper off the drug slowly, under a doctor’s supervision, while taking steps to remedy the underlying cause, as described above.
Leo Galland, MD, is director of the Foundation for Integrated Medicine in New York City. He has held faculty positions at Rockefeller University, Albert Einstein College of Medicine and Stony Brook University. He is author of The Fat Resistance Diet (Broadway). www.fatresistancediet.com
He is internationally known for his clinical expertise in the restoration of normal gastrointestinal function using natural therapies. www.mdheal.org
