Acid reflux: The painful condition wherein stomach acid and food flow from the stomach back up into the esophagus, which can cause sore throats, hoarseness, and heartburn, and, if it occurs chronically, gastroesphageal reflux disorder (GERD) (1). And while it’s generally considered to come from an excess of acid, it can also be a result of too little acid—and that’s not as counterintuitive as it may seem: Acid reflux isn’t actually the term for the acidity of the stomach, it’s just what happens when the esophageal sphincter (the muscle that controls the passage between the esophagus and stomach) doesn’t close completely, allowing acid to move back up into the esophagus, causing the pain and sore throat associated with the condition. Too much acid can contribute to acid reflux in the first place. Alternatively, too little acid may prevent timely digestion, causing a buildup of food in the stomach, preventing the esophageal sphincter from closing, and allowing the backflow of stomach fluids that are too acidic for the esophagus.
How do your customers know if they’re suffering from hyperchlorhydria (too much acid) or hypochlorhydria (a deficiency of acid)? They’ll have to ask a doctor. The doctor will take a history of their health and symptoms, and may test the pH of their stomach (2). Stomach secretions generally have a pH of 1-2; a pH of 3-5 indicates hypochlorhydria, while a pH higher than 5 indicates achlorhydria—the absence of acid at all.
For relief, diet is often the best place to start. An article from Johns Hopkins Medicine describes the GERD Diet, intended for people who suffer from chronic acid reflux (3). There are certain foods that cause the esophageal sphincter to relax and delay the digestive process, making food sit in the stomach longer and causing acid reflux. Foods that are high in fat, salt, or spice are top troublemakers, including:
- Fried food
- Fast food
- Potato chips and other processed snacks
- Chili powder and pepper (white, black, cayenne)
- Fatty meats such as bacon and sausage
Other problematic foods include tomato-based sauces, citrus fruits, chocolate, peppermint, and carbonated beverages (3).
“Moderation is key since many people may not be able to or want to completely eliminate these foods,” notes Ekta Gupta, MBBS, M.D., Gastroenterologist with JHM (3). Dr. Gupta advises sufferers to avoid eating problem foods closer to bedtime “so they’re not sitting in your stomach and then coming up your esophagus when you lay down at night.” Also: Eat small frequent meals instead of larger, heavier meals and avoid late-night
dinners and bedtime snacks.
There’s also a list of foods that can help prevent acid reflux, including high-fiber foods, which help people feel full and prevent overeating; alkaline (non-acidic) foods; and watery foods, which can dilute and weaken stomach acid (3). It’s worth it, here, to recommend that your customers discuss this with a healthcare provider—if the problem is too little stomach acid, diet may warrant more discussion. For instance, low stomach acid can be remedied by having the stomach produce more acid, which calls for zinc (2). Zinc is found in pumpkin seeds, oysters and crabs, beef and pork, baked beans, and cashews.
Dr. Gupta also recommends milk—with a caveat: “Milk is often thought to relieve heartburn. But you have to keep in mind that milk comes in different varieties—whole milk with the full amount of fat, 2% fat, and skim or nonfat milk. The fat in milk can aggravate acid reflux. But nonfat milk can act as a temporary buffer between the stomach lining and acidic stomach contents and provide immediate relief of heartburn symptoms.”
The experts with Harvard Health also noted some tips (1). Chief among them: Eat little, and slowly. When the stomach is full, that can push acid into the esophagus, regardless of whether the issue is too much or too little acid. Small meals throughout the day may help. The article also recommends an exclusion diet—removing foods from the list above plus onions, garlic, coffee, tea, chocolate, and alcohol; waiting to see if that solves the problem; and then adding the foods back in one at a time to figure out which one triggers the acid reflux. Tip: A lot of these foods are excluded in a low-FODMAP diet, so spices, dressings, and sauces from low-FODMAP brands like Casa de Santé can help your customers if they choose to go the dietary route.
Looking to supplements, there is promising research. Researchers reporting in the Journal of Pineal Research gave 175 participants 20mg omeprazole (a GERD medication sold under brand names including PriLOSEC) and 176 participants a supplement cocktail containing melatonin, L-tryptophan, vitamins B6 and B12, folic acid, methionine, and betaine (4). The researchers explained that melatonin has “known inhibitory activities on gastric acid secretion and nitric oxide biosynthesis,” which is important, because nitric oxide plays a major role in the relaxation of the esophageal sphincter. The other compounds in the formula have anti-inflammatory and analgesic effects. The results: 65.7% of the omeprazole group reported regression of symptoms after 40 days of treatment, while 100% of the supplement group reported complete regression of symptoms after the same time period. The authors conclude: “This formulation promotes regression of GERD symptoms with no significant side effects.”
As always, it’s important to recommend that your customers see a doctor about this condition. It may be caused by diet and stress—or it can be caused by a bacterial infection, or by medication. If a healthcare provider determines that diet and supplements are the best course of action, your customers will know where to go. WF
- “9 ways to relieve acid reflux without medication,” Harvard Health Publishing. Posted 11/16/2021. Accessed 12/01/2021. https://www.health.harvard.edu/digestive-health/9-ways-to-relieve-acid-reflux-without-medication
- Jayne Leonard, “What is Hypochlorhydria?” Medical News Today. Published 07/17/2018. Accessed 12/01/2021. https://www.medicalnewstoday.com/articles/322491#_noHeaderPrefixedContent
- “GERD Diet: Foods That Help with Acid Reflux (Heartburn),” Johns Hopkins Medicine. Accessed 12/01/2021. https://www.hopkinsmedicine.org/health/wellness-and-prevention/gerd-diet-foods-that-help-with-acid-reflux-heartburn
- Ricardo de Souza Pereira, “Regression of gastroesophageal reflux disease symptoms using dietary supplementation with melatonin, vitamins and amino acids: comparison with omeprazole,” Journal of Pineal Research. 41(3). 195-200(2006). https://pubmed.ncbi.nlm.nih.gov/16948779/