Take care of GERD

A study shows that water may be more effective than acid-inhibiting drugs in its effect on gastric pH.

Study participants were given either a glass of water, antacid, ranitidine, omeprazole, esomeprazole, or rabeprazole. Their gastric pH was recorded for 6 hours after each drug intake. Water increased gastric pH by more than 4 after just one minute. In contrast, antacid took 2 minutes, and most of the other drugs took more than two hours.

According to the study in Digestive Diseases and Sciences:

“Water and antacid immediately increased gastric pH, while PPIs showed a delayed but prolonged effect compared to ranitidine.”

Sources:

Green Med Info

Digestive Diseases and Sciences December 2008; 53(12): 3128-3132

Dr. Mercola's Comments:

Acid reflux is an extremely common health problem, affecting as many as 50 percent of the US population. Other terms used for this condition are gastroesophageal reflux disease (GERD), or peptic ulcer disease. Symptoms of acid reflux, or GERD, include:

Heartburn	Hoarseness	A feeling that food is stuck in your throat	Tightness in your throat
Wheezing	Asthma	Dental problems	Bad breath

Typically, acid reflux is believed to be caused by excessive stomach acid production. However, this "conventional wisdom" has been shown to be incorrect.

What's the REAL Cause of Acid Reflux?

It's important to understand that acid reflux is NOT due to having too much acid in your stomach, but rather it's a condition related more commonly to hiatal hernia – a condition in which the acid comes out of your stomach, which is where it's designed to be confined to.

After food passes through your esophagus into your stomach, a muscular valve called the lower esophageal sphincter (LES) closes, preventing food or acid from moving back up. Gastroesophageal reflux occurs when the LES relaxes inappropriately, allowing acid from your stomach to flow (reflux) backward into your esophagus.

In the early 80s, Dr. Barry Marshall, an Australian physician, discovered that an organism called helicobacter pylori (initially called campylobacter) causes a chronic low-level inflammation of your stomach lining, which is largely responsible for producing many of the symptoms of acid reflux.

One of the explanations for why suppressing stomach acid is so ineffective—and there are over 16,000 articles in the medical literature attesting to this—is because when you decrease the amount of acid in your stomach, you suppress your body's ability to kill the helicobacter bacteria!

So suppressing stomach acid production tends to just worsen and perpetuate the condition. I'll elaborate on the hazards of these drugs in a moment, but first, let's review a few gems from the medical literature.

Some Natural Remedies Work Better than Drugs—Including Water!

The first study, featured above, found that even something as simple as drinking water can help suppress acute symptoms of acid reflux by temporarily raising stomach pH.

A dozen subjects were given either:

1. A glass of water
2. Antacid
3. Ranitidine
4. Omeprazole
5. Esomeprazole, or
6. Rabeprazole

Their gastric pH was recorded for 6 hours after each drug intake. In 10 of the 12 subjects, water increased gastric pH by more than 4 after just one minute. In contrast, antacid took two minutes, and the remaining four drugs took between 50 minutes and almost three hours to reduce pH by the same amount.

The gastric pH remained raised for three minutes after drinking water, and 12 minutes with antacids. The other drugs maintained the raised pH for at least six hours—but again suppressing your stomach acid in this way may eventually worsen your condition, particularly if heliobacter pylori bacteria are involved.

Now granted, drinking a large glass of water may not be sufficient for many with acid reflux (although I'd say it won't hurt to give it a try!), but this study just goes to show that very simple strategies can oftentimes accomplish what you're aiming for, without resorting to potentially dangerous drugs. In this case, one strategy in particular should be at the very top of your list if you suffer with heartburn…

Your First Line of Treatment – Increasing Healthy Bacterial Flora

Ultimately, the answer to heartburn and acid indigestion is to restore your natural gastric balance and function. Not only is it useful for optimal gut function but it is crucial for your long-term health, as your gut flora can increase your absorption of nutrients by 50 percent and create useful B vitamins and vitamin K2. It is very clear from reviewing the literature that you can't be healthy until your gut flora is optimized. That is one of the ways sugars harm you—they push your gut flora balance in the wrong direction.

So one of the first things you'll want to do is to make sure you're consuming enough good bacteria . This will help balance your bowel flora, which can help eliminate helicobacter bacteria naturally. It will also aid in proper digestion and assimilation of your food.

Ideally, you'll want to get your beneficial bacteria from traditionally fermented foods, such as:

• Natto
• Fermented vegetables, like Kimchee
• Kefir, a fermented milk drink made from RAW milk
• Yoghurt made from raw milk

However, you can be virtually guaranteed that if you are purchasing products like yogurt and kefir from a conventional grocery store, they're worse than worthless. Not only do most of them have no live cultures but they are loaded with sugar to make them taste better. So make sure to check the labels of any commercial products you buy, and avoid those with ANY added sugars. Also avoid pasteurized products.

Some health food stores might have the authentically fermented healthy foods but most likely you will have to make them yourself or purchase them from healthy organizations like Weston Price Chapters that hook communities up to sources of these types of traditional foods.

If you are unable to find access to these traditionally fermented foods then it makes perfect sense to use a high quality probiotic. There is little doubt in my mind that if you can only do one or two supplements, probiotics are the one that should make the cut.

Other Novel Alternatives Indicated by Medical Research

Before I move on to discuss potential drug complications and my top six recommendations to safely eliminate heartburn and acid reflux, I want to highlight four additional alternatives, based on a quick review of the medical literature.

• Sauerkraut or Cabbage juice is one of the strongest stimulants for your body to produce acid. This is a good thing as many people have low stomach acid which is the cause of their gut problems. Having a few teaspoons of cabbage juice before eating, or better yet, fermented cabbage juice from sauerkraut, will do wonders to improve your digestion
• Astaxanthin—This exceptionally potent antioxidant was found to reduce symptoms of acid reflux in patients when compared to a placebo, particularly in those with pronounced helicobacter pylori infection. Best results were obtained at a daily dose of 40 mg.
• A dietary supplement containing melatonin, l-tryptophan, vitamin B6, folic acid, vitamin B12, methionine and betaine, was found to be superior to the drug omeprazole in the treatment of GERD.
  
  Part of the success is thought to be due to melatonin’s inhibitory activity on nitric oxide biosynthesis, which plays an important role in transient lower esophageal sphincter (LES) relaxation, which, as I mentioned earlier, is part of the real underlying problem of GERD.
  
  Impressively, 100 percent of patients receiving this supplement reported a complete regression of symptoms after 40 days of treatment, compared to just under 66 percent of those taking omeprazole. The authors concluded that “this formulation promotes regression of GERD symptoms with no significant side effects.”
• Ginger has been found to have a gastroprotective effect by blocking acid and suppressing heliobacter pylori. According to a 2007 study, it’s also far superior to lansoprazole for preventing the formation of ulcers, exhibiting six- to eight-fold greater potency over the drug! This is perhaps not all that surprising, considering the fact that ginger root has been traditionally used against gastric disturbances since ancient times.

Drugs are NOT Advisable for Majority of Heartburn and Acid Reflux Cases

Now on to the drugs… One of the most commonly prescribed drugs for heartburn and acid reflux are proton pump inhibitors (PPIs) or drugs that VERY effectively block your stomach's ability to produce acid. While that may sound like a good thing, in most cases it's the worst possible approach, because as I mentioned earlier, the problem typically stems from having too little stomach acid.

Proton pump inhibitors like Nexium, Prilosec and Prevacid are severely overprescribed and misused. As a result they end up hurting far more people than they're helping, because these drugs are actually designed to treat a very limited range of severe problems. According to Mitchell Katz, director of the San Francisco Department of Public Health who wrote an editorial on this topic, proton pump inhibitors (PPIs) are only warranted for the treatment of:

• Bleeding ulcers
• Infection with the ulcer-causing bacteria Helicobacter pylori
• Zollinger-Ellison syndrome (a rare condition that causes your stomach to produce excess acid)
• Severe acid reflux, where an endoscopy has confirmed that your esophagus is damaged

PPIs were never intended for people with heartburn, and according to Katz, "about 60 to 70 percent of people taking these drugs have mild heartburn and shouldn't be on them." However, I believe the number may be even higher than that, because there are over 16,000 articles supporting the fact that suppressing stomach acid does NOT treat helicobacter pylori infection (which Katz included above). If you're taking a PPI drug to treat your heartburn you're doing two things, but neither of them is actually beneficial to your health:

1. You’re treating a symptom only; you’re not addressing the underlying cause, and
2. By doing so, you’re exposing yourself to additional, and potentially more dangerous health problems, courtesy of the drug itself

Carefully Weigh the Risks and Benefits of these Drugs Before Taking Them!

PPIs suppress the production of stomach acid, and in the severe cases listed above, they may be warranted short-term. However, since upwards of 95 percent of heartburn cases are not caused by too much but rather too little stomach acid, these drugs may worsen your condition.

PPI drugs are also fraught with serious side effects, including:

• Pneumonia
• Bone loss
• Hip fractures
• Infection with Clostridium difficile, a harmful intestinal bacteria

You'll also develop both tolerance and dependence on them, so you can't stop taking them without suffering repercussions. In fact, you should NEVER stop taking proton pump inhibitors cold turkey. You have to wean yourself off them gradually or else you might experience a severe rebound of your symptoms. Ideally, you'll want to get a lower dose than you're on now, and then gradually decrease your dose.

Once you get down to the lowest dose of the PPI, you can start substituting with an over-the-counter H2 blocker like Tagamet, Cimetidine, Zantac, or Raniditine. Then gradually wean off the H2 blocker over the next several weeks. While you wean yourself off these drugs (if you're already on one), start implementing a lifestyle modification program that can eliminate this condition once and for all.

Safe and Effective Strategies to Eliminate Heartburn and Acid Reflux

The following strategies can help you get your heartburn under control:

Eliminate food triggers -- Food allergies can be a problem, so you'll want to completely eliminate items such as caffeine, alcohol, and all nicotine products.

Increase your body's natural production of stomach acid -- One of the simplest strategies to encourage your body to make sufficient amounts of hydrochloric acid (stomach acid) is to consume enough of the raw material.

One of the most basic food items that many people neglect is a high quality sea salt (unprocessed salt), such as Himalayan salt. Not only will it provide you with the chloride your body needs to make hydrochloric acid, it also contains over 80 trace minerals your body needs to perform optimally, biochemically.

Sauerkraut or cabbage juice are some of the strongest stimulants for your body to produce acid. This is a good thing as many people have low stomach acid which is the cause of their gut problems. Having a few teaspoons of cabbage juice before eating, or better yet, fermented cabbage juice from sauerkraut, will do wonders to improve your digestion as it can be made with high levels of Himalayan salt and the bacteria in the sauerkraut will help to heal your gut.

Take a hydrochloric acid supplement – Another option is to take a betaine hydrochloric supplement, which is available in health food stores without prescription. You'll want to take as many as you need to get the slightest burning sensation and then decrease by one capsule. This will help your body to better digest your food, and will also help kill the helicobacter and normalize your symptoms.

Modify your diet – Eating large amounts of processed foods and sugar/fructose is a surefire way to exacerbate acid reflux as it will upset the bacterial balance in your stomach and intestine. Instead, you'll want to eat a lot of vegetables, and high quality biodynamic organic and preferably locally grown foods.

Optimize your vitamin D levels -- As I've mentioned many times in the past, vitamin D is essential, and it's essential for this condition as well because there's likely an infectious component causing the problem. Once your vitamin D levels are optimized, you're also going to optimize your production of 200 antimicrobial peptides that will help your body eradicate any infections that shouldn't be there.

You'll want to make sure your vitamin D level is about 60 ng/ml. As I've discussed in many previous articles, you can increase your vitamin D levels through appropriate amounts of sun exposure, or through the use of a safe tanning bed. If neither of those are available, you can take an oral vitamin D3 supplement.

Implement an exercise routine – Exercise is yet another way to improve your body's immune system, which is imperative to fight off all kinds of infections.