QUESTION

I have heartburn. I don’t want to take dangerous acid-suppressing drugs. Is there a safe supplement I can take to feel better?

ANSWER

Heartburn, a common symptom of gastroesophageal reflux disease (GERD), happens when stomach acid rises up and inflames the delicate lining of the esphagus. It's painful, uncomfortable and common. Many people turn to proton pump inhibitor drugs such as esomeprazole (Nexium) or omeprazole (Prilosec), which significantly reduce the stomach's ability to produce digestive acid. But chronic use of such drugs can have dangerous consequences, including malabsorption of vitamin B12, iron and calcium...negative changes to the balance of bacteria in the gut "microbiome"...increased risk of food poisoning...decreased gallbladder function...possible increased risk for cognitive decline...increased cardiovascular risk. The drugs are especially risky when taken by people who also take blood thinners such as warfarin (Coumadin) and clopidogrel (Plavix), increasing the risk of uncontrolled bleeding. Although the evidence against the entire class of proton pump inhibitors is mixed, it is wise to avoid them in favor of safer alternatives. Fortunately, there are several natural remedies that can soothe your heartburn. But first...

GET TO THE ROOT OF YOUR GERD

Before you begin treating your GERD, I recommend that you seek care with a naturopathic or integrative physician. To find out why you have GERD, you'll need a medical evaluation, which should include a food sensitivity test. Hiatal hernias (a condition in which the upper part of the stomach pushes up into the esophagus) as well as certain prescription medications can cause GERD, and if that’s true in your case, you want to know! Before you go to see a naturopathic or integrative physician, keep a diet diary for one week—writing down everything you eat and drink—and show it at your appointment. A diet diary can uncover nutrient deficiencies and inflammatory and anti-inflammatory food intake, which can have an impact on the stomach and how it functions.

MY GO-TO GERD SUPPLEMENTS

One of the best is slippery elm powder, which is mixed with water and then consumed like a thickened broth, a gruel-like "tea." Slippery elm coats and soothes the throat, esophagus and stomach, and it helps to rebuild the mucous lining. Slippery elm also contains antioxidants that can deter further damage. To make it, pour a cup of boiling water over one tablespoon of the powder and steep for three to five minutes. Try a cup in the morning and at night. That's enough for most people with heartburn to feel better. It's safe for everyone. Marshmallow root tea also can soothe inflamed mucous membranes. Like slippery elm, it contains mucilage, which coats the lining of the throat, esophagus and stomach. It is also very safe, and you can use it by itself or alternately with slippery elm "tea." To make it, you can buy tea bags, or if you buy powdered root, pour one cup of warm water (not hot) over one tablespoon of powder. Boiling water may break down some of the mucilage that makes it effective. (Marshmallow root may reduce blood sugar, however, so if you are taking medications for diabetes, check with your doctor.) Licorice in the form of tea or jam, capsules, lozenges or extracts can also help. It's a soothing, coating agent for the stomach. It's fine for short-term use, but long-term use can elevate blood pressure. You can avoid that risk with deglycyrrhizinated licorice (DGL). The sleep hormone melatonin is also used to treat GERD. Melatonin is secreted by both the pineal gland in the brain and specialized cells in the gastrointestinal tract. Studies suggest that while brain-produced melatonin helps with sleep, the melatonin produced by the gastrointestinal tract protects its mucosal lining from damage caused by oxidative stress. Some research suggests that it blocks the release of acid, too. Studies show that five or six milligrams of melatonin are effective. It is usually taken in the evening, since it can make you drowsy.

PUTTING IT ALL TOGETHER

When I treat a patient for GERD, I will be sure to know the reason for it, will remove any food sensitivity, tidy up the patient’s diet so that it is more nourishing and less inflammatory, and encourage eating slowly and not during stressful, rushed moments. I will then give some slippery elm powder to make into "tea" in the morning and evening. Depending on the patient, I will also recommend a GERD supplement that contains other healing, soothing agents for the stomach such as the ones listed above. They are safe to use in any combination. For more tips, see the "Bottom Line Guide: Best Ways to Manage Your GERD."