Get Rid of Acidity

Stomach acid helps digest food, activate enzymes, and destroy germs that make it to your stomach.[1] However, stomach acid can also cause “heartburn,” that burning or uncomfortable feeling in your chest.[2] Chronic heartburn, also known as Gastroesophageal Reflux Disease (GERD) or “acid reflux disease,” isn’t due to “too much” acid, but acid in the wrong place (your esophagus instead of your stomach).[3][4] Excessive production of stomach acid can cause erosions in the stomach and the duodenum (part of your small intestine), called ulcers or "Peptic Ulcer Disease."[5][6] This article will help you handle your stomach acid problems, whether they’re due to stomach acid being where it shouldn’t be or the overproduction of stomach acid. If you continue to experience problems, see your doctor.

Steps

Seeking Medical Attention

  1. Recognize the symptoms of acid reflux. “Acid reflux” is what causes the burning pain or discomfort in your chest or throat called “heartburn” (which doesn’t have anything to do with your heart). If you have other symptoms, you may have a more serious condition, like gastroesophageal reflux disease (GERD), also known as acid reflux disease.Here are some symptoms to look for:[7]
    • Pain that worsens when you lie down or bend over[8]
    • Regurgitation of food into your mouth (be careful of aspirating or inhaling gastric contents)
    • Acid taste in the mouth
    • Hoarseness or a sore throat
    • Laryngitis
    • Chronic dry cough, especially at night
    • Asthma
    • Feeling like there’s a “lump” in your throat
    • Increase in saliva
    • Bad breath
    • Earaches
  2. Understand the risk factors for GERD. Acid reflux occurs when the valve at the entrance to your stomach, called the lower esophageal sphincter (LES) doesn’t close properly, allowing stomach acid back up into your esophagus. This causes the burning known as “heartburn.” If this happens more than twice a week, you have acid reflux disease, also known as GERD. Below are some common risk factors for acid reflux disease:[4]
    • Eating large meals
    • Lying down right after a meal
    • Being overweight or obese
    • Bending over after eating
    • Bedtime snacking
    • Eating trigger foods, like citrus or chocolate
    • Drinking certain beverages, like alcohol or coffee
    • Smoking
    • Pregnancy
    • Taking NSAIDs (aspirin, ibuprofen, etc.)
    • Hiatal hernia. A hiatal hernia occurs when the stomach bulges up into the chest area through an opening in your diaphragm. It will need to be surgically treated.[9]
  3. Recognize the symptoms of ulcers. Most ulcers are caused by a bacterial infection called Helicobacter pylori.[3] The most common sign of an ulcer is a dull or burning pain in your belly. The pain may come and go, but may appear strongest at night or between meals.[10] Other symptoms of ulcers include:[11]
    • Bloating
    • Burping or feeling like you need to burp
    • Lack of appetite
    • Nausea or vomiting
    • Weight loss
  4. Know when to seek immediate medical attention. In addition to the above symptoms, ulcers can cause internal bleeding in the stomach and intestines, which can be extremely dangerous. If you see any of the following symptoms, get medical treatment immediately:[7]
    • Dark red, bloody, or black stool
    • Difficulty breathing
    • Dizziness or fainting
    • Feeling tired for no reason
    • Paleness
    • Vomit that looks like coffee grounds or contains blood
    • Sharp, severe stomach pain
  5. See your doctor. If you have frequent or persistent heartburn, you should see your doctor. If you have GERD and don’t seek treatment, it can cause serious medical conditions, including esophagitis (an inflammation of the esophagus lining),[12] esophageal bleeding or ulcers,[13] the pre-cancerous Barrett’s esophagus,[14][15] and increased risk of esophageal cancer.[16]
    • If you have ulcers, these require medical treatment. They can cause other conditions, including internal bleeding, stomach perforation, and gastric outlet obstruction (where the passageway from the stomach to the small intestine is blocked).[3]
    • In some cases, ulcers from Helicobacter pylori can cause stomach cancer.
    • Some medications, such as Fosamax ( an osteoporosis drug), steroids, and immunosuppressants, can cause excessive acid production. If you are taking these medications, do not stop taking them until you have consulted with your doctor.
  6. Ask your doctor to check for Helicobacter pylori. Since the 1980s, doctors have discovered that the type of bacteria called H. pylori causes most stomach ulcers. About ⅔ of the world’s population carries H. pylori, but for most people it doesn’t cause any symptoms.[5] Between 30-67% of people in the United States are estimated to carry H. pylori.[17] In developing countries, that figure can be as high as 90%.[18]
    • You can get H. pylori from food, water, or eating utensils. You may also contract it through contact with saliva, fecal matter, or other body fluids of infected people.[5]
    • Because the sanitation conditions in developing countries are often different than those in the US and other countries, you may contract H. pylori if you travel to another country, especially if you drink the water or eat undercooked food. Poor hygiene and poor sanitation, while preparing and cooking food, are also common ways to get H. pylori.
    • If you have H. pylori, you should have your whole family or any people you live with tested as well. Reinfection can occur unless the infection is eradicated in everyone with whom you live in close contact.[19]
    • Your doctor can use noninvasive techniques to test for 'H. pylori, such as urea breath test, serology, and stool antigen tests.
  7. Ask a pharmacist to recommend an antacid. If you can’t get to the doctor immediately and want some relief from acid reflux symptoms, ask your pharmacist. S/he can recommend an effective (but temporary) over-the-counter antacid. A pharmacist can also help advise you to choose an antacid that won’t interact with your other medications. Common choices include:[20]
    • Zantac, 150 mg once per day
    • Pepcid, 20 mg twice per day
    • Lansoprazole, 30 mg once per day
    • Antacid tablets, 1-2 tablets every 4 hours

Implementing Lifestyle Remedies

  1. Talk with your doctor about stopping NSAID use. Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause ulcers.[3] NSAIDs reduce inflammation by blocking certain enzymes in your body. One of these enzymes also produces a chemical that protects your stomach lining from stomach acid. Using NSAIDs reduces this protective chemical, which can lead to ulcers.[21]
    • Common NSAIDs include aspirin, ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), ketoprofen (Orudis KT), and nabumetone (Relafen).[22] They also come in prescription strengths.
    • When using over-the-counter NSAIDs, do not use them for more than three days for fever or 10 days for pain relief. If you need long-term pain relief, talk with your doctor about other options.[23]
    • NSAIDs are more likely to cause ulcer complications when you use them long-term (1-4% of users will develop ulcers). The risk increases the longer you use them.[22]
    • The elderly and people with H. pylori co-infection are also at a higher risk of developing life-threatening ulcer complications when using NSAIDs.[24]
  2. Reduce your stress. In the past, it was commonly believed that stress caused ulcers. Doctors no longer believe this is true; most ulcers are caused by H. pylori infections. However, stress can make ulcers worse.[25] It may also increase stomach acid secretion in some people.[26][27]
    • Set aside time to relax. Take a pampering bubble bath. Go shopping just for fun. Take up a new hobby. Making time for leisure activities can help you destress.[28]
    • Try yoga or tai chi. Yoga and tai chi are forms of exercise that focus on deep breathing and meditation. They have both been found to relieve stress in clinical studies.[29][30][31][32]
    • Get some exercise. Physical exercise can decrease feelings of stress and anxiety. Aim for at least 2.5 hours of moderate physical activity every week.[33]
    • Get social support. Often we feel stressed when we’re facing a lot of pressure and don’t feel supported. Talk with family or friends, join a support group, go to church — whatever makes you feel like you’re part of a supportive community.
    • See a mental health professional. Some people believe that you need to have “huge” issues to see a therapist, but this simply isn’t true. If you’re feeling stressed or anxious, seeing a counselor or therapist could help you discover why and learn ways to deal with your feelings.[34]
  3. Stop smoking.[35] Smoking is bad for your health, full stop. While smoking hasn’t been shown to increase stomach acid production, it can cause acid-related discomfort and physical damage in several ways.[36]
    • Smoking increases your risk of GERD by weakening the lower esophageal sphincter (LES), the muscle at the entrance of the stomach that keeps acid from flowing back into the esophagus. Smokers have a much higher risk of frequent and chronic heartburn.[37]
    • Smoking weakens your immune system and increases your risk of H. pylori infection, which increases your likelihood of developing stomach ulcers. Smoking also slows the healing of ulcers and makes them more likely to reoccur.[36]
    • Smoking increases pepsin, an enzyme produced by your stomach that may harm your stomach lining in excessive amounts. It also decreases factors that help heal your stomach lining, including blood flow and mucus production.[37]
  4. Maintain a healthy weight. Carrying excess weight in your abdominal area puts pressure on your lower esophageal sphincter, forcing your stomach contents and stomach acid into the esophagus and causing heartburn.[38] This is also why heartburn is a common side effect of pregnancy. If you have a BMI greater than 29, losing weight may help reduce your heartburn.[39]
    • Before starting any weight loss regimen, consult with your physician.
    • If you are severely overweight (BMI equal to or greater than 40), bariatric surgery may be an option to help you reduce your weight and improve acid reflux symptoms. Talk with your doctor about whether this surgery is right for you.[40][41]

Eating and Drinking to Reduce Acid

  1. Drink lots of water. Staying hydrated by drinking enough water each day can help keep stomach acid in your stomach, where it belongs.[42]
    • You may want to look into “alkaline water,” which may help reduce stomach acidity. Because you need some acidity to help you digest properly, talk with your doctor before trying alkaline water.[43]
  2. Monitor your alcohol consumption. If you have problems with stomach acid, you may need to reduce or even stop drinking alcohol. The biggest culprits are beverages with a low ethanol concentration (<5%), such as beer and wine.[44] Fermented alcoholic beverages (beer, wine, champagne, sherry, etc.) are considered powerful stimulators of stomach acid production.[45] No direct link has been discovered between alcohol and stomach ulcers, but people who have ulcers are also more likely to have cirrhosis of the liver, a condition often caused by heavy alcohol consumption.[25]
    • Alcoholic beverages produced by distillation, such as whiskey and gin, do not appear to stimulate stomach acid production.[25][44]
    • No matter what you choose to drink, drink only in moderation. The National Institute on Alcohol Abuse and Alcoholism recommends that you consume no more than four alcoholic drinks per day and no more than 14 per week if you are male. If you are female, consume no more than three alcoholic drinks per day and no more than 7 per week.[46]
    • A “standard” drink is any of the following: 12 ounces of regular beer (5% alcohol by volume, or ABV), 8-9 ounces of malt liquor or high-gravity beer (7% ABV), 5 ounces of regular wine (12% ABV), 3-4 ounces of fortified wine (17% ABV), 2-3 ounces of cordial or liqueur (24% ABV), 1.5 ounces of brandy or 80-proof spirits (40% ABV).[47]
  3. Watch your caffeine intake. Caffeine appears to stimulate acid secretion in the stomach.[25] Coffee, in particular, may cause heartburn because of caffeine and other substances coffee contains.[48]
    • Even uncaffeinated beverages, such as tea, can cause heartburn. For example, mint herbs such as peppermint or spearmint can provoke heartburn.[49]
    • If you can’t live without your coffee, choose an espresso, French roast, or other dark roast coffee. Not only do they contain less caffeine, they also contain the compound N-methylpyridine, which may actually block your stomach’s production of stomach acid.[25] Coffee, in particular, may cause heartburn because of caffeine and other substances coffee contains.[47] While it isn’t known for sure whether cranberry helps prevent ulcers related to H. pylori, it is generally safe to consume and provides other health benefits, including keeping your urinary tract healthy.[50]
  4. Avoid eating before bedtime or lying down. Eating within two to three hours of lying down or going to sleep can cause heartburn. It takes roughly two hours for your stomach to empty its contents into your intestines. Stay upright for two to three hours after eating to avoid heartburn.[51]
    • If your heartburn is worse at night, try elevating the head of your bed by four to six inches, or use a wedge-shaped pillow to help you sleep in a semi-elevated position.[35]
  5. Eat smaller meals. Eating large meals can put undue pressure on your stomach, which can cause acid reflux symptoms. Eat smaller meals throughout the day to avoid putting pressure on your stomach.[35]
    • Wearing loose clothing can also help you avoid putting excess pressure on your stomach.[35]
  6. Avoid high-fat foods. High-fat foods tend to decrease the pressure in your lower esophageal sphincter (LES), which could mean that stomach acid backs up through it into the esophagus. Go for lower fat foods and incorporate plenty of vegetables, fruits, and whole grains into your diet.
    • High-fat foods may also increase the amount of time it takes for your stomach to empty its contents into the intestines, putting you at increased risk of acid reflux symptoms.[52][53]
    • Chocolate not only contains a lot of fat, it also contains methylxanthine, which has been shown to relax your LES and cause heartburn in some people.[36]
  7. Avoid spicy foods. Spicy foods, such as peppers, raw onions, and garlic, can cause your LES to relax, allowing stomach acids back up into the esophagus. If you suffer from frequent acid reflux symptoms, avoid spicy foods.[37]
  8. Avoid high-acid fruits. Citrus fruits and tomatoes (yes, tomatoes are fruits!) are high in acid, which can worsen your heartburn symptoms.[54] If you have frequent acid reflux symptoms, skipping these fruits may help.
    • Oranges, grapefruits, and orange juice are common triggers of heartburn symptoms.[55]
    • Tomato juice and tomatoes are also highly acidic and may trigger heartburn.
    • Pineapple juice is highly acidic and may cause heartburn.[56]
  9. Drink a glass of milk. The calcium in milk can act as a temporary buffer for stomach acid. However, because it’s also a high-fat food, it may trigger your stomach to produce more acid, in the long run, so choose a low-fat version.[57]
    • Try drinking goat’s milk or skim cow’s milk. Both of these options are very low in fat.[41]
  10. Chew gum. Chewing gum stimulates your body’s production of saliva, which acts as a natural acid buffer. Chewing gum when you feel heartburn coming on may help.[57]
    • Avoid mint gums. Mint, especially peppermint and spearmint, may actually trigger heartburn.[37]

Trying Natural Remedies

  1. Try licorice. Several studies have shown licorice root (the herb, not the sweet candy) to be effective in helping your esophageal lining resist irritation from stomach acid.[58]
    • Make sure you look for de glycyrrhizin ted (DGL) licorice. The active ingredient glycyrrhizin can cause serious side effects.[59]
    • When using licorice to treat acid reflux, take 250-500mg three times daily. Chew the root either one hour before or two hours after meals.[60]
    • You can also make a licorice tea by infusing 1-5 grams of dried licorice root in 8 ounces of water. Drink this tea three times daily.[59]
    • You should not take licorice if you have any of the following conditions: heart failure or heart disease, hormone-sensitive cancers, fluid retention, high blood pressure, diabetes, kidney or liver disease, low potassium, or erectile dysfunction. Pregnant and breastfeeding women should not take licorice.
  2. Try ginger. Ginger has been used to treat indigestion in traditional Chinese medicine.[44] No scientific evidence has found ginger to be effective at treating symptoms of acid reflux, but ginger does also have other health benefits, such as treating nausea and upset stomach.[61]
    • Take ginger supplements in capsule form or take ginger with meals. Eating raw ginger on its own may actually cause mild heartburn.
  3. Try cranberry. Preliminary research suggests that cranberry may inhibit the growth of the bacteria H. pylori in your stomach.[47] While it isn’t known for sure whether cranberry helps prevent ulcers related to H. pylori, it is generally safe to consume and provides other health benefits, including keeping your urinary tract healthy.[50]
    • Try drinking 3 ounces of pure cranberry juice (not “cocktail” or a juice blend) per day.[47] While it isn’t known for sure whether cranberry helps prevent ulcers related to H. pylori, it is generally safe to consume and provides other health benefits, including keeping your urinary tract healthy.[50]
    • You can also eat 1.5 ounces of fresh or frozen cranberries.
    • Cranberries have high levels of oxalate, which is related to the formation of kidney stones. If you’re at high risk for kidney stones, talk to a doctor about whether cranberry is right for you.
  4. Try baking soda. Baking soda, or sodium bicarbonate, is a natural antacid that may help neutralize stomach acid that has found its way back into your esophagus. Your pancreas naturally produces sodium bicarbonate to help neutralize excess stomach acid.[62]
    • Alka-Seltzer is the brand name of a common over-the-counter version of sodium bicarbonate.
    • Take one half-teaspoon, dissolved in water, every two hours for heartburn.[63]
    • If you are on a low-sodium diet, don’t use sodium bicarbonate as it does contain sodium.[64]

Tips

  • Don't assume that your stomach is overproducing acid. Ask your doctor about other possible causes.
  • Don't take any NSAID pain relievers, such as aspirin or ibuprofen, for longer than 10 days. If you’re still in pain, talk with your doctor.
  • In extremely rare cases, tumors called gastrinomas can cause you to have extremely high levels of stomach acid. This is called Zollinger-Ellison Syndrome, and it’s very rare. Your doctor can diagnose it with blood tests and endoscopy.[65]

Warnings

  • There is little to no scientific research that supports herbal treatments for heartburn or acid reflux. Some herbal supplements can cause severe side effects or interactions, so talk with your doctor before you use any herbs.[44]

Related Articles

Sources and Citations

  1. ↑ http://www.md-health.com/Stomach-Acid.html
  2. ↑ http://www.webmd.com/heartburn-gerd/guide/understanding-heartburn-basics
  3. ↑ 3.0 3.1 3.2 3.3 http://www.webmd.com/heartburn-gerd/guide/reflux-disease-gerd-1
  4. ↑ 4.0 4.1 http://www.webmd.com/heartburn-gerd/guide/what-is-acid-reflux-disease
  5. ↑ 5.0 5.1 5.2 http://www.emedicinehealth.com/heartburn/article_em.htm
  6. ↑ http://www.webmd.com/digestive-disorders/digestive-diseases-peptic-ulcer-disease
  7. ↑ 7.0 7.1 http://www.webmd.com/heartburn-gerd/guide/understanding-gerd-symptoms
  8. ↑ http://www.mayoclinic.org/diseases-conditions/heartburn/basics/symptoms/con-20019545
  9. ↑ http://www.webmd.com/digestive-disorders/hiatal-hernia
  10. ↑ http://www.webmd.com/digestive-disorders/h-pylori-helicobacter-pylori
  11. ↑ http://www.webmd.com/digestive-disorders/h-pylori-helicobacter-pylori?page=2
  12. ↑ http://www.webmd.com/digestive-disorders/esophagitis
  13. ↑ http://www.webmd.com/heartburn-gerd/guide/complications-untreated-gerd
  14. ↑ http://www.webmd.com/heartburn-gerd/guide/barretts-esophagus-symptoms-causes-and-treatments
  15. ↑ Meurer, Linda MD, MPH, Bower, Douglas MD, Management of Helicobacter Pylori Infection, American Family Physician(65) (7) 1327-1337
  16. ↑ http://www.webmd.com/digestive-disorders/esophageal-cancer
  17. ↑ Roshana Shesha, Kamal Kojrala, KC. Shivraj et al. H Pylori Infection Among Patients with Upper Gastrointestinal Symptoms. Journal of Family Primary Care 2014, April 3 (2) 154-158
  18. ↑ LM Brown, Helicobacter Pylori: Epidemiology and routes of Transmission. Epidemiology Review 2000 22 (2) 283-297
  19. ↑ Yazuz Selem Sari, Didem Can, Vahit Tundi et al. H Pylori: Treatment Just The Patient or For the Whole Family?. World Journal of Gastroenterology, Feb 28, 2008, 14 (8) 1244-1247
  20. ↑ http://www.webmd.com/heartburn-gerd/guide/treating-heartburn-over-counter-medicine
  21. ↑ http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/peptic-ulcer/Pages/symptoms-causes.aspx
  22. ↑ 22.0 22.1 http://orthoinfo.aaos.org/topic.cfm?topic=a00284
  23. ↑ http://my.clevelandclinic.org/health/drugs_devices_supplements/hic_Non-Steroidal_Anti-Inflammatory_Medicines_NSAIDs
  24. ↑ http://www.aafp.org/afp/2007/1001/p1005.html
  25. ↑ 25.0 25.1 25.2 25.3 25.4 http://www.hopkinsmedicine.org/healthlibrary/conditions/digestive_disorders/stomach_and_duodenal_ulcers_peptic_ulcers_85,P00394/
  26. ↑ http://www.ncbi.nlm.nih.gov/pubmed/8409313
  27. ↑ http://link.springer.com/article/10.1007%2FBF01537249
  28. ↑ http://www.helpguide.org/articles/stress/stress-management.htm
  29. ↑ http://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/yoga/art-20044733
  30. ↑ https://nccih.nih.gov/health/yoga/introduction.htm
  31. ↑ http://www.health.harvard.edu/staying-healthy/the-health-benefits-of-tai-chi
  32. ↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2211366/
  33. ↑ http://www.adaa.org/living-with-anxiety/managing-anxiety/exercise-stress-and-anxiety
  34. ↑ http://www.nhs.uk/conditions/stress-anxiety-depression/pages/benefits-of-talking-therapy.aspx
  35. ↑ 35.0 35.1 35.2 35.3 http://www.webmd.com/heartburn-gerd/guide/what-is-acid-reflux-disease?page=2
  36. ↑ 36.0 36.1 36.2 http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/smoking/Pages/facts.aspx
  37. ↑ 37.0 37.1 37.2 37.3 http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/smoking/Pages/facts.aspx#gerd
  38. ↑ Gelhott, A MD PharmD, Gastroeseophageal Reflux Disease: Diagnosis and Management, American Family Physician 1999 1; 59 (5) 1161-1169
  39. ↑ Scott, M. MD, Aimee, M PharmD, Gastroesophageal Reflux Disease: Diagnosis and Management, American Family Physician 1999 1 59 (5) 1157-1165
  40. ↑ Vivek, Prachard, John Alvordy, Gastroesophageal Reflux Disease and Severe Obesity Fundoplication and Bariatric Surgery, World Journal of Gastroenterology 2010, August 2010 14 16 (30) 3751-3776
  41. ↑ 41.0 41.1 Pallati PK, Shaligram A, Shostrom VK, Oleynikov D, McBride CL, Goede MR, Improvement of GERD after Various Bariatric Procedures, Obesity Related Diseases May-June 2014 19 502-507
  42. ↑ https://www.tuftsmedicalcenter.org/-/media/Brochures/TuftsMC/Patient%20Care%20Services/Departments%20and%20Services/Otolaryngology/Acid%20reflux%20precautions.ashx
  43. ↑ http://www.healthline.com/health/gerd/beverages#Water5
  44. ↑ 44.0 44.1 44.2 44.3 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1374273/
  45. ↑ http://www.ncbi.nlm.nih.gov/pubmed/9155575
  46. ↑ http://rethinkingdrinking.niaaa.nih.gov/IsYourDrinkingPatternRisky/WhatsLowRiskDrinking.asp
  47. ↑ 47.0 47.1 47.2 47.3 http://rethinkingdrinking.niaaa.nih.gov/WhatCountsDrink/WhatsAstandardDrink.asp
  48. ↑ http://www.webmd.com/digestive-disorders/news/20100322/brewing-gentler-java
  49. ↑ http://www.healthline.com/health/gerd/coffee-tea
  50. ↑ 50.0 50.1 50.2 http://umm.edu/health/medical/altmed/herb/cranberry
  51. ↑ http://www.ncbi.nlm.nih.gov/pubmed/17074022
  52. ↑ http://www.mckinley.illinois.edu/handouts/gerd_diet.html
  53. ↑ http://www.webmd.com/heartburn-gerd/triggers
  54. ↑ http://www.emedicinehealth.com/heartburn/page5_em.htm#foods_to_avoid_with_heartburn
  55. ↑ http://www.webmd.com/heartburn-gerd/features/top-10-heartburn-foods
  56. ↑ http://www.healthline.com/health/gerd/beverages#Teas2
  57. ↑ 57.0 57.1 http://www.webmd.com/heartburn-gerd/home-heartburn-remedies-natural-remedies-heartburn?page=2
  58. ↑ http://www.patienteducationcenter.org/articles/herbal-remedies-gerd/
  59. ↑ 59.0 59.1 http://umm.edu/health/medical/altmed/herb/licorice
  60. ↑ http://umm.edu/health/medical/altmed/condition/gastroesophageal-reflux-disease
  61. ↑ http://umm.edu/health/medical/altmed/herb/ginger
  62. ↑ http://www.healthline.com/health/gerd/baking-soda
  63. ↑ http://www.mayoclinic.org/drugs-supplements/sodium-bicarbonate-oral-route-intravenous-route-subcutaneous-route/proper-use/drg-20065950
  64. ↑ http://www.healthline.com/health/gerd/baking-soda#Risks4
  65. ↑ Jeffrey Norton MD FACS, Robert Jenson MD, Role of Surgery in Zollinger-Ellis Syndrome,Journal of the American College of Surgeons Oct 2007 Vol 205 Issue 4 Supp S34-S37
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