Reduce Excess Stomach Acid

Your stomach is full of naturally produced acid that helps break down food and protects the GI tract from infection. But, excess stomach acid can cause uncomfortable symptoms, pain, and even severe health problems. The most common symptom is heartburn (a.k.a. gastroesophageal reflux), which occurs when stomach acid leaks into the esophagus. Frequent heartburn suggests gastroesophageal reflux disease (GERD), which can damage the esophagus and throat. Reducing excess stomach acid is the best way to manage these problems.

Steps

Seeking Medical Attention for GERD

1. See a doctor if necessary. If you make the lifestyle changes suggested above but see no change in symptoms, it's time to see a doctor. Long-term GERD can cause esophageal injury and is associated with other severe health problems. Prolonged inflammation and repeated injury can also increase the risk of developing esophageal cancer. Don't hesitate to seek medical treatment if lifestyle changes don't fix your stomach acid issues.
2. Ask your doctor for medication recommendations. Medical treatment for GERD is broken down according to severity of symptoms. Many of medications are available over-the-counter (OTC). You should still consult your doctor to ensure a proper treatment regimen. If he or she can write you a prescription for an OTC medication, you might even be able to get it covered by insurance. Follow the dosage and timing instructions carefully for each different drug to prevent potentially severe side effects.
   • For mild to moderate GERD: Take antacids as needed (Tums, Maalox) to neutralize acid if your symptoms occur once weekly or less. They provide relief within minutes, but only last for about one hour. Take surface agents (sucralfate/Carafate) to protect esophageal and stomach lining and promote healing. Take histamine 2 receptor antagonists (Zantac, Pepcid) to decrease acid secretion.
   • For severe or frequent (2 or more episodes per week) GERD: take proton pump inhibitors (omeprazole, lansoprazole, esomeprazole, pantoprazole, dexlansoprazole, rabeprazole) to prevent acid secretion in the stomach. Some of these are available OTC, and the standard dose is one pill daily for 8 weeks. Side effects include: bacterial infections and diarrhea, anemia and osteoporosis, and interactions with other medications.
3. Discuss the option of an endoscopy. In a screening upper endoscopy, doctors use a camera on a flexible tube to look at the throat, esophagus, and stomach. During the procedure, they might take biopsies to assess inflammation, check for H. pylori (a type of bacteria), and rule out cancer. Discuss whether your symptoms call for an endoscopy with your doctor.
4. Be open to surgery if your doctor recommends it. Rarely, GERD symptoms don't respond to any medications, in which case you may need surgery. One surgical approach (fundoplication) wraps the upper part of the stomach around the esophagus, then sews it in place to reinforce the esophageal opening. A second approach wraps a string of magnetized beads around the point where the esophagus meets the stomach. This closes the lower esophagus, but lets it expand when swallowing so food can get through.
   • Young people who will suffer from life-long GERD symptoms can also consider surgery.

Using Natural and Alternative Therapies

1. Try natural remedies. There hasn't been much research done on natural remedies for acid reflux. Though these remedies aren't fully accepted by the medical or scientific communities, they may help relieve symptoms:
   • Baking soda - ½ to 1 teaspoon of baking soda in a glass of water may help to neutralize stomach acid
   • Aloe vera - drinking aloe juice may sooth the burning sensation
   • Ginger or chamomile tea - these are thought to reduce stress, relieve nausea, and help with digestion
   • Licorice and Caraway are both herbs that many suggest may help symptoms
   • DGL (Deglycyrrhizinated Licorice Root Extract) chewable tablets: a supplement available at most health food stores
   • Mastic (Arabic gum): a supplement available at most health food stores
2. Avoid debunked natural therapies. You may have heard that peppermint can help with acid reflux, but studies show that peppermint oil actually makes it worse. Another common belief is that milk can relieve symptoms. While it's true that milk will neutralize stomach acid for a little while, it stimulates more acid production in the long run.
3. Increase your salivation. Studies suggest that increased salivation can neutralize stomach acid. You can increase your salivation by chewing gum or sucking on lozenges. Just make sure they're sugar-free to prevent high calorie intake.
4. Consider getting acupuncture. It might look scary, but studies have shown that acupuncture can improve symptoms of regurgitation and heartburn. The mechanism at play here isn't fully understood, scientifically, though.

Making Lifestyle Changes

1. Eat a balanced, healthy diet. In general, a balanced diet is rich in fruits, vegetables, whole grains, and low-fat/fat free dairy. It also includes lean (low-fat) proteins, such as poultry, fish, and beans. Your diet should also be low in saturate and trans fats, cholesterol, sodium (salt), and added sugars. The USDA has many resources available to learn more about how to create a balanced diet.
2. Achieve and maintain a healthy body mass index (BMI). In medical terms, a healthy weight is defined by something called a body mass index (BMI). The BMI estimates your appropriate weight range according to height and sex. A normal BMI is 18.5-24.9. BMIs below 18.5 are underweight, from 25.0-29.9 are overweight, and above 30.0 are obese.
   • Use a BMI calculator to find out your BMI.
   • Adjust your diet and exercise to bring your BMI into the "normal" range.
3. Count calories to lose or maintain weight. Checking nutrition labels for calories is a simple and efficient way to manage your weight. Make sure you stay within the recommended calorie range for your dietary needs every single day. You can estimate your daily calories needs by multiplying your weight in pounds by 10. So, if you weight 180 lbs, you should eat 1800 calories daily to maintain your weight.
   • Note that this number can vary depending on your gender, age, and daily activity level. For a more accurate number, use a calorie calculator.
   • The healthiest rate to lose weight is at about one pound per week. A pound of fat is about 3500 calories, so decrease your daily intake by 500 calories. (500 calories x 7 days/week = 3500 calories/7 days = 1 lb/week).
   • Use a calorie tracking website or phone app to help keep track of what you're eating.
4. Avoid eating large portions. Eat meals slowly, and take small, thoroughly chewed bites for efficient digestion. Large, poorly chewed bites will add to how much time it takes for your stomach to break down food. You'll over-eat as a result. Eating quickly can also make you swallow too much air, which can lead to bloating.
   • It can take up to 20 minutes for your stomach to signal your brain that you are full. Because of this, people who eat quickly tend to over-eat.
5. Avoid foods that make GERD symptoms worse. Unfortunately, there are no specific foods that have been scientifically proven to cure GERD. You can, however, avoid foods that have been shown to make it worse:
   • Caffeinated drinks (coffee, tea, soda)
   • Caffeine-like chemicals (chocolate, peppermint)
   • Alcohol
   • Spicy foods (hot peppers, curry, hot mustards)
   • Acidic foods (citrus fruits, tomatoes, sauces and dressings that have vinegar)
   • Large amounts of foods that cause bloating and gas (cabbage, broccoli, Brussels sprouts, legumes, dairy, and high-fat foods)
   • Sugar or sugary foods
6. Maintain a regular exercise schedule. The American Heart Association recommends at least 30 minutes of moderate activity at least 5 days per week. Or, you can combine 25 minutes of vigorous aerobic activity 3 days a week with moderate- to high-intensity muscle-strengthening twice a week.
   • If that sounds like more than you can manage, something is always better than nothing! Do your best to get as much exercise as you can. Even going for a short walk is better than sitting on the couch!
   • The more calories you burn through exercise, the more calories you can eat! Many calorie-tracking programs help you keep track of how exercise affects how much you can eat on a day-to-day basis.
7. Avoid straining or exercising vigorously, especially shortly after eating. Depending on the size and type of meal, your stomach takes 3-5 hours to digest and empty its contents. To avoid reflux, let most of that time pass or eat smaller meals before participating in such activities.
8. Avoid bad habits that make symptoms worse. If you smoke or use any other tobacco products, you should quit as soon as possible. Alcohol can also make acid reflux worse, so either cut it out of your diet or cut back significantly. Finally, avoid lying down soon after eating. If you can't do that, try sleeping with your head elevated by several pillows.

Tips

• If you are having a heartburn attack, it has been recommended to avoid laying on your back, as this gives the acid a better chance at splashing up.
• Keep a journal with lists of the foods you eat, the time it takes you to complete a meal, and any acid-related symptoms that you experience within an hour after your last meal. A journal will help you uncover causes of acid buildup.

Warnings

• A stomach acid level that is too low can be just as detrimental to your health as a stomach acid level that is too high. If you overdose on antacid tablets or other acid reducing medications or treatments, your digestion may be affected and your nutrition may suffer. Following the precise guidelines listed on over the counter or prescription treatments for excess acid is extremely important.
• While some excess stomach acid is caused by foods that are eaten, changes in mood or stress levels, or excess alcohol consumption, some individuals have consistent stomach acid problems. Consistently high stomach acid levels can lead to serious problems such as the deterioration of the esophagus or the development of ulcers. If you experience persistent stomach acid symptoms, consult a physician.
• The use of prescription antacids that reduce the stomach acid can lead to vitamin B12 deficiency which can in turn cause pernicious anemia. This is a serious illness which can eventually cause death if left untreated. Our stomachs are designed to work with adequate acid and proper digestion of food and absorption of vital nutrients cannot occur when the acid is "shut-off" with prescription antacids.

Sources and Citations

See also

• Stay Regular
• Eat After an IBD Flare
• Choose a Gastroenterologist
• Treat Gallbladder Disease
• Diagnose Allergic Colitis in Babies
• Deal With Constipation
• Relieve Constipation Quickly and Naturally
• Get Rid of a Belly Ache from Too Much Junk Food
• Stop Stomach Problems
• Force a Burp

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