Stomach acids coming back up into your esophagus can burn or even damage tissue. Gastroesophageal reflux disease (GERD) affects nearly a third of U.S. adults each week. If you are one of them, proton pump inhibitors (PPIs) including Nexium and Prilosec may be your go-to remedy.
Proton-pump inhibitors: the harms
Every drugstore has an aisle offering these over-the-counter and many more related brands. One problem is that the majority of people reported persistent symptoms in one large study of PPI users. And besides often not being an effective solution, these drugs can be harmful: Bone fractures, Clostridium difficile infection, community-acquired pneumonia, vitamin B12 deficiency, kidney disease, and dementia are linked to PPIs. Other risks include excess acid production when the drug is stopped —making resumption more likely — as well as the dangers when combining with a slew of other medications. Severe cases may benefit from PPIs. After all, extended acid reflux can cause esophageal tissue damage can lead to a condition called Barrett’s esophagus. These cellular changes can be precancerous.
But the soaring numbers of people using them for long periods suggest it’s time for a different approach.
Better first-line treatments
Experts agree that diet and lifestyle changes should be the first line of treatment. Avoid nicotine and alcohol; avoid possible triggers including peppermint, chocolate, caffeine, citrus fruits, tomatoes, and high fat foods; eat smaller meals, at least two hours before sleep and lose weight if necessary.
Probiotics and GERD
As discussed in a recent article from the International Probiotics Association, “probiotics may be relevant to changes seen in GERD:
- Specific probiotics accelerate gastric emptying by interacting with stomach mucosal receptors. Transient lower esophageal sphincter relaxation is often triggered in GERD.
- Specific Lactobacillus and Bifidobacterium are linked with alterations in the immune response and antagonistic activity toward potential pathogens through the production of short-chain fatty acids, such as lactic acid.
- Intestinal motility and immunity can be impacted by small intestinal bacterial overgrowth (SIBO) in which probiotics can be beneficial.”
The article also describes a recent review examining the efficacy of probiotics in alleviating the frequency and severity of symptoms in GERD in the general adult population. Details on the methods and results are described in Gastroesophageal Reflux Disease and Probiotics: A Systematic Review.
The authors concluded, “Probiotic use can be beneficial for GERD symptoms, such as regurgitation and heartburn.”
When reflux first strikes, adjust your diet and lifestyle. Add a probiotic supplement. They are safe and inexpensive. And they won’t vanquish your stomach acids, which after all, are vital to digestion.