Acid reflux occurs when stomach contents and acid reflux into the esophagus through the lower esophageal sphincter (AKA cardiac sphincter), causing pain, irritation, and possibly damage to the esophageal lining. In some cases, people experience reflux symptoms such as the sensation of heartburn radiating out from the stomach and esophageal area into the chest and heart area, giving the sensation of a burning sensation or burning heart. If this happens chronically, it is usually diagnosed as gastroesophageal reflux disease (GERD), and symptoms are commonly referred to as GERD symptoms or symptoms of GERD. Chronic acid reflux and severe acid reflux may require more advanced care if natural options do not fully relieve symptoms.
Key Takeaways:
-
Acid reflux isn't always from too much acid — It can be caused by food sensitivities, poor digestion, or low stomach acid, especially due to duodenal irritation.
-
Long-term PPI use is risky — Extended use of acid-blocking meds can lead to kidney issues, nutrient deficiencies, and other health problems like reduced bone mineral density.
- Natural remedies help — Soluble fiber, melatonin, digestive enzymes, and identifying trigger foods such as acidic foods or fatty foods can effectively manage or reverse acid reflux.
This article outlines how to treat acid reflux without PPI and explores root causes and sustainable solutions.
Causes of Acid Reflux
Occasional acid reflux may occur from overeating or eating foods that irritate the esophagus, stomach lining, or more commonly, the small intestine. In fact, many patients we see at BioLounge are experiencing acid reflux as a result of irritation to the upper area of the small intestine called the duodenum, where food passes from the stomach, through the pyloric sphincter, and into the small intestine.
The upper area of the duodenum sees a lot of action. The intestines are lined with immune cells that respond to the constantly changing environment. As soon as food enters, the pancreas and gallbladder begin secreting fluids that continue digestion so you can absorb your food while also neutralize stomach acid that has traveled with your meal into the intestine. Immune cells go to work identifying the mush that has just entered to make sure it is safe for you (if you've ever experienced food poisoning, this is your body's way of telling you that your food was NOT safe).
Irritation of this section of your digestive tract can cause pressure, which forces the stomach acid back up into the esophagus, causing acid reflux. This irritation can be caused by too much food, food sensitivities, poor motility (food is moving too slowly), and even too little stomach acid, which seems counterintuitive.
It's important to note that on rare occasion, severe GERD or chronic acid reflux can be caused by a hiatal hernia, which occurs near the lower esophageal sphincter and must be corrected with surgical intervention.
Risks of Acid Reflux
Aside from discomfort, the low pH of stomach acid is dangerous to the esophageal tissue and over time can increase the risk of esophagitis, ulcers, strictures, aspiration pneumonia, Barrett's esophagus, and gastric cancer or esophageal cancer. These long-term complications can become chronic disease conditions that affect overall quality of life. Other symptoms may also develop, such as difficulty swallowing, chest pain, or even dental erosion.
For these reasons, it is essential to explore how to treat acid reflux without PPI use, especially for long-term relief.
Risk of PPI Use
The standard of care is a class of drugs called PPIs (proton pump inhibitors) which reduce the amount of acid produced in the stomach. While this action may calm symptoms and provide quick relief, it does nothing to address the root cause of acid reflux, and PPIs carry serious risk if used beyond their intended 6-week max duration.
Research now shows that using PPIs such as Omeprazole (Prilosec), Esomeprazole (Nexium), Lansoprazole (Prevacid), Rabeprazole (AcipHex), and Pantoprazole (Protonix) for more than 6 weeks increases the risk of serious health problems including: kidney injury, dementia, stomach cancer, anemia, and osteoporosis.
Why Do These Risks Occur?
BECAUSE WE NEED STOMACH ACID TO DIGEST AND ABSORB OUR FOOD! Moreover, the low acidity of the stomach is the first barrier to infections. Pathogenic microbes from our mouth and food should be killed in the stomach before they have a chance to infect us through the intestines.
How to Heal Acid Reflux Naturally
If you're wondering how to treat acid reflux without PPI, here are safe, effective steps supported by science and experience:
-
Avoid refined carbs and sugar that irritate the small intestinal bacteria and lining and increase pressure in the small intestine and stomach. This can be particularly important for those carrying excess weight, as losing or maintaining a healthy weight is key in reducing intra-abdominal pressure.
-
Consume fewer calories at each meal and avoid fatty foods, high carb, and high caloric meals which slow digestion.
-
Increase soluble fiber. Research shows that increasing soluble fiber by 12.5 grams per day is an effective treatment for GERD. You can increase soluble fiber by adding beans, lentils, flax, chia, and avocado to your meals.
-
Take 3 mg melatonin 1 hour before bed for 8 weeks. Melatonin reduces stomach acid and strengthens the lower esophageal sphincter. Clinical trials have shown that after 8 weeks, it works just as well as a PPI.
-
Try Chinese herbs. Acupuncture and herbal medicine can help relieve symptoms of GERD naturally.
-
Assess food sensitivities. Identifying and removing trigger foods like acidic foods or fatty foods that cause an inflammatory response in the small intestine improves countless inflammatory conditions and, 9 times out of 10, reverses acid reflux completely.
-
Do not eat within 3 hours of bedtime. This reduces pressure on the GI tract and helps prevent reflux.
-
Incorporate lifestyle changes that support gut health and reduce reflux triggers. These include a whole-foods diet, regular physical activity, and maintaining a healthy weight.
-
Take a broad-spectrum digestive enzyme with your meals. Instead of taking PPIs to reduce stomach acid, digestive enzymes with HCl, pancreatic enzymes, and ox bile can improve digestion and reduce irritation.
Next Steps
Like many drugs, PPIs have utility and can be helpful in the short term, but it's critical to look at their action and long-term risk factors. If you’re looking for how to treat acid reflux without PPI drugs, many of the natural remedies listed above can be safely tried at home. However, if reflux symptoms persist, please contact your provider and consider a deeper investigation into the root cause of your condition.
Every body is different, so work closely with your functional medicine provider to identify the factors affecting your unique body and move forward with confidence.