Natural Remedies for GERD

If you’re experiencing heartburn-like symptoms more than a couple of times a week, you may be one of the 20% of U.S. adults with gastroesophageal reflux disease (GERD). GERD is a more chronic and severe form of heartburn.¹Shaqran TM, Ismaeel MM, Alnuaman AA, et al. Epidemiology, causes, and management of gastro-esophageal reflux disease: a systematic review. Cureus. 2023 Oct 21;15(10):e47420. https://doi.org/10.7759/cureus.47420

Common sensations include burning pain in the chest or throat, difficulty swallowing, burping, a sour taste in the mouth, bloating, nausea, dental erosion, persistent coughing, and wheezing.

Natural treatments vs. antacids for GERD

Multiple manufacturers recalled prescription and over-the-counter anatacids in 2019 when the carcinogen N–nitrosodimethylamine (NDMA) was found in Zantac (ranitidine).²McGwin G. The association between ranitidine use and gastrointestinal cancers. Cancers (Basel). 2020;13(1):24. Published December 23, 2020. https://doi.org/10.3390/cancers13010024 Millions of babies, children, and adults had taken prescription ranitidine for heartburn and GERD. Many more purchased Zantac over the counter.

Proton pump inhibitors (PPIs), another popular class of drugs that treat GERD, have been linked to everything from cognitive decline to osteoporosis to early death.³Ito T, Jensen RT. Association of long-term proton pump inhibitor therapy with bone fractures and effects on absorption of calcium, vitamin B12, iron, and magnesium. Curr Gastroenterol Rep. 2010;12(6):448-457. https://doi.org/10.1007/s11894-010-0141-0 People who take PPIs have a higher chance of contracting pneumonia and bacterial Clostridium difficile (C. diff) infections while in the hospital.⁴Trifan A, Stanciu C, Girleanu I, et al. Proton pump inhibitors therapy and risk of Clostridium difficile infection: systematic review and meta-analysis. World J Gastroenterol. 2017;23(35):6500-6515. https://doi.org/doi:10.3748/wjg.v23.i35.6500

What causes GERD?

GERD often involves a loosened lower esophageal sphincter (LES), an opening between the esophagus and stomach. First, food moves through the esophagus with the help of saliva. When that food enters the stomach, it creates a “slurry” with just the right mixture of digestive juices. Without enough stomach acid, which helps break down nutrients, bacterial overgrowth can occur.

The slurry continues downward into the small intestine. Although the process should be a one-way trip, with a loose LES, it can reverse course. This irritates the esophageal lining, where an absence of protective mucus-secreting cells increases vulnerability. The result is often discomfort or pain. Over time, irritation may damage surrounding tissue.

The LES loosens naturally with age,⁵Besanko LK, Burgstad CM, Cock C, Heddle R, Fraser A, Fraser RJ. Changes in esophageal and lower esophageal sphincter motility with healthy aging. J Gastrointestin Liver Dis. 2014;23(3):243-248. https://doi.org/10.15403/jgld.2014.1121.233.lkb along with changes in the production of stomach acid. Sometimes people with GERD have low stomach acid, not high. LES tightness or laxity is controlled by a balance of neurotransmitters and hormones. Acid stimulation helps close the LES tightly. If the sphincter is loose, even a moderate amount of acidic food slurry can irritate the esophageal lining. Foods that GERD sufferers are instructed to avoid (chocolate, coffee, and tomatoes) do not cause GERD. They only aggravate an already irritated esophagus.

A long list of factors can increase the chance of GERD, including family history, poor diet, food allergens, being overweight, hiatal hernia, pregnancy, stress, tight clothing around the midsection, smoking, environmental toxins, and certain medications, especially immunosuppressants.

Nine natural solutions for reflux

Natural approaches to GERD management focus on controlling root causes, strengthening the LES, correcting acid imbalance, and healing and rebuilding irritated mucosal membrane tissues. As symptoms improve with lifestyle changes and natural medicines, many patients can reduce or discontinue medication. Remember these nine tips for keeping acid in check:

1. Don’t lie down immediately after eating.
2. Avoid exercising right after eating.
3. Slim down if you’re overweight.
4. Avoid foods that irritate your stomach, and eat smaller, more frequent meals.
5. Raise the head of the bed.
6. Drink less alcohol and stop smoking.
7. When symptoms are very uncomfortable, consider bland foods like oatmeal.
8. Drink between meals, not with them, as the latter thins out food and digestive juices, making it easier to travel in reverse.
9. Go for a gentle walk after a large meal.

An anti-inflammatory diet may also help relieve GERD. Fermented and cultured foods contribute to a balanced microbiome, which also counters inflammation and supports immune function. With low stomach acid, drinking small amounts of apple cider vinegar, lemon juice, or lime juice (always diluted in water) before meals can be helpful. Consider using a straw, as these substances can erode tooth enamel.

Alleviating GERD discomfort with nutritional supplements

Scientific evidence supports melatonin⁶Bang CS, Yang YJ, Baik GH. Melatonin for the treatment of gastroesophageal reflux disease; protocol for a systematic review and meta-analysis. Medicine (Baltimore). 2019;98(4):e14241. https://doi.org/10.1097/MD.0000000000014241 for GERD because it protects esophageal mucosa by minimizing contact with acid, bile, and pepsin, while helping the LES work more effectively. Taken at night, melatonin also supports better sleep, which may reduce bodily inflammation and reduce the likelihood of nighttime symptom interruptions. Probiotics also introduce healthy bacteria to the gut, which may aid digestion and help improve common GI symptoms like nausea, pain, gurgling, and burping.⁷Cheng J, Ouwehand AC. Gastroesophageal reflux disease and probiotics: a systematic review. Nutrients. 2020;12(1):132. Published 2020 Jan 2. https://doi.org/10.3390/nu12010132

Many botanical medicines can soothe GERD symptoms, and some may help rebuild the esophageal lining:

• Curcumin (Curcuma longa)⁸Kwiecien S, Magierowski M, Majka J, et al. Curcumin: a potent protectant against esophageal and gastric disorders. Int J Mol Sci. 2019;20(6):1477. Published 2019 Mar 24. https://doi.org/10.3390/ijms20061477
• Slippery elm (Ulmus fulva)
• Potable aloe vera juice⁹Panahi Y, Khedmat H, Valizadegan G, Mohtashami R, Sahebkar A. Efficacy and safety of Aloe vera syrup for the treatment of gastroesophageal reflux disease: a pilot randomized positive-controlled trial. J Tradit Chin Med. 2015;35(6):632-636. https://doi.org/10.1016/s0254-6272(15)30151-5
• Zinc carnosine¹⁰Hewlings S, Kalman D. A review of Zinc-L-Carnosine and its positive effects on oral mucositis, taste disorders, and gastrointestinal disorders. Nutrients. 2020;12(3):665. Published 2020 Feb 29. https://doi.org/10.3390/nu12030665
• Licorice root (Glycerizza glabra), in the form of deglycyrrhizinated licorice¹¹Di Pierro F, Gatti M, Rapacioli G, Ivaldi L. Outcomes in patients with nonerosive reflux disease treated with a proton pump inhibitor and alginic acid ± glycyrrhetinic acid and anthocyanosides. Clin Exp Gastroenterol. 2013;6:27-33. https://doi.org/10.2147/CEG.S42512

What’s in a natural treatment plan for GERD?

Natural approaches to GERD relief address the underlying causes, especially those related to lifestyle, diet, and exercise habits. Non-pharmaceutical therapies aim to correct foundational anatomic and physiologic imbalances that contribute to GI woes. Strengthening the LES is often a first step.

Psychosocial stress is a predictable and modifiable cause of GERD.¹²Jansson C, Wallander MA, Johansson S, Johnsen R, Hveem K. Stressful psychosocial factors and symptoms of gastroesophageal reflux disease: a population-based study in Norway. Scand J Gastroenterol. 2010;45(1):21-29. https://doi.org/10.3109/00365520903401967 Working to reduce overall stress through exercise, mindfulness meditation, hobbies, being with loved ones, and time in nature is an important part of a natural treatment plan.

Acupuncture has also been shown to help with heartburn and GERD symptoms.¹³Dossett ML, Cohen EM, Cohen J. Integrative medicine for gastrointestinal disease. Prim Care. 2017;44(2):265-280. https://doi.org/10.1016/j.pop.2017.02.002

Some people with severe GERD may need prescription medication or surgery. For many others, the condition is manageable and even reversible. The most successful natural care plans are built alongside patients, integrating preferences, goals, and realistic, sustainable changes.

Footnotes

• 1
  Shaqran TM, Ismaeel MM, Alnuaman AA, et al. Epidemiology, causes, and management of gastro-esophageal reflux disease: a systematic review. Cureus. 2023 Oct 21;15(10):e47420. https://doi.org/10.7759/cureus.47420
• 2
  McGwin G. The association between ranitidine use and gastrointestinal cancers. Cancers (Basel). 2020;13(1):24. Published December 23, 2020. https://doi.org/10.3390/cancers13010024
• 3
  Ito T, Jensen RT. Association of long-term proton pump inhibitor therapy with bone fractures and effects on absorption of calcium, vitamin B12, iron, and magnesium. Curr Gastroenterol Rep. 2010;12(6):448-457. https://doi.org/10.1007/s11894-010-0141-0
• 4
  Trifan A, Stanciu C, Girleanu I, et al. Proton pump inhibitors therapy and risk of Clostridium difficile infection: systematic review and meta-analysis. World J Gastroenterol. 2017;23(35):6500-6515. https://doi.org/doi:10.3748/wjg.v23.i35.6500
• 5
  Besanko LK, Burgstad CM, Cock C, Heddle R, Fraser A, Fraser RJ. Changes in esophageal and lower esophageal sphincter motility with healthy aging. J Gastrointestin Liver Dis. 2014;23(3):243-248. https://doi.org/10.15403/jgld.2014.1121.233.lkb
• 6
  Bang CS, Yang YJ, Baik GH. Melatonin for the treatment of gastroesophageal reflux disease; protocol for a systematic review and meta-analysis. Medicine (Baltimore). 2019;98(4):e14241. https://doi.org/10.1097/MD.0000000000014241
• 7
  Cheng J, Ouwehand AC. Gastroesophageal reflux disease and probiotics: a systematic review. Nutrients. 2020;12(1):132. Published 2020 Jan 2. https://doi.org/10.3390/nu12010132
• 8
  Kwiecien S, Magierowski M, Majka J, et al. Curcumin: a potent protectant against esophageal and gastric disorders. Int J Mol Sci. 2019;20(6):1477. Published 2019 Mar 24. https://doi.org/10.3390/ijms20061477
• 9
  Panahi Y, Khedmat H, Valizadegan G, Mohtashami R, Sahebkar A. Efficacy and safety of Aloe vera syrup for the treatment of gastroesophageal reflux disease: a pilot randomized positive-controlled trial. J Tradit Chin Med. 2015;35(6):632-636. https://doi.org/10.1016/s0254-6272(15)30151-5
• 10
  Hewlings S, Kalman D. A review of Zinc-L-Carnosine and its positive effects on oral mucositis, taste disorders, and gastrointestinal disorders. Nutrients. 2020;12(3):665. Published 2020 Feb 29. https://doi.org/10.3390/nu12030665
• 11
  Di Pierro F, Gatti M, Rapacioli G, Ivaldi L. Outcomes in patients with nonerosive reflux disease treated with a proton pump inhibitor and alginic acid ± glycyrrhetinic acid and anthocyanosides. Clin Exp Gastroenterol. 2013;6:27-33. https://doi.org/10.2147/CEG.S42512
• 12
  Jansson C, Wallander MA, Johansson S, Johnsen R, Hveem K. Stressful psychosocial factors and symptoms of gastroesophageal reflux disease: a population-based study in Norway. Scand J Gastroenterol. 2010;45(1):21-29. https://doi.org/10.3109/00365520903401967
• 13
  Dossett ML, Cohen EM, Cohen J. Integrative medicine for gastrointestinal disease. Prim Care. 2017;44(2):265-280. https://doi.org/10.1016/j.pop.2017.02.002