From acupuncture to yoga: Everything you need to know about acid reflux

If you eat gassy foods--the result is heartburn, but if this condition becomes chronic--it's called gastroesophageal reflux disease (GERD). Here's how to deal with it.

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Picture courtesy: ivanarcangel.blogspot.in
Picture courtesy: ivanarcangel.blogspot.in

What it is: Reflux occurs when partly digested food and acid travel from your stomach up into your oesophagus, causing the telltale burning sensation in your chest. It can resemble a heart attack-hence the name heartburn. Some experience pain as food is being swallowed, the result of stomach acids pushing up while the food is trying to move down.

Why it happens: Normally, a muscle that acts like a valve between your stomach and oesophagus (called the lower oesophageal sphincter, or LES) prevents the backwash of food from the stomach. But when the LES is overwhelmed by pressure from your gut-which can happen if you eat gassy foods-the result is heartburn. If this condition becomes chronic (twice a week or more), it's called gastroesophageal reflux disease (GERD).

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Untreated, GERD can cause still more problems, such as a chronic cough, sore throat, hoarseness and chest pain. Severe acid reflux can injure the oesophagus, causing ulcers and strictures (narrowing of oesophagus) and even oesophageal cancer.

What's Known

  1. Mend Your Mattress Ways: The classic advice has long been to elevate your head while sleeping so that gravity helps keep stomach acid where it should be. That works-but here's a newer way: sleep on your left side, says Prateek Sharma, MD, a professor of medicine at the University of Kansas School of Medicine. That way, your oesophagus is optimally positioned to prevent acid from entering. This is because in a horizontal position, it's easier for the stomach acids to flow back into the oesophagus, causing reflux symptoms.
  2. Avoid Trigger Foods: Caffeine, alcohol, chocolates, carbonated drinks, spicy dishes, high-fat foods-take longer than other foods to move through your digestive tract, which lets pressure build in your stomach, creating reflux symptoms. "In cases where there's inflammation or active erosions in the stomach lining, acidic foods may worsen the symptoms of reflux. But, generally speaking, it's the overall food quality and eating habits that matter," says Prevention columnist and clinical nutritionist Ishi Khosla. She suggests having live food, (probiotics and sprouts), anti-inflammatory foods (flaxseeds, fish and berries) and fruits and veggies.
  3. Downsize Your Meals: "Having smaller, frequent meals is better-it's easier to digest than a large one. Also, keep a gap of 3 to 4 hours between your meal and bedtime,'' advises Khosla.
  4. Get A Move On: The more sedentary you are, the more you retard your gastric motility (the time it takes for food to pass through your system). Getting regular exercise helps minimise that potential and calm the nerves.

What's Natural
Belly Breathing: Practising this deep-breathing technique for 30 minutes a day can dramatically reduce the symptoms of reflux, according to recent research. Breathing exercises strengthen the muscles of the diaphragm and chest, which may help the LES prevent acid from seeping out of the stomach.

Acupuncture: One small study from Arizona looked at people on medication for heartburn who still had symptoms. Those who started acupuncture improved significantly than those who doubled their medication. Says Dr Shubha R, senior naturopath, SOUKYA International Holistic Health Centre, Bengaluru, ''Acupuncture surely helps in managing chronic reflux (if taken for a minimum of 14 sessions, each lasting 30 minutes). But, it has to be complemented with a proper diet, medication and relaxation techniques.''

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Alternative Meds: ''Ayurvedic medications like madiphala rasayana and indukantham kashayam, and homoeopathic preparations like Nux Vomica and Robinia are quite effective in easing reflux symptoms,'' says Shubha. However, these medicines need to be prescribed based on individual symptoms and constitution. Consult a certified doctor for a prescription.

Yoga/Massage: ''Stress is a known contributor and aggravator of acid reflux. Yoga techniques, like yoga nidra, pranayam and massage therapy are powerful antidotes,'' says Shubha.

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What's Tried & True
Antacids: For occasional heartburn, antacids, which contain compounds that help buffer stomach acid, can provide relief for up to 3 hours. Because they don't prevent acid from being produced, they're taken only after symptoms appear.

H2RA Drugs (Histamine Type 2 Receptor Antagonists): These were the primary drugs used for reducing acid secretion, before PPIs were discovered. These include Ranitidine and Famotidine. ''H2RA are quite effective in treating milder cases of acid reflux. Sometimes H2RA drugs may be introduced for a short duration to help wean the patient away from PPIs," says Dr Gourdas Choudhuri, director and HOD, Gastroenterology and Hepatobiliary Sciences, Fortis Memorial Research Institute, Gurgaon.

Proton Pump Inhibitors (PPIs): ''Available as omeprazole, lansoprazole, rabeprazole, pantoprazole, esomeprazole and the latest ilaprazole, the PPIs work by reducing/suppressing the formation of acid in the stomach,'' says Choudhuri. Explains Prevention advisor Dr Rajiv Khosla, senior consultant, Gastroenterology, Max Super Speciality and Holy Family Hospital, New Delhi, ''Generally, PPIs are prescribed for about 4 weeks, followed by smaller doses for some more time (if needed). Consult a doctor to determine the right dosage and duration for these. Though PPIs are relatively safe drugs, prolonged consumption can cause a decrease in calcium absorption by the body and an increased risk for intestinal infections.'' Experts also say that medication should be complemented with lifestyle changes for long-term relief from GERD.

Surgery: A laparoscopic anti-reflux surgery is the last option. "The upper portion of the stomach is wrapped around the lower end of the oesophagus, reinforcing the 'valve' that will prevent reflux," says Khosla.