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How to Manage Reflux Naturally

Reflux, or Gastroesophageal reflux disease (GORD) occurs when stomach acid frequently flows back into the oesophagus, leading to mucosal damage and symptoms such as heartburn, regurgitation of food or acid, chest pain, chronic cough, difficulty swallowing and dental erosion. While many people experience occasional episodes of reflux, long-term symptoms are referred to as GORD.


Some natural ways to alleviate GORD symptoms include marshmallow tea and a slurry (made by mixing the powder with a little water, so it coats the oesophagus)


There are many factors that contribute to the onset of GORD, the most common being reduced tone in the lower oesophageal sphincter (LOS). This can be caused by certain medications, such as NSAIDs, calcium channel blockers, barbiturates, and anticholinergics. Decreased saliva production and delayed stomach emptying are also contributing factors, as are lifestyle factors such as smoking, obesity, a diet high in fatty and processed foods, and alcohol consumption.

 

Gut dysbiosis has been shown to contribute to both reflux and GORD symptoms and slow transit time and methane overgrowth can increase symptoms. Gut dysbiosis occurs when there is an imbalance between beneficial bacteria and harmful bacteria in the gut microbiome. Certain species of Proteobacteria and Fusobacteria produce lipopolysaccharides (LPS) which contribute to systemic inflammation and are thought to promote reflux by oesophageal sphincter relaxation. Research shows that high levels of Proteobacteria and Fusobacteria are more evident in people with GORD.

 

Conventional treatment includes proton pump inhibitors (PPI), H2 Receptor Antagonists (H2RAs) and other antacids which reduce stomach acid and can help with symptom management. However, they fail to address the cause of the reflux and are associated with many side effects such as diarrhoea, nausea, and abdominal pain. They also increase the risk of Small Intestine Bacteria Overgrowth (SIBO), Colonic Methane Overgrowth (CMO), nutrient malabsorption, and gut dysbiosis.


Listed below are some of the recommendations that I suggest to my clients:


Dietary modifications:

 

1.      Eat a fibre-rich, plant-based, Mediterranean style diet.

2.      Avoid trigger foods such as chocolate, fatty foods, and processed foods.

3.      Avoid alcohol, sugar, and minimise coffee.

4.      Have a 3-hour window between dinner and bedtime.

5.      Do not consume fluid with meals or immediately after meals.

 

Lifestyle changes:

 

1.      Elevating the head of the bed by 20-30 cm can reduce night-time reflux.

2.      Stop smoking or vaping.

3.      Reducing weight can alleviate symptoms.

4.      Managing stress through breathing and nervous system support.

 

At the Microbiome Group we use Microbiome testing to help identify and treat any underlying drivers of reflux. We develop individual treatment plans based on your unique microbiome profile, which include dietary and lifestyle recommendations and targeted supplements.



REFERENCES:

De Bastiani et al. (2023) Assessment of small intestinal bacterial overgrowth and methane production in patients on chronic proton-pump inhibitor treatment: prevalence and role of rifaximin in its management in primary care. Minerva Gastroenterol 2023;69:523-8.

DOI: 10.23736/S2724-5985.21.03118-1

 

Baumeister et al. (2019) Gut microbiota and oesophageal disease – an update Microbiota Health Dis 1: e207 1 II.

DOI: 10.26355/mhd_20201_207



Vicky Ellenport BHSc NUT is a registered Nutritionist and Microbiome Analyst who uses a food first approach in her treatment protocols. You can find out more about consultations with her here: Vicky Ellenport | The Microbiome Group


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