The TV commercials for Tums and other antacid medications make it sound so easy: Pop a pill or two, and you wont have to worry about your heartburn. But in many cases thats the worst thing you could do. Your heartburn may not actually be the root of your problem, but rather just a symptom of it. Heartburn is the primary symptom of a much more serious condition called gastroesophageal reflux disease, or GERD. And all those acid-blocking remedies for heartburn are just masking and not addressing the real problem of GERD.
In GERD, the muscles of the oesophagus and the stomach, as well as the oesophageal sphincter (a circular muscle that separates the stomach from the oesophagus), dont operate properly. Either the sphincter can’t hold back the stomach’s swirl of acid and the enzyme pepsin, or the oesophagus can’t contract adequately to push substances down into the stomach. Delayed gastric emptying may also be to blame.
The primary symptoms of GERD include persistent heartburn, a sour or bitter taste in the mouth and regurgitation. These symptoms appear most often after meals, and especially at night when gravity isn’t working in your favour, and when swallowing is diminished.
Treating the actual cause of GERD, rather than the symptoms like heartburn, is the only way to get rid of it for good. But your symptoms wont go away overnight.
So you need a way to relieve your pain while youre working to cure it permanently. But you dont have to keep turning to Tums. There are a number of safe, natural herbs that can relieve the symptoms of GERD, like heartburn, without blocking the acid your body needs. Several top choices are slippery elm bark powder, marshmallow root powder, liquorice, and meadowsweet. But first, lets go over some of the other little-known facts about GERD.
There are three different types of GERD
Originally, researchers thought that GERD manifested in the same way in all people. Now we know that GERD occurs as three basic types:
1.) Non-erosive or negative-endoscopy reflux disease (NERD), which may account for up to 70 percent of patients with GERD (Aliment Pharmacol Ther 2003;17 Suppl 2: 43-51).
2.) Erosive oesophagitis and its more severe complications, such as oesophageal ulceration (Am J Gastroenterol 2002;97(8): 1901-09).
3.) Barretts oesophagus (Am J med Sci 2003;326(5): 264-73).
NERD is the mildest form of GERD and is a functional disease, which means that there are no changes to the bodys tissues. With erosive oesophagitis there are organic changes, such as erosion of the lining of the oesophagus or even ulceration. In the case of Barretts oesophagus, the cells lining the oesophageal wall change into what are thought to be precancerous cells.
If you think you may be suffering from some of these symptoms, you should see your physician to determine if it is GERD.
One of the theories on how GERD symptoms develop is that the lining of the oesophagus becomes weakened, leaving it vulnerable to acid even very small amounts (Gastroenterol Clin N Am 2002;31: S35-S44). But there are a number of herbs that have been used to supplement the lining of the oesophageal wall by providing an extra protective barrier. These herbs are rich in a substance known as mucilage.
Protect against GERD by adding extra armour to your stomach wall
Mucilage is a sticky gel-like polysaccharide found in certain herbs. The best examples are slippery elm bark powder and marshmallow root powder. When taken after meals, the specific herb mixes with digestive secretions and forms a protective gel on top of the food in the stomach. So, if any reflux does occur, the first thing that comes through is the mucilaginous gel rather than the acid. The gel also puts a protective coating on the lower oesophagus, which protects it from subsequent acid attack. As implied above, these herbs are best taken in powder form (either loose or in capsules): Take a rounded teaspoon of powder mixed with a little water or three capsules after meals and before bed if heartburn occurs at night.
Liquorice is a staple natural medicine recommendation for stomach ulcers, but it can also be quite useful for GERD (Mills S, Bone K. Principles and Practice of Phytotheraphy: Modern Herbal Medicine, Churchill Livingstone, Edinburgh, 2000, 465-478). Like the mucilaginous herbs it is taken after meals, at a dose of extract equivalent to about one gramme of root (typically 300mg of extract). Long-term use of liquorice can lead to high blood pressure, so if you already have this condition or are at risk for it, use a form of liquorice known as DGL (deglycyrrhinized liquorice), which is much lower in the phytochemical that causes the hypertension, but still works.
Another herb much loved by English herbalists, is meadowsweet (Filipendula ulmaria). Theres not much scientific research behind it: Its use for digestive complaints is largely traditional. Meadowsweet can be brewed into a tea and taken that way, or you can take it in liquid extract or tablet form. About the equivalent of 500 to 1,000mg of herb is a typical dose, again taken after meals.
Good advice or old wives tale?
Youve probably heard some pretty interesting advice for combating heartburn everything from propping the head of your bed up with bricks to avoiding hot peppers. Is there any value in this advice? The answer is both yes and no. I dont think its necessary to put bricks under your bed, but some people do say that sleeping on their left side does seem to help if you experience heartburn at night (Am J Gastroenterol 2000;95(10): 2692-97).
You should certainly avoid overeating, drinking too much liquid with meals (especially carbonated drinks), and eating foods that trigger attacks. But sometimes more subtle food intolerances can underlie GERD. In particular, the usual suspects, namely dairy products and gluten-containing foods, may be to blame. Theres certainly no harm in experimenting with eliminating foods in either of these categories from your diet (one at a time) to see if you get any additional results.