Treating GERD with Supplements

Q: I’m very interested in your nutritional approach for GERD, and any other natural remedies you would suggest. The nutritional information I’ve read is overwhelming and sometimes very confusing! Thank you!

A: GERD or Gastrointestinal reflux is usually a result of irritation of the esophagus from a relaxed esophageal sphincter. In some cases, it is a result of a hiatal hernia, or a bacterial infection called Helobacter Pylori.

Certain foods may aggravate GERD such as peppermint, citrus, dairy, tomatoes, grains containing gluten, as well as caffeine and alcohol. Medications such as non-steroidal anti-inflammatories, birth control pills and some heart medications may also aggravate the symptoms. NSAIDs can also lead to bleeding and ulceration in the stomach or small intestine.

The following supplements can be helpful for the symptoms of GERD:

• DGL (deglycyrrhizinated licorice root)
• Marshmallow root
• Slippery elm
• Aloe vera
• Melatonin
• Apple cider vinegar

Acid blockers may be necessary for severe gastritis, ulcer or Barrett’s esophagus, a precancerous condition, but prolonged use can lead to calcium and magnesium deficiency, and achlorhydria (absence of hydrochloride acid) leading to an overgrowth of bacteria in the small intestine (SIBO). This condition as well as H. Pylori are diagnosed by a breath test, and both are treated with different antibiotics and/or supplements like garlic and Candibactin.

Q: Thank you! I’ve been on acid blockers for over 10 years, and for the most part they have been of great benefit, but they don’t seem to be helping at this point. I’m on 2 Nexium daily. A paleo/low FODMAP diet was suggested to me. Any thoughts? And, both my parents had surgery for hiatal hernia and we’re on acid blockers their entire lives. Is this sometimes a genetic condition??

A: You may want to look into Small Intestinal Bacterial Overgrowth (SIBO) and achlorhydria. I agree with the dietary recommendations since paleo cuts out grains and dairy and the FODMAP looks at foods that may be associated with SIBO. It is possible that there is a genetic influence. We do know that inguinal hernia can be due to weakness in collagen fibers of the body wall and this is believed to be genetic. It is possible that something similar is occurring with the hiatal hernia as well.