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What’s Laryngopharyngeal Reflux?

Laryngopharyngeal reflux is also known as LPR for short. The difference between acid reflux as it normally occurs and LPR is that the gastric contents reach the upper part of the esophagus causing symptoms such as asthma (maybe), hoarseness, coughing, sore throat, possibly even dental erosion.

Strangely enough, heartburn is a symptom in fewer than half the people who have laryngopharyngeal reflux. That’s probably why it’s also called “atypical reflux”.

GERD has been recognized as a problem involving acid reflux since the 1930s. But the influence of stomach acid on the larynx was only really recognized in 1968, and the link between respiratory conditions and acid reflux was only acknowledged in 1979.

The good news is that even though the condition was slow to be recognized, treatment can be very effective, and the treatment of LPR reflux disease eliminates LPR symptoms in the airways and lungs.

By comparison with people who have GERD, where heartburn is the chief symptom, laryngopharyngeal reflux produces symptoms higher up the esophagus or in the larynx or pharynx.

Symptoms of Laryngopharyngeal Reflux?

Other symptoms of laryngopharyngeal reflux include postnasal drip, difficulty swallowing, wheezing, Globus pharyngis, and constant throat clearing. Heartburn is not a symptom in the majority of cases.

We assume this is because the stomach acid contents simply don’t stay in the esophagus for long enough to cause damage, but they reach the much more sensitive tissues of the throat, producing perhaps a burning sensation, spasm, or difficulty in breathing. It’s been reported that the sensations are most acute in the early morning just after waking from sleep.

Unfortunately, the diagnosis of laryngopharyngeal reflux is rather difficult because of the wide range of symptoms that may be displayed, and the fact that there are a number of other causes for these symptoms.

One of the diagnostic tools that tends to be used is the administration of acid suppression drugs: if this results in a reduction of symptoms, the implicit diagnosis is LPR. However, some scientific studies have emphasized that it’s important to measure the level of acidity in the pharynx to be absolutely sure of the cause of the symptoms.

Management of the condition tends to involve weight loss and diet changes, together with proton pump inhibitors. Although effective in the majority of cases of GERD, they are sometimes not as effective in treating LPR.

It is important, however, to treat this condition because there are some serious complications which include laryngeal granulomas, laryngospasm, laryngeal granulomas, subglottic/glottic stenosis, and even (fortunately rarely) laryngeal carcinoma.

Diagnosis

To emphasize the difference between the conditions we can look at the diagnostic criteria using pH monitoring.

A diagnosis of GERD would be made if somebody experiences more than 45 episodes of reflux per day, or has prolonged exposure to acidic stomach material in the lower esophagus. (Some exposure is normal, and occurs during belching.)

However, only one or two episodes of reflux that reaches a pH of below 4 in the upper esophagus are regarded as characteristic of LPR. It’s only true that some variation between different medical facilities in these diagnostic criteria, but the theme is always the same: laryngeal and pharyngeal mucosa are much more easily damaged by acidic stomach contents than the esophagus.

So we can conclude that LPR and GERD are two separate and distinct conditions, and the question, therefore, is whether they should be treated differently.

Certainly, the way the esophagus functions appears to be different in the two conditions. The clearance of acid from the esophagus takes a much longer time in individuals who have GERD than it does in those with LPR. Furthermore, the motility of the esophagus is quite different between the two groups, and so is the pattern of reflux, since LPR patients are much more prone to reflux while standing and GERD patients are much more prone to reflux when lying down.

Assuming that medical investigation, which may include pressure testing and pH probe testing, reveals a clear diagnosis, what is to be done?

Treatment

There’s a difference in the way that patients with LPR and GERD respond to anti-acid medication. Proton pump inhibitor (PPI) therapy must be much more intense for LPR patients than for GERD patients, in whom the administration of PPI therapy often results in rapid improvement in symptoms.

Furthermore, a report from Reavis and colleagues indicated that people with LPR are much more at risk of esophageal dysplasia than those with GERD, so effective treatment is actually really important.

What Causes This Kind Of Acid Reflux?

The problem is there’s not a lot of information about the etiology and causation of laryngopharyngeal reflux. Obesity is not a factor; and individuals with LPR often have apparently normal motility of the esophagus; furthermore, LPR often occurs when people standing; and the reflux events tend to be rather brief compared to the prolonged ones that are symptomatic of GERD.

All of this raises a number of interesting questions. The damage to the larynx characteristic of LPR is caused by both acid and activated pepsin. This damage is often irreversible. Regrettably, however, the etiology of events that cause LPR is largely unknown.

The most likely hypothesis is currently that there is a dysfunction of the upper esophageal sphincter. The most common symptoms found during the investigation are simply those of chronic inflammation; serious changes such as ulcerative disease or cancer are much rarer.

One of the most unpleasant (and dangerous) symptoms of LPR is paroxysmal laryngospasm. You can read more about this here.

Treatment

As mentioned above, treatment for LPR and GERD are different. It turns out that the resistance of the esophagus to acid damage is considerable, apparently being able to tolerate up to 50 acid reflux episodes every single day without injury; by contrast, it appears that only three episodes of exposure of the larynx to acid and pepsin can produce injury; this means that chronic therapy is probably the answer for LPR.

A daily dose of PPI, which inhibits the final stage of acid production, can be effective in controlling stomach acid but the effects tend to last for only 14 hours. With LPR it’s, therefore, necessary to take another dose in the evening to ensure that the laryngeal mucosa receives 24-hour protection.

As an adjunct to medication, counseling on lifestyle and diet changes is usually appropriate. In younger patients who have very severe LPR, Nissen fundoplication surgery may be the treatment choice.

* Reavis KM, Morris CD, Gopal DV, Hunter JG, Jobe BA. Laryngopharyngeal reflux symptoms better predict the presence of esophageal adenocarcinoma than typical gastroesophageal reflux symptoms. Ann Surg 2004;239(6):849–856; discussion 856–858.

Acid Reflux Treatment – Effects Of PPIs

Hydrogen receptor antagonists are drugs that were developed to decrease the production of stomach acid, in other words as a modern acid reflux treatment. They work by blocking the action of histamine on parietal cells in the stomach. Although extremely popular and successful, and widely used in the 1980s and 90s for the treatment of heartburn symptoms and dyspepsia, they have been supplanted by proton pump inhibitors.

The safety of these drugs in treating acid reflux is recognized in the fact that the most common members of this group of medications – namely cimetidine, ranitidine, famotidine, and nizatidine – are all available over-the-counter without a prescription.

The first drug to be developed in this group was cimetidine, which is marketed as Tagamet. Its development can be traced back to the fact that as long ago as 1964 scientists recognized that histamine stimulates the production of stomach acid. However, they also knew that traditional antihistamines do not affect stomach acid production. This led scientists to the conclusion that there were two types of histamine receptors, and if they were able to identify the one in the stomach, they would be able to produce a compound that inhibited its action.

By analyzing the structure of histamine, and manufacturing hundreds of compounds to try and identify antagonists of the unknown hydrogen receptor in the stomach, they were able to eventually manufacture cimetidine. This proved to be a breakthrough in the medical treatment of the symptoms of acid reflux. Subsequently, another company refined the structure of the compound and in doing so produced ranitidine, which was marketed as Zantac. This product was found to be more powerful and have a longer-lasting effect. By 1988 it was actually the world’s largest-selling prescription drug. A most effective remedy for acid reflux it was, too, as my story indicates.

These drugs work by competing with histamine for the parietal cell hydrogen receptor; firmly attached to this, they block the secretion of acid. This has proved incredibly effective in treating peptic ulcers, gastroesophageal reflux disease, and dyspepsia.

For those who suffered – and still do – from stomach problems caused by stress, the introduction of these hydrogen blockers was a radical and immensely transformative experience. They’re still extremely useful for people who are looking for a heartburn remedy and are much more effective at suppressing the symptoms of acid reflux than simple antacids, whose effect is limited and the duration of which tends to be rather short. Cimetidine proved to have a number of side effects, which led to the other products becoming more popular.

These drugs are being replaced by proton pump inhibitors, which have now become the preferred treatment for heartburn, GERD, and esophagitis, due to the fact that they promote healing rather better than hydrogen antagonists.

Proton Pump Inhibitors

Proton pump inhibitors work by blocking the action of hydrogen potassium ATPase which then inhibits gastric acid production. They are now the medication of choice for acid reflux treatment and the cure of gastroesophageal reflux disease and peptic ulcer.

The final step in acid production is clearly the one that is most beneficial to “attack”. The action of the proton pump in the secretory membrane of the parietal cell was known to fulfill this requirement; using newly discovered compounds known as benzimidazoles allowed scientists to develop refined products such as omeprazole which effectively stopped the production of acid in the stomach.

These compounds have a sophisticated mechanism of action, but basically, they target the last step in acid production, which is therefore independent of the stimulus to acid secretion, and they also bind to the enzyme, which makes their effect long-lasting.

Naturally enough, this work continues: the development of more sophisticated ways of treating acid reflux is the goal. Although PPIs share some common molecular structural features, the fact that they have different chemical formulae results in different levels of effectiveness, activation at different levels of pH, and speeds of metabolization by the liver.

They have “revolutionized” treatment of acid reflux, but a new class of drugs is now under development — the potassium competitive acid blockers will acid pump antagonists.

Regrettably, proton pump inhibitors do produce an elevated chance of the development of food allergies because of the presence of undigested proteins in the stomach which then pass into the small intestine. This leads to the possibility of sensitization to proteins and allergic reactions, but it’s unclear whether this is a consequence of long-term use only.

In general, they have few side effects, but those which do occur include headache, nausea, abdominal pain, and some more subtle effects such as decreased vitamin B12 absorption. The use of these drugs is also associated with an increased risk of acquiring pneumonia, skin aging, and Clostridium difficile infection.

Furthermore, long-term treatment of acid reflux with PPIs seems to produce an increase in the likelihood of fracture of the hip, wrist, and spine of people aged 50 or older. This seems to be because these drugs interfere with the bone production mechanism of the bone producing cells osteoclasts.

And discontinuation of the prescription seems to produce a rebound effect whereby gastric symptoms are temporarily increased – although this is a short-term effect, it can be a problem.

Acid Reflux Home Remedies

Finding Home Remedies That Work Is Easier than You Think!

Acid reflux remedies can be a very effective way of dealing with heartburn and reflux pain. There are medications available for these conditions, but they have some significant drawbacks which can read about elsewhere on this site. Acid reflux home remedies can be very effective way to get relief from the pain.

Antacid Tablets

One of the most common home remedies for acid reflux is calcium, in one form or another. It’s a component of many antacid tablets that are available over-the-counter without a prescription. However, if you find that you’re consuming lots of antacid tablets, you should see a doctor – you may have gastroesophageal reflux disease. Furthermore, long-term heartburn needs attention as it can lead to inflammation of the esophagus (esophagitis) and more serious complications like Barrett’s esophagus.

Iberogast

Other natural remedies for acid reflux include herbal remedies, which are not widely known about. One of the most effective is a German product called Iberogast. This product contains nine different herbs, which are peppermint, licorice, milk thistle, greater cell and dined, lemon balm, German chamomile, clowns mustard plant, Angelica, and Carraway.

This is a very interesting mixture of herbs, put together after many years of development. And, very excitingly, if you look at Amazon, there are a lot of favorable reviews for this product. In fact, out of 120 reviews, 75 are 5-star, and 18 are 4-star.

This acid reflux home remedy is not so well-known in North America but has been used extensively in Europe for many years, so it deserves some investigation! I started off by looking at Amazon.com to establish exactly what people have said about this product. A typical reviewer taking Iberogast said he started to use it three months ago, at a point where he was having “awful” heartburn and acid reflux with accompanying nausea.

(In general, many people turn to Iberogast because their doctors have simply said there was no more to be done, often after prescribing proton pump inhibitors or PPIs. Certainly a lot of people taking Iberogast talk about how miserable their lives were due to the acid reflux symptoms. Clearly finding home remedies for acid reflux that actually work was very important to them.)

So the person in question ordered Iberogast from Amazon and found that after two weeks of taking it he wasn’t experiencing anything like as much acid reflux. At this point he decided to reduce his daily dose of proton pump inhibitor – PPI – by 50%, that is, from two tablets of Protonix per day to one tablet.

After taking the acid reflux home remedy Iberogast for two months, his prescription for the proton pump inhibitors tablets ran out. Extraordinarily, he says he has not taken any PPIs since. He continues to take Iberogast. This man admits that he did make an effort to reduce his weight and stress levels, and adopt a more relaxed lifestyle, so it’s not entirely clear whether this product, Iberogast, apparently the best of the acid reflux home remedies, was entirely responsible for the improvement in his acid reflux symptoms, but it’s certainly an interesting review.

Another reviewer says: “I too have been having a positive experience with Iberogast.” He goes on to say that he’s a retired military officer in good health except for a bad stomach condition which began in 2009. A series of endless tests including a colonoscopy, Barium swallows, and so on, revealed nothing.

Only when he went to Germany and spoke to a pharmacist did he hear about Iberogast. It’s an all-natural home remedy for acid reflux, he observes, and it has no toxicity (unlike some modern medications, I regret to say). So there’s no strain on the liver or any other organs. At the time of writing, the reviewer writes that he’d been taking Iberogast for only a week, but he had felt significant relief for the first time after 18 months of everyday acid reflux discomfort!

He also makes the point that Germany, where the product is made, and where he bought the product while on vacation, is the leader when it comes to natural remedies, with professionals who know exactly which product works for which ailment.

Another Amazon reviewer, reporting in 2011, says that she’d even been to the Mayo Clinic for answers to her difficulties with irritable bowel syndrome, gastroesophageal reflux disease, and general stomach problems. Her attempts to solve the problems she was experiencing by taking prescribed medication only resulted in a whole load of side-effects which were actually worse than the stomach problems she was experiencing beforehand.

After finding a doctor who worked outside mainstream medicine, she was recommended Iberogast and after taking it for only two weeks she reported “an improvement in the condition”. She concludes: “I highly recommend this product.” It is an effective acid reflux treatment.

Now people’s experiences of taking acid reflux home remedies, or home remedies for anything else, are all very well, but they are not scientific reviews. What we need to do is look for scientific research that has been conducted on these home remedies and find out whether or not if there’s any evidence that they live up to the recommendations and testimonials on Amazon.

So let’s begin by thinking about what may cause acid reflux before we consider the use of home remedies. In my research, I found Badgut.org. This is an interesting website that seems to be specifically about helping people to overcome problems with their stomach and gut. They talk about the correlation between vague symptoms of irritable bowel syndrome (IBS), dyspepsia, and other stomach conditions.

They also point out that stomach conditions are often chronic in nature, may come and go, and often get worse after meals. Without any specific diagnosis, complaints are sporadic, and there may be no consistent identifying factors. It’s certainly possible that stress is playing a role in all stomach ailments, particularly IBS and heartburn, dyspepsia or acid reflux.

Regardless of the origin of these conditions, Badgut.org focuses on finding home remedies for acid reflux and other stomach issues which will deal effectively with acid reflux, IBS, and heartburn, and they have a feature on Iberogast. Their claim is that 20 million people use it, and only 18 have reported adverse events over the years, which seems extraordinary!

The product is made in Germany, used throughout Europe, and has finally reached North America. It’s a herbal tincture which contains no salt or yeast, no dairy products, no artificial ingredients, and no allergens like gluten.

The claims made for this herbal acid reflux home remedy are quite extraordinary. They include the relief of intestinal spasms, the reduction of acid production, the power to act as a local anesthetic, and the ability to inhibit the growth of Helicobacter pylori (which can be responsible for the formation of stomach ulcers).

If these claims are true, this product is a truly remarkable home remedy for acid reflux and heartburn. Badgut.org says: “A four-week study involving 208 patients with stomach problems showed that it was generally effective in reducing symptoms.”

But we need more evidence than that! PubMed has a report on Iberogast which seems to suggest it really is as effective as its proponents claim. In reviewing this herbal remedy, the authors start by making the observation that it’s a complex herbal preparation of nine constituents (these are listed above). The study investigated therapeutic effectiveness, toxicity, how well the product was tolerated and made clinical observations on a group of people who had been taking drugs for symptoms of dyspepsia (think acid reflux or heartburn) and irritable bowel syndrome.

The authors found that the chemical composition of Iberogast, an acid reflux home remedy, was such that it could benefit individuals whose gut musculature was either tense and spasming or lacking muscular tone. This is truly remarkable and probably explains why the product is so effective in reducing the symptoms of functional dyspepsia and IBS (irritable bowel syndrome). At the time of this study – 2002 – Iberogast was approximately as effective as the prescription drugs called prokinetics.

Because Iberogast targets only the gastrointestinal tract, it’s perfectly safe; also its constituents are non-toxic. The conclusion of this study was that it could actually become the first choice in the treatment of functional gastrointestinal diseases.

Now, times have moved on since 2002, of course, and there are a whole series of different drugs now available for the treatment of acid reflux, most notably proton pump inhibitors or PPIs. These are about as far away from home remedies as it is possible to get! And although they’re extremely effective at reducing acid production, they haven’t been prescribed for a long time, so the long-term effects are unknown. Iberogast, by contrast, is a home remedy for acid reflux that has been prescribed for 40 years and is known to be safe.

So what does the scientific research say about Iberogast? A study reported in the prestigious journal Nature, in 2007, reported that Iberogast did indeed have significant effects on the activity of the intestinal tract, improving motility, and significantly reducing functional dyspepsia.

A study reported in Neurogastroenterology & Motility Volume 21, Issue 6, pages 632–625, June 2009, concluded there was a significant improvement in a group of people taking Iberogast, and the researchers were able to observe a significant impact on the activity of the stomach and gut.

In summary, this is one of the natural acid reflux home remedies which seems to work for around 60% of the people who take it, and it’s a remedy which is perfectly safe, a home remedy which beats acid reflux, and which may even allow you to gradually stop taking prescription medication. In short, it’s highly recommended.

As this important study observes: “….drugs for treating functional gastrointestinal disorders currently recommended in guidelines are proton pump inhibitors, antidiarrheals, anticholinergic spasmolytics, tricyclic antidepressants, and herbal drugs. All possess specific tolerability issues that have to be evaluated and considered when selecting a suitable therapy for patients. Proton pump inhibitors tend to be over-utilized. They have been associated with rebound acid hypersecretion, which may aggravate the symptoms of functional dyspepsia.”

They report that in a study on 2267 people with functional dyspepsia, patients received Iberogast for up to 4 weeks. 27% of patients discontinued therapy after 1 week because they were free of symptoms! Symptoms decreased on average by 78%. Approximately 80% of physicians and patients assessed the effectiveness of Iberogast as very good or good. There were no adverse drug reactions to Iberogast or any other interactions.

In another study, there were significantly more symptom-free patients after therapy with Iberogast than after metoclopramide. Furthermore, the time off work was significantly shorter under Iberogast than under metoclopramide. There were no adverse drug reactions to Iberogast, but five patients receiving metoclopramide reported vertigo and dizziness. In line with these results, 90% of physicians rated the tolerability of Iberogast as very good, compared to 71% for metoclopramide. WOW!

Other Practical Acid Reflux Home Remedies

Other excellent strategies and home remedies for soothing acid reflux and heartburn include the following:

Be careful what you eat

 

There may well be some specific foods that trigger your heartburn. These triggers tend to differ from person to person, but there are some which are frequently blamed for causing heartburn. These might include peppermint, caffeine, chocolate, citrus fruit juices, spicy foods like honey and chilies, garlic, high-fat foods, and even tomatoes. The only way you can identify which foods are causing you discomfort and heartburn is to keep a food diary and monitor which foods tend to produce a reaction of excess acid or acid reflux. It’s true, as we’ve always said, that the best home remedies are under your own control! (Image courtesy of Stuart Mile / FreeDigitalPhotos.net)

Be careful when you eat

It’s always a good idea to take five or six small meals a day rather than three big ones because eating a large quantity of food at any one time can trigger heartburn quite badly. Once again, you need to experiment with your own dietary conditions to see exactly what causes your symptoms to get worse.

Be careful how you eat

Now, this is an important one because eating slowly can certainly help as a remedy for acid reflux.

Lose weight

One of the most powerful acid reflux “home remedies” is to lose excessive body weight. This is because a bloated abdomen with internal fat compressing the stomach, makes acid reflux much more likely. If you can follow a diet and exercise program, not only will you shed extra pounds, but you’ll also reduce your stress level, which is also associated with acid reflux symptoms.

Get rid of cigarettes and reduce alcohol

Although you may be fond of both of these, there’s no doubt that smoking certainly reduces the tone in the muscle which stops acid regurgitating upwards into the esophagus. Not only this, but giving up smoking is a remedy for many other health conditions, so it’s a great time to quit.

Make sure you wear loose clothing

A very simple acid reflux home remedy is to wear clothing that is loose around the abdomen so that the pressure on the abdomen is reduced and the pressure on the stomach which causes acid to move upwards into the esophagus is much reduced.

Tilt your bed

A simple remedy often put forward as a remedy for heartburn and as an acid reflux remedy, but still well worthwhile is to raise the head of your bed by 6 inches by putting blocks under the top legs of your bed. (Propping yourself up on pillows will not work.)

Acid Reflux Treatment

GERD, Heartburn, and Acid Reflux Treatment Is Easy!

One of the questions I’m often asked is whether or not acid reflux treatment with lifestyle changes and dietary changes is a realistic approach, or whether treatment using prescription drugs is necessary.

The answer is that acid reflux remedies can be very effective, and are well worth trying. And, yes, sometimes medical help is needed. This is because acid reflux symptoms, heartburn, and GERD signs and symptoms (GERD stands for “gastroesophageal reflux disease”) are actually quite variable; some people obtain relief quite quickly and easily, while others have a problem that seems to be more resistant to treatment of any kind.

This means that you may have to try a number of approaches until you discover the one that works best for you.

Some therapists believe that one of the most effective methods of treating acid reflux symptoms is to keep a food diary in which you note everything you eat and the consequences you experience. This allows you to eliminate from your diet with foods which appear to cause symptoms of GERD or acid reflux.

The usual culprits include alcohol, smoking tobacco, heavy meals, fatty foods, spices, caffeine, carbonated drinks, citrus products, acidic juices, acidic condiments like vinegar, and possibly other items. Keeping a food diary will allow you to identify these. But there are many other acid reflux home remedies that are widely recommended and often help clear the symptoms of heartburn and GERD.

The best approach to a complete lifestyle package for the control of GERD and acid reflux is described in the eBook Heartburn No More: you can discover more about this if you look at the feature in the right-hand column of this page.

Treatment: Acid Reflux Remedies & Home Remedies

In general, advice about acid reflux remedies can be summarized as follows:

1) Eat smaller meals, and have more of them. Overloading your stomach is likely to trigger the dysfunction of the lower esophageal sphincter which results in acid being allowed into the esophagus. So two or three large meals every day should be replaced by, say, four or five smaller ones.

2) Don’t eat for at least two or three hours before you lie down. We know that people with gastroesophageal reflux disease are much more likely to experience reflux when lying down and standing up. It follows that if you have a heavy meal, or indeed anything, near to your bedtime, you’re precipitating the chances of experiencing reflux. And you want to avoid that night, if possible.

3) If you need to take rest during the day, sleep sitting in a chair, perhaps reclining slightly for a nap. Adjust your clothing so that you’re not wearing anything tight around your stomach area. Certainly, tight-fitting clothes can increase the pressure in the abdomen when you bend or move about, and we know that’s one cause of acid reflux.

4) If you’re overweight or even obese, it’s important to lose weight, because the pressure in your abdomen is going to be much higher. This means that when you bend or move about the contents of the stomach are more likely to reflux into the esophagus.

Admittedly, losing weight isn’t always easy, but there’s a balance to be found between your tolerance for discomfort and your willpower about losing weight. And, as you can easily see, all these lifestyle modifications are a cheap form of acid reflux treatment!

5) It’s also worth checking with your doctor to see if any of the medication you’re taking might be responsible for acid reflux of stomach problems. Certainly, things like anti-inflammatories, NSAIDs (i.e. non-steroidal anti-inflammatories), can cause stomach problems.

Medication As Treatment For Acid Reflux

You may find that lifestyle changes and over-the-counter medications are sufficient to eliminate the symptoms of acid reflux. The simplest over-the-counter medications you can obtain are antacids, such as Maalox, Rennies, Mylanta, and so on.

These are simple alkaline compounds that react with the acid to neutralize it. Unfortunately, they can cause diarrhea or constipation, and they are not really an effective long-term solution, even though they can serve as a powerful treatment in the short-term. (Image courtesy of sattva / FreeDigitalPhotos.net)

There are a number of other products which you may already know about. Products like Gaviscon coat the inside of the stomach and reduce the symptoms of acid reflux.

Then there are hydrogen blockers, which were the first so-called “blockbuster” drugs, and which proved very effective in helping people with excess stomach acid. These compounds are still available, many of them over the counter; they include Pepcid, Tagamet, and Zantac. (Famotidine, Cimetidine, and Ranitidine, respectively).

These products can be an effective treatment for heartburn and gastroesophageal reflux disease, but like all medications, they may have side effects.

The latest generation of medication available to treat acid reflux is the proton pump inhibitors such as Prilosec, Prevacid, and others. These tend to be more effective at stopping the production of stomach acid, but they don’t treat acid reflux effectively in all cases, and they do have some side effects, about which you can read more information below. However, they are now regarded as the reflux treatment of choice.

Acid Reflux Treatment: Surgery

If the treatments mentioned above aren’t effective, a surgical procedure known as the Nissen fundoplication may be desirable.

This is actually the treatment commonly used for paraesophageal hiatus hernia, but it can also be used in other situations where medication for GERD is either ineffective or undesirable. It was developed by Dr. Rudolph Nissen in 1955 and has gained popularity ever since.

It’s called a fundoplication because the gastric fundus – which simply means the top part of the stomach – is wrapped around the bottom part of the esophagus and stitched into place. This has the effect of reinforcing the lower esophageal sphincter; in addition, the hiatus through which the esophagus passes into the stomach is tightened up with sutures. In the classic procedure, the gastric fundus is taken all the way around the esophagus and stitched in place, although partial fundoplication is also possible, especially in cases where achalasia* is present.

The effect of the surgery, which is usually performed laparoscopically, is to prevent acid reflux, because when the stomach contracts, it seals off the entrance to the esophagus. Unfortunately, there can be side effects, particularly gas bloat, but these tend to reduce with time. In general, fundoplication is regarded as both an effective and safe procedure.

Video About Treating Acid Reflux


*Achalasia
 is an esophageal motility disorder, which affects the lower esophageal sphincter causing it to lack of muscle tone. The motility of the esophagus is reduced so peristalsis doesn’t function correctly. This can make it difficult to swallow, the symptoms of achalasia include difficulty swallowing, regurgitation chest pain.

Side Effects Of Acid Reflux Treatment With Drugs

When they first came out, some experts thought that PPIs might increase the risk of stomach cancer. This was untrue, but people may take PPIs on a daily basis for years, so it’s important to know if there are any other interactions.

1) Interaction with clopidogrel (marketed under the names of Ceruvin, Clopilet, and Plavix).

Clopidogrel discourages blood clots and helps prevent heart attacks and stroke for heart patients. But clopidogrel increases the risk of gastrointestinal bleeding. A PPI prescribed with clopidogrel makes blood clots less likely to form… but unfortunately PPIs — and omeprazole in particular — inhibit an enzyme crucial to the activation of clopidogrel. In 2009, the FDA warned that patients taking clopidogrel should avoid taking omeprazole because PPIs cut clopidogrel’s effectiveness by 50%.

However, two studies published in 2010 showed no increase in a heart attack or stroke among those taking a PPI with clopidogrel. This acid reflux treatment drug did seem to reduce the risk of gastrointestinal bleeds. Opinions vary, however: FDA officials pointed to flaws in the interpretation of the trial and stuck by the agency’s warning. The American Heart Association, the American College of Cardiology, and the American College of Gastroenterology recommended an individual risk-benefit approach for each patient. For example, older people, those taking warfarin, and those with a prior gastro-bleed, among others may need a PPI.

Another strategy might be taking a PPI and clopidogrel at separate times. PPIs work best if they are taken first thing in the morning,so clopidogrel could be taken at night.

Fracture risk. Some studies have linked PPIs and a higher risk of fracture of the hips, but the evidence is not conclusive. Even so, the FDA decided in 2010 to issue a warning about it. Some research shows that PPIs may reduce the absorption of calcium from the duodenum, causing osteoporosis, and a higher risk of fracture. Though small, the risk may be another reason for not taking a PPI unless essential.

Pneumonia risk. Studies of treatment of acid reflux with PPIs suggest people taking PPIs seem to be more likely to get pneumonia – both people living in the community and hospital patients. This appears to be because reduced stomach acid allows the bacteria count can go up. And then treatment for acid reflux allows bacteria-laden stomach contents to move up the esophagus and into the trachea and lungs, causing pneumonia.

C. difficile risk. Clostridium difficile infections develop in hospitals after people are prescribed antibiotics. Such infections cause diarrhea but can also become life-threatening. There is a link of some kind between PPI use and C. difficile infection: experimental evidence indicates that PPIs may make the gut environment more favorable to C. difficile bacteria.

Iron and B12 deficiency. Stomach acid helps the body absorb iron and vitamin B12. An unintended consequence of PPIs might be deficiencies of this vitamin and mineral, but research has shown that the effect is mild, so this aspect of acid reflux treatment is not a cause for concern.

Acid Reflux Symptoms

GERD & Heartburn Treatment Is Easier Than You Think!

The symptoms of acid reflux tend to be rather obvious: burning pain in the chest, which is alleviated by the use of antacids or other medication, belching, burping, perhaps the taste of acidic stomach contents in the mouth or throat…. if you suffer from acid reflux you probably know exactly what I’m talking about.

And the symptoms are often worse when you lie down or at night in bed, and also after a heavy meal.

However, there are less common acid reflux symptoms that it’s well worth knowing about because sometimes acid reflux appears in an unusual way. It’s important to treat acid reflux because if it becomes chronic, it can lead to Barrett’s esophagus, which is a precursor to cancer. So here are symptoms of acid reflux, both well-known and not so well known. If they’re familiar, you need to pay some attention to them.

1) Chest Pain

Obviously this occurs because stomach acid is moving up into the esophagus, and it’s the most classic and obvious symptom of acid reflux.

But when the pain lasts for a long time or is even more intense than you might expect, it can be mistaken for a heart attack. Unfortunately, it sometimes is a heart attack. This is due to the fact that the stomach and heart share branches of the same nerve – the vagus nerve.

In practice, you’re likely to know the difference, but it’s important that a sudden and unexpected onset of chest pain is not ignored. Indeed, one study found that in a group of people presenting at a hospital with symptoms of GERD (gastroesophageal reflux disease), around 0.6% had symptoms due to ischemic heart disease.

Clearly, therefore, cardiac disease is one of the first things that has to be checked for in men and women whose chest pain is unexplained. Having said that, apparently as many as 30% of patients who are undergoing investigation of cardiac conditions due to chest pain produce no findings which account for the discomfort they’re experiencing.

These patients are often defined as having chest pain of undetermined origin, although a series of studies have revealed that when investigation based on pH and pressure monitoring in the esophagus is carried out, around 25% to 50% of these patients have evidence of abnormal GERD.

2) The Pain Worsens When You Lie Down

It makes sense when you think about it: stomach acid is supposed to stay in the stomach, but if the valve between the esophagus and stomach is weakened, then obviously there’s going to be more tendency for the acid to move up into the esophagus when you lie down or bend over. No wonder this is a symptom of acid reflux home remedies for which can be found here. It is also a symptom of heartburn.

The pressure of abdominal organs can cause stomach contents to move up into the esophagus; if you’re lying down, you lose the effect of gravity keeping contents of the stomach where they should be, so that the acidic material is more likely to move up into the esophagus.

This is the reason for that popular piece of advice so often given on sites about GERD and heartburn symptoms: raise the head of the bed by 6 inches or so so that you minimize the chances of reflux during the night, and do not eat a big meal in three hours before bedtime.

3) Pain Just After Eating

We’re all familiar with the sense of indigestion that comes from eating too much or too quickly, but when you experience symptoms of acid reflux after a meal, it may mean that you’re eating too much, so that the valve between the esophagus and stomach is overloaded, or it may mean that you’re eating the wrong things. The culprits here tend to be big fatty meals, alcohol intake, and smoking tobacco.

4) GERD Leaves A Bitter Taste

If you’ve ever had a case of reflux that was so strong you nearly vomited, you probably know exactly what acidic material in your mouth or throat tastes like. It’s not exactly pleasant. Indeed, these symptoms of acid reflux can be worse than unpleasant: they may cause choking. Certainly, if this happens at night you should see a doctor. If you wake up choking, you need medical attention urgently.

5) Symptoms Of Acid Reflux Can Make Your Voice Croaky

One of the most peculiar symptoms of acid reflux is hoarseness. The strange thing about reflux is that it can happen without the burning sensation, but the acid may reach as far as your vocal cords and begin to irritate them so that you become hoarse. If this happens more often just after you’ve eaten, it’s probably a sign of reflux. Read more about pharyngeal reflux here.

6) Sore Throats Don’t Always Mean A Cold

Although we tend to associate sore throats with coughs and colds, it’s entirely possible for acid reflux to cause a sore throat which becomes chronic. If you have no other symptoms, you might look at the possibility of acid reflux remedies.

7) Coughing

It follows that other respiratory symptoms such as coughing and wheezing can also be due to heartburn or acid reflux symptoms. One of the ways that you can establish whether or not this is true for you is by having ambulatory pH monitoring, where the amount of acid that is reaching your esophagus is measured over a 24-hour period as you go about your daily activities.

8) Watch Out For Asthma As A Symptom Of Acid Reflux

The reasons why symptoms of asthma and acid reflux go together are not clear, but go together they do. Whether one is a cause of the other is open to debate. It’s possible that acid in the throat causes the tracheae (the tubes taking air into the lungs) to close so as to protect the lungs from the entry of acidic material.

In one study*, it was found that among 109 asthma patients, heartburn, acid regurgitation, and swallowing difficulties were experienced by 77%, 55%, and 24% of the group respectively. At least 37% of asthmatics required anti-reflux medication. The conclusion the study reached was that asthma medications were associated with an increased likelihood of gastroesophageal reflux.

All we can say from this study is that there is a strong correlation with reflux-associated β-agonist inhaler use in asthmatics.

9) Feeling Sick

A consistent feeling of nausea after you’ve eaten may well indicate a problem with acid reflux. That’s particularly true if there is no other obvious reason why you keep feeling sick.

10) Producing A Lot Of Salivae

The stimulation of the nerves in the throat by the acid from the stomach can produce a reflex response of extra saliva production.

11) Swallowing Difficulty

If you’re having trouble swallowing, and it’s been going on for a while, then you might find that medical attention is a good idea. Damage to the tissues in the esophagus can cause scarring, swelling, and difficulty swallowing.

One study of dyspepsia and indigestion in England involved over 2,000 people. The idea was to find out how many people actually experienced dyspepsia or heartburn, and what the symptoms were.

The respondents to the postal questionnaire were asked if they had ever had indigestion for more than a few days, and where their symptoms were located. They were asked whether they had symptoms characteristics of heartburn and whether they had seen a doctor about them.

Over one-third of the people who responded to the questionnaires had never had dyspepsia; around 50% had symptoms of both gastroesophageal reflux and other upper abdominal pain. The results suggested that there was a large degree of overlap between men and women with pain in the upper abdomen, a sense of fullness or discomfort, and those with symptoms of reflux including pain behind the sternum and heartburn.

Acid Reflux Remedies

If you have acid reflux you want a remedy. The pain can be excruciating. I guess you already know that because you’re looking at this website.

So what are your options? Well, one of the remarkable things about the Internet is how information about home remedies has spread so widely and so quickly. You can now get a good solution for almost any common condition – including, I’m happy to say, acid reflux remedies and heartburn remedies.

I think acid reflux home remedies are so popular because they can be just as effective as medical solutions, and they’re a lot cheaper.

But I’m not saying that medical treatments can’t be helpful. Far from it.

Back in 1984, Zantac saved me from the agonizing stomach pain of a stress-induced ulcer. (Zantac was only available on prescription at the time.) To this day, I can remember the relief I felt when the burning pain diminished and then finally died away.

Unfortunately, I soon developed some pretty unpleasant side effects: intensely uncomfortable cramping pains in my guts, bloating, and depression.

Although Zantac and its equivalent products are still on the market, and these days they are available over-the-counter, plenty of people who would prefer to try and natural remedies for acid reflux.

Think about the latest drugs being used to control heartburn and acid reflux – ones like omeprazole. Now regarded as the “gold standard” for controlling acid reflux, the evidence is now emerging that long-term use of these drugs has all kinds of subtle and not-so-subtle side effects.

In people over 50, they increase the risk of spine, hip, and wrist fractures by 100%. That’s because they affect bone formation. They can lead to vitamin B12 deficiency. They’ve been shown to increase the risk of catching pneumonia, and they massively increase the risk of gastrointestinal infection with organisms like Clostridium difficile. There are many other side-effects, too – magnesium deficiency, kidney failure, liver failure… the list goes on.

And because there are many side effects, how can you take these drugs long-term and be sure you’re safe?

The sad answer to this question is: you cannot be sure you are safe while taking these drugs. You simply cannot take these modern medications and be sure that your health will be safeguarded. But you can be safe using a traditional acid reflux remedy

For short-term prescription – fine. Long-term – no way. That’s my opinion. 

And I think that’s where an acid reflux home remedy can be so much more attractive. For one thing, such remedies allow you to take responsibility for your own health. While you might want to get a medical prescription for short-term relief, longer-term you might want to try using proven, effective acid reflux remedies that stand a good chance of curing your symptoms once and for all.

That seems like a great idea to me.

By the way, my name is Rod Phillips and I’m a therapist, living in the UK. My partner, Maria Edwards, who’s a complementary therapist, and I have worked together on this website.

My clients are all people who want to improve the quality of their life by using natural remedies and natural treatments for all kinds of problems. The fact is, they are among hundreds of thousands, if not millions, of people who can testify to the effectiveness of home remedies, natural medicines, and holistic or complementary therapies.

Heartburn No More – Top Choice Among Heartburn Remedies

The “home remedy” program I’m recommending for dealing with acid reflux and GERD is called Heartburn No More.

And I’m recommending it to you because I’ve tried it out on my own clients. During 2012 I recommended it to 60 clients with acid reflux, and it worked for about 50 of them. They are now pain-free. Symptom-free. Their lives restored.

That’s a pretty impressive success rate. But before I show you my Heartburn No More review, before I tell you what it’s all about one more thing. If you want to try it, you can do so with no financial risk whatsoever. It’s available with 60-day money-back guarantee, no questions asked.

That makes it risk-free.

And I think 60 days is long enough to give it a try and know if it’s right for you. Long enough to know if this is an acid reflux remedy that’s going to cure the symptoms of acid reflux, GERD, and heartburn that you currently experience.

So what is it?

It’s a holistic package of remedies for heartburn. This means it will change many different aspects of your life. Not just the symptoms of heartburn, but how well you sleep, how much stress you feel, how much energy you have, how positive and optimistic you feel….. and of course it totally eliminates the factors that might be giving you stomach problems.

It’s written by a guy called Jeff Martin who killed off his own acid reflux symptoms by using these holistic treatments and acid reflux remedies. (By the way, he’s online every day to give you support within 24 hours if you have any questions.)

A video about these issues!

So what do you get for your money?

There are two options when you buy into this: the basic package, and the advanced package. The advanced package includes the basic package and adds a high-quality DVD and a cookbook with hundreds of delicious options for food that will end symptoms of heartburn, acid indigestion, and reflux symptoms.

Let’s start by talking about the basic package. This is a 214 page eBook packed full of information about acid reflux remedies.

I think 214 pages is a bit much, but the good news is that you can absorb the chapter summaries without reading everything. Then, if you want more detail on something, you can take your pick. The chapter summaries give you all the information you need to deal with the problems you’re experiencing.

The book starts by explaining what acid reflux symptoms and heartburn symptoms represent, and what really causes them. There are some surprises in store for you here: did you know, for example, that yeast infections can be a cause of acid reflux symptoms?

Jeff Martin then compares holistic medicine and natural acid reflux remedies with conventional medicine and considers what they both have to offer in the treatment of heartburn. This is a really interesting section, and you’ll certainly look at your doctor’s advice differently after you’ve read it!

But the real backbone of the program is a 5 step system which gives you permanent relief from heartburn and acid reflux using suitable home remedies.

There are 10 dietary principles behind this 5 step system. It’s all about finding the best diet right for you – the one which will prevent heartburn from ever happening again.

In addition to these 10 dietary principles, Jeff Martin describes a ton of supplements and cleansing routines which will give you the chance of putting everything in your system back into balance. After you’ve done this, you can use his ongoing diet advice and lifestyle changes to ensure your acid reflux never, ever comes back.

I don’t know whether you’re into cleansing and fasting, but don’t worry about it if you’ve never tried it before! (Yes, cleansing and fasting are part of the treatment program!) Nothing in this book is difficult or unpleasant, and the heartburn remedies he describes are all designed to be practical for people living a modern lifestyle.

And Jeff Martin also talks about heartburn remedies and other complementary therapies that work well to help cure your acid reflux, gastroesophageal reflux disease, and heartburn. Not only that, but he also tells you how you can ensure your whole digestive tract is in balance and running smoothly …. to stop heartburn ever returning …. and, just as important, he explains how you can dramatically increase your health and vitality.

I don’t think there’s another information product available on the Internet that contains more high-quality and useful information than Heartburn No More.

Not only do you get the 214 page eBook which reveals the best acid reflux remedies, the best heartburn remedies, and GERD solutions, but you also get all this amazing high-powered information about how to keep your body in a state of perfect health — or at least, as near to it as you can get!

The advanced package contains everything in the basic package with an additional DVD and cookbook. The DVD, or downloadable video, describes a program that will immediately stop the pain of acid reflux. On-screen, Jeff Martin gives you complete instructions about what to do, what to eat, what supplements to use, and a simple formula that will end the pain and discomfort of acid reflux within two days.

You also have a cookbook unique to this program, specially designed for acid reflux remedies and GERD and heartburn sufferers. It contains 150 delicious recipes that are designed to work in harmony with your stomach and gut so you don’t get any more symptoms of acid reflux, ever…..

You also get instructions on how to change what you’re eating so that you don’t have any adverse or allergic reactions; you get complete meal plans; you get information about which foods you can eat together safely, and a whole lot more besides. Acid reflux symptoms, acid reflux treatment, acid reflux causes – you name it.

This is absolutely fantastic stuff for anyone who’s got stomach problems, heartburn symptoms, symptoms of acid reflux, or requires GERD treatments or remedies.

If you want to say goodbye to belching, nausea, acid burning, and all those other horrible reflux symptoms…. well, Heartburn No More is the one for you.