Acid reflux and heartburn, also known as gastroesophageal reflux disease, is an extremely common health complaint, affecting over 25 million adults in the United States every day. Almost 20% of the people that experience symptoms of acid reflux or heartburn will develop gastroesophageal reflux disease, a chronic illness that causes stomach acid to irritate the lining of the oesophagus. There are few effective treatments for the uncomfortable effects of acid reflux, of which most are pharmaceutical medications that carry a risk of side effects.
Heartburn and acid reflux, although difficult to treat directly, are systemic issues that are generally caused by dietary intake or lifestyle habits. It’s possible to prevent the development of gastroesophageal reflux by making some small lifestyle changes, leading to reduced symptoms and better overall health. In this article, we’ll outline the major causes of acid reflux and heartburn, and provide a list of preventative techniques that can protect you from this irritation disorder.
The Causes and Symptoms of Acid Reflux
Acid reflux, or heartburn, occurs when the contents of the stomach are pushed back up the oesophagus. This can result in a variety of symptoms and complications. Some of the symptoms caused by acid reflux include an acidic taste in the mouth, bad breath, chest pain, breathing problems, chest pain, and the wearing away of teeth
. The symptoms of acid reflux can be extremely uncomfortable, but in most cases acid reflux occurs only rarely and is completely harmless. When acid reflux occurs too often, however, it can severely burn the oesophagus.
The contents of the stomach are extremely acidic. Gastric acid, also known as stomach acid, is used by the body to break down ingested food and is composed mainly of hydrochloric acid. The contents of the stomach typically have a pH level of 1-3, making it almost as acidic as battery acid. A single drop of unadulterated stomach acid is able to eat through wood.
The body is protected from the acidic contents of the stomach by a mucous secreted by the stomach lining, but this is not true for the oesophagus. Stomach acid can damage and burn the oesophagus, causing extreme discomfort.
Research indicates that up to 7% of the population of the United States experience acid reflux on a daily basis. Regular acid reflux symptoms can be indicative of gastroesophageal reflux disease, a chronic ongoing illness that can be extremely debilitating and significantly impact quality of life.
There are a number of serious health disorders that can be caused by continuous ongoing acid reflux, with teeth erosion one of the most concerning symptoms. Research performed by the University of Adelaide in 2012 demonstrated that ongoing acid reflux can wear away the enamel coating of teeth, which can potentially destroy them.
Some of the most commonly prescribed pharmaceutical solutions for acid reflux and gastroesophageal reflux disease are proton pump inhibitors. These medications are a class of drugs that reduce the amount of gastric acid the body produces.
While proton pump inhibitors are able to minimize the symptoms of acid reflux, they also have a wide range of adverse effects. Acid reflux medications can cause poor nutrition, an increased risk of bone fractures, intestinal bacterial overgrowth or even chronic kidney disease.
The safest and most effective way to avoid acid reflux and gastroesophageal reflux disease is by practicing preventative measures. There are a number of simple lifestyle and dietary changes that can dramatically decrease your risk of developing acid reflux. Let’s take a look at the 14 most effective natural ways to prevent acid reflux:
1. Avoid Overeating
Overeating is the primary cause of most cases of acid reflux. The oesophagus is separated from the stomach by a ring of muscle known as the lower esophageal sphincter. This muscle acts as a valve that prevents the highly corrosive contents of the stomach from escaping, and is the reason your lunch doesn’t pour out when you’re upside down.
The lower esophageal sphincter opens naturally and unconsciously when you swallow, emit stomach gas, or vomit. At all other times, this ring of muscle keeps the stomach sealed from the oesophagus.
A weak lower esophageal sphincter is the primary cause of acid reflux and gastroesophageal reflux disease, especially in chronic instances of the disorder. Overeating can place a large amount of stress on this sphincter muscle even in healthy individuals, with a distended, swollen stomach causing it to open and allow stomach contents to escape.
Several clinical trials have demonstrated a clear link between the consumption of large meals and an increase in the frequency of acid reflux.
To reduce your risk of acid reflux, the best practice is to remain mindful of the amount of food you eat. The human stomach in an unstretched state can hold up to one liter of liquid, while a fully distended stomach will hold up to four liters, depending on the individual. Keep this in mind when choosing your food portion size to prevent overeating.
2. Lose Unnecessary Body Weight
Excess body fat can also significantly contribute to acid reflux. The lower esophageal sphincter may separate the stomach from the esophagus, but is strengthened and supported by another muscle located above the stomach called the diaphragm. The diaphragm is critical in breathing and speaking, but also plays a role in maintaining the integrity of the stomach.
Excessive adipose fat deposits, especially around the stomach, can create a high amount of pressure on the abdomen. This pressure can cause the lower esophageal sphincter to migrate vertically, away from the support of the diaphragm. This condition is known as a hiatus hernia and can be difficult to diagnose, causing shortness of breath, heart palpitations, chest pains, and chronic acid reflux.
Hiatus hernia is the primary cause of acid reflux in obese or severely overweight individuals, and can even affect pregnant women during the late stages of pregnancy. A study performed in 2008 by the Houston College of Medicine determined that abdominal obesity is largely responsible for acid reflux in overweight individuals, while a 2013 study demonstrated a link between the organ displacement caused by pregnancy and acid reflux.
While acid reflux symptoms may recede in the postnatal period for pregnant women, there is no such reprieve for overweight individuals.
A controlled study performed by the Stanford University School of Medicine concluded that weight loss improves both stomach pH levels and the symptoms of acid reflux, as well as providing a remedy to gastroesophageal reflux disease. Ultimately, losing excessive body fat will not only eliminate acid reflux, but offer a dramatic increase in overall health and a decreased risk of a wide range of health disorders. If you’re suffering from acid reflux and are overweight, excessive fat loss should be a priority.
3. Reduce Your Carb Intake
Another way to minimize your risk of developing acid reflux symptoms is to reduce your carb intake. Research indicates that diets rich in carbohydrates are a leading cause of acid reflux, causing bacterial overgrowth in the digestive system. When carbohydrates are digested, methane and hydrogen gas are released as part of the digestive process. Excessive gas can lead to increased pressure on the lower esophageal sphincter, causing stomach contents to escape.
Several clinical studies have led to the conclusion that low carb diets can significantly reduce the frequency of acid reflux. While the exact mechanism that contributes to this effect is not currently known, there are at least three separate studies that have proven minimizing carb intake leads to reduced bacterial imbalance in the digestive system, minimizing occurrences of acid reflux.
One particular study, performed in 2003, focused on determining the effect of gut bacteria on acid reflux. Patients given a prebiotic agent that promoted the growth of bacteria that are known to induce excessive gas exhibited an increased frequency of acid reflux, proving a clear connection between carbohydrate-induced bacterial overgrowth and gastroesophageal reflux disease.
There are many diets that provide a nutritionally balanced macronutrient intake while reducing overall carb intake. Low carb diets can be especially efficacious in reducing acid reflux symptoms in overweight individuals, as carb restriction has the added benefit of contributing to rapid weight loss.
4. Limit Alcohol Intake
Lowering alcohol intake can also minimize the frequency of acid reflux occurrences. Alcohol is a muscle relaxant that can both relax the lower esophageal sphincter and disrupt the ability of the body to clear stomach acid from the oesophagus. A 2002 study observed a clear link between the consumption of white wine and gastroesophageal reflux. Alcohol-induced acid reflux is common even in healthy individuals.
Alcohol is also able to increase the acidity of stomach contents, exacerbating acid reflux symptoms. There are a number of clinical trials that provide a clear link between alcohol consumption and acid reflux, but the exact mechanism of action is currently unknown. What can be taken away from this data, however, is that limiting alcohol intake can definitely alleviate acid reflux.
5. Minimize Coffee Intake
Caffeine, the active ingredient in coffee, has been shown to temporarily weaken the lower esophageal sphincter in a similar fashion to alcohol While caffeine consumed via coffee has been demonstrated to cause acid reflux, a study that gave patients a solution of water mixed with powdered caffeine yielded no significant changes to acid reflux frequency, a paradoxical finding that suggests the preparation method of coffee may contribute to acid reflux occurrence.
Drinking coffee on an empty stomach may be the cause of many cases of acid reflux. A 1999 study determined that drinking coffee directly after eating a meal has no effect on acid reflux frequency. Coffee consumed on an empty stomach, however, can actually worsen the effects of acid reflux, causing greater damage to the oesophagus when stomach acid is emitted by the lower esophageal sphincter.
Interestingly, decaffeinated coffee has been found to actually reduce the frequency of acid reflux in contrast to high-caffeine content tea. A 1997 study demonstrated that patients suffering from chronic gastro-oesophageal reflux experienced a reduction in symptoms after drinking decaffeinated coffee. This evidence suggests that while regular coffee can worsen acid reflux symptoms, switching to decaf can have a positive impact.
6. Chew Gum
Chewing gum has not been linked to any reduction in acid reflux frequency, but has been demonstrated to lower the acidity of the oesophagus. A 2005 study concluded that chewing sugar-free gum can minimize the symptoms of acid reflux, while another study performed in 2001 determined that simultaneously walking and chewing gum can reduce the damage caused to the oesophagus by gastric acid exposure.
Chewing gum seems to minimize the damage and discomfort caused by acid reflux by increasing the rate at which the mouth secretes saliva, which can rebalance the pH level in the oesophagus.
7. Minimize Raw Onion Consumption
Raw onion contains a large amount of fermentable fiber. When digested, these fibers create a surplus of gas in the digestive system, which can increase pressure on the lower esophageal sphincter. Onions have been found to be rich in fructooligosaccharides, or FOS. FOS is an indigestible carbohydrate that has been clinically proven to significantly increase occurrences of acid reflux.
A 1990 trial testing the effect of raw onion on healthy patients determined that there is a clear link between the consumption of raw onion and acid reflux symptoms. Raw onion has also been shown to potentially irritate the lining of the oesophagus, exacerbating the effects of acid reflux. If you’re suffering from acid reflux, raw onion should definitely be avoided.
8. Reduce Your Consumption of Carbonated Beverages
Medical professionals often advise patients that are suffering from chronic acid reflux to limit their intake of carbonated beverages. Carbonated beverages release a large amount of gas in the stomach, which weakens the lower esophageal sphincter in a similar fashion to raw onion. Evidence from a 2010 clinical trial suggests that carbonated beverages can also increase the acidity of the oesophagus.
Many popular carbonated drinks are also rich in sugar, which also increases the acidity of the stomach and contributes to obesity. Cutting out carbonated beverages not only minimizes the risk of developing acid reflux, but improves overall health.
9. Avoid Citrus Juice
Citrus juices such as orange juice or grapefruit juice are highly acidic. A study performed by the Dallas Medical School that tested 400 individual sufferers of chronic acid reflux determined that more that 70% of patients experience an increase in acid reflux frequency after consuming citrus juice.
It’s not clear whether the acidity of citrus juice alone is the cause of acid reflux in this case, as pH-balanced citrus juice has a similar effect, but it’s likely that the overall composition of citrus juice causes esophageal irritation.
Overall, citrus juice may not be a direct cause of acid reflux, but can definitely affect the pH level of both the stomach and the oesophagus, exacerbating the damage caused by gastric acid reflux occurrences.
10. Eat Less Chocolate
There is a compelling body of evidence that suggests chocolate may play a role in causing acid reflux. Doctors often advise individuals that suffer from frequent occurrences of acid reflux to refrain from chocolate consumption. However, there, is as of yet, no clear correlation between chocolate and increased acid reflux frequency. An old study performed in 1975 concluded that a 120 ml serving of chocolate syrup may weaken the lower esophageal sphincter, but as the trial used no control method the results are inconclusive.
A controlled study performed in 1988 at the Wake Forest University of North Carolina recommended a reduction in chocolate intake for acid reflux sufferers based on an increase in oesophageal acid exposure one hour after the ingestion of chocolate. While the evidence that chocolate may increase the frequency of acid reflux is tenuous at best, some sufferers of chronic acid reflux choose to abstain to minimize their overall likelihood of experiencing oesophageal discomfort.
11. Avoid Mint Consumption
Peppermint and spearmint are both commonly-used herbs. Used frequently to improve the taste of candy, mouthwash, toothpaste, gum, and herbal teas, these botanicals may actually increase the frequency of acid reflux occurrences. The cause of this increase in acid reflux may be due to the high menthol content of these herbs. A recent 2016 study on the causes of gastroesophageal reflux disease links menthol to acid reflux due to the drying effect the chemical has on the oesophagus, which increases inflammation and irritation.
Spearmint flavoring has not been demonstrated to cause an increase in acid reflux, but raw spearmint was linked to increased reflux occurrence in a study performed at McMaster University in 1999. F you feel as though mint or spearmint products tend to worsen your acid reflux symptoms, consider cutting them out of your diet.
12. Sleep With Your Head Elevated
Many sufferers of acid reflux complain that occurrences are more frequent during the evening or at night. These symptoms can cause insomnia or break sleeping habits, making it difficult to maintain good sleep hygiene. Elevating the head of the bed has been shown to counteract this issue, with posture playing an important role in the frequency of acid reflux occurrences.
Two separate clinical studies have pointed to sleeping with an elevated head as an effective strategy for minimizing acid reflux. Raising the head of the bed by 4 to 8 inches has been demonstrated to also offer enhanced healing, better circulation, a reduction in arthritic pain and more restful sleep overall.
13. Avoid Eating Within Three Hours of Sleeping
Doctors frequently advise sufferers of acid reflux to avoid eating within three hours of going to bed. This recommendation makes logical sense, as many foods exacerbate acid reflux, but there are conflicting sources of information with regards to this preventative technique.
One study performed in 1998 monitored 20 chronic acid reflux patients over two nights, given a late night meal on the first, and fasting on the second. The trial concluded that late night meal consumption had no effect on the frequency of acid reflux occurrences.
Another study performed by the Osaka City University more recently in 2005, however, reached a contradictory conclusion. In this study, which tested a broader range of 147 individuals, a shorter interval between meal consumption and sleep was linked directly with increased acid reflux occurrences after adjusting for smoking habits, drinking habits, and body mass index.
While these trials contradict each other, the evidence suggests that it’s best to wait at least a short while between eating and sleeping in order to give the body sufficient time to digest.
14. Sleep on Your Left Side
There appears to be a correlation between sleeping on the right side of the body and an increase in the occurrence of acid reflux. At least three separate clinical trials have linked right-side sleeping to acid reflux. The exact reasons for this increase in acid reflux activity are uncertain, but may be linked to the anatomy of the digestive system.
The oesophagus is connected to the right side of the stomach, where the lower esophageal sphincter is located. When sleeping on the right side, the lower esophageal sphincter is placed below the level of stomach acid, causing the sphincter to work harder to prevent stomach contents from entering the oesophagus. While sleeping on the right side, the lower esophageal sphincter is placed above the level of stomach acid, easing the stress on the muscle tissue.
This practice may be difficult for some individuals as sleeping position preferences vary from person to person, but if you suffer from acid reflux you may want to attempt to change your sleeping position habits.
Overall, acid reflux is typically caused by either dietary intake, sleeping position, or lifestyle habits such as eating schedule. While there are rare cases in which acid reflux is caused by genetic issues, it can be treated effectively in most cases by making small, simple changes to dietary and lifestyle habits. Acid reflux is generally indicative of underlying health issues such as obesity or poor nutrition. By addressing these issues, you’ll not only prevent acid reflux, but improve your overall health.