But you may not know about alternative treatments for gastroesophageal reflux disease. Here are three options. Santa spoiler alert: One treatment will have you stepping away from the holiday cookies.
•Take melatonin. Mention this natural hormone and most people think "sleep aid." But research reported in the April 2011 Journal of Pharmacology shows melatonin reduces stomach acid but doesn't block it, as many GERD medicines do, notes Mark Stengler, a naturopathic medical doctor and author of books on integrative medicine. That matters because "you need stomach acid for normal digestion" and "to prevent bad bacteria," he explains. For his adult GERD patients, Stengler prescribes 3 to 6 milligrams of melatonin daily at bedtime; it is not recommended for children and pregnant women.
•Cut carbs. Obese GERD patients who cut back their carbohydrate intake to 20 grams a day or less had "a substantial decrease" in acidity and symptoms, reports gastroenterologist Nicholas J. Shaheen, whose team did studies at the University of North Carolina-Chapel Hill. In his practice, Stengler has his GERD patients cut back to 75 grams of carbs a day, or about half the average daily intake; if you try this but haven't seen notable improvement in two weeks, he says, carbs are not your answer.
•Sleep on your left side. An easy remedy that helps relieve GERD by taking advantage of anatomy and gravity is simply sleeping on your left side, says Lauren Gerson, gastroenterologist at Stanford School of Medicine. Her team's review of research showed that right-side sleeping makes reflux worse. Other research found that stomach sleeping is the worst position for people with GERD because it puts extra pressure on the stomach and a key muscle in the esophagus.
Conventional treatments:
David Greenwald, a gastroenterologist at Montefiore Medical Center in New York City, recommends "proven therapies" such as weight loss, not smoking, avoiding alcohol and foods known to trigger reflux, and the use of over-the-counter or prescription medicines. It's true, Greenwald notes, that GERD medicines can cause problem side effects, ranging from bone loss to drug interactions, but he says "a huge number of people are helped by them."
•Lifestyle changes such as maintaining a healthy weight (excess fat puts added pressure on the LES), not smoking (smoking impairs LES function), limiting alcohol (excess relaxes the LES), avoiding foods and beverages that trigger your symptoms. Not everyone reacts negatively to the same triggers. Chocolate may bring on the burn for one person with GERD but be no problem for another, for example. The "usual suspects" are citrus fruits and drinks; tomato products such spaghetti sauce, salsa, chili and pizza; spicy foods, garlic and onions; caffeine; fried and fatty foods; and mint flavorings. Other lifestyle changes that can help include: eating smaller meals; not eating during the last 3 hours before bedtime; avoiding tight clothes and belts; and elevating the head of your bed by about 4 inches using a wedge or risers under the bed (not pillows).
•Medications are the next step. Over-the-counter (OTC) antacids (such as Tums, Rolaids, Mylanta) work fast to neutralize acid to stop heartburn for short-term relief. Prescription and H-2 blocking tablets (Zantac, Tagamet, Pepcid) work on histamine receptors to make the stomach produce less acid. Proton Pump Inhibitors (PPIs) such as (Prilosec, Prevacid, Nexium) capsules reduce acid production by a different method. Some PPIs are available OTC; others require prescription. All can have side effects and some are serious.
•Surgery: Some people with GERD may opt for fundoplication (wrapping part of the stomach around the esophagus) or endoscopic procedures (performed inside the body through a thin tube inserted in the mouth) to strengthen the LES and thus prevent acid leakage.
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