Managing GERD – Other Ways to Help Heartburn (Part 2 of 2)

In part 1 of this GERD series, you learned about what GERD is, its symptoms, and common underlying issues hiding behind acid reflux and heartburn. In part 2, I want to go over my recommendations on how to manage GERD and improve your symptoms naturally. Let’s get into it.

My Tips for Managing GERD and Improving Heartburn

If you are dealing with symptoms of GERD on a regular basis, I have good news for you. You can manage and improve your symptoms naturally with the help of a few simple strategies. Here is what I recommend:

Improve Your Diet

Research has shown that chronic inflammation and oxidative stress may play a major role in acid reflux, heartburn, and GERD (1). One of the best ways to tackle this issue is through better nutrition. According to a 2019 study published in the Journal of Thoracic Disorders, improving your diet and removing certain foods may help to improve symptoms of reflux disorders (2). For example, reducing or removing spicy foods, simple sugar and carbs, caffeine, chocolate, carbonated drinks, and alcohol may help. Avoiding large, calorie-dense, and heavy meals and late-night eating may also help to reduce symptoms.

I recommend removing refined sugar, refined oils, artificial ingredients, overly processed foods, and any triggering foods from your diet. Since food sensitivities are a common culprit behind acid reflux and heartburn, I recommend checking for food sensitivities. Common food sensitivities include gluten, wheat, soy, corn, peanuts, dairy, and shellfish. Spicy foods, acidic foods, high-histamine foods, chocolate, coffee, carbonated drinks, and alcohol are other common dietary triggers for GERD (2, 3, 4, 5).

Instead, I recommend following an anti-inflammatory, gut-friendly, nutrient-dense whole foods diet. Eat plenty of leafy greens, vegetables, non-triggering herbs, fruits, nuts, seeds, pasture-raised eggs and poultry, grass-fed beef, fresh wild-caught fish and seafood, and wild game. 

Since microbiome imbalance is a common underlying problem behind GERD, I recommend supporting your gut through fermented foods and drinks (unless you have a histamine intolerance issue or known SIBO), including sauerkraut, kimchi, fermented vegetables and herbs, coconut yogurt, and coconut kefir, and kombucha. Fermented foods may help to improve the secretion of digestive juices, support digestion, and offer antimicrobial benefits in fighting H pylori and other gut infections. 

If symptoms worsen with fermented probiotic foods, this can be an indicator for SIBO which is better assessed with a SIBO specific Breath Test. Remember also, fermented foods are high in histamine, and may affect you negatively if you have histamine metabolism issues or DAO deficiency. 

You may also benefit from prebiotic-rich foods as well that feed the good bacteria in your gut, including jicama, Jerusalem artichokes, dandelion greens, and apples. 

Time Your Meals Better

What you eat matters. But when you eat and how you eat matters just as much, especially if you are dealing with symptoms of GERD. Moreover, paying attention to hydration may also help to reduce your symptoms.

As a busy person, you may find yourself eating while standing up, eating on the go, rushing your meals, or stress-eating. The problem with this scenario is that your body must activate your parasympathetic nervous system to create stomach acid. Your body needs you to be relaxed in order to do this. Being in a stressed, anxious, fight-or-flight state, your body will have a more difficult time producing enough stomach acid (6, 7). 

I recommend that you aim to eat all your meals while relaxed to improve stomach acid production. Eat your largest meal in your most relaxed state. Eat slowly and chew your food well. Remember, digestion starts in your mouth, so chewing every bite well will help the rest of the process and may reduce the risk of stomach acid. Avoid late-night meals to reduce acid reflux when you go to bed (2).

In Canada, the US, and some other countries starting your meal with a salad is part of the cultural norm. This may not be the best idea if you are dealing with acid reflux and heartburn. When you start eating, your body will start making stomach acid. When you are eating protein, it especially increases the release of stomach acid. To support optimal stomach acid production, it may be a better idea to begin your meal with protein followed by a salad or vegetables or eat your veggies alongside your protein (8). I eat salad routinely every day, and always at the end of my meal (and oftentimes AS the meal).

I recommend hydrating your body and drinking plenty of water throughout the day to support hydration and bowel motility. However, it is wise to hold off the water at least 30 minutes before and after your meal, as well as during your meal. Water can dilute stomach acid. Holding off water may support proper stomach acid activity, better protein metabolism, and improved digestion. The only exception is if you have to take a supplement or medication with food. In that case, take it with 2 ounces of water when directed.

Improve Your Sleep and Elevate Your Bed

Poor sleep and chronic stress may contribute to chronic inflammation, which may play a role in reflux diseases (1). Sleep disorders may also increase symptoms of reflux (9, 10). I recommend reducing your stress levels and improving your sleep. Practicing meditation, breathwork, and gratitude, moving your body, and spending time in nature may help to reduce stress and support your overnight sleep (11, 12, 13, 14). Avoid electronics, sugar, heavy meals, alcohol, and stress in the evening (15, 16, 17). Avoid laying down, taking a nap, or going to sleep right after your meal. Wait for at least three hours after your meals before sleep. Develop a relaxing evening routine to prepare you for a good night’s sleep. Invest in a supportive mattress and pillows. 

If you are experiencing acid reflux and heartburn regularly at night or during your sleep, elevating the head of your bed and elevating your body from the waist up may help. For some people, raising your head and upper body with additional pillows may be effective, but it’s not always enough. There are some beds that allow modifying the height of your mattress. You may also place a cement block or piece of wood under the feet of your bed in some cases. You may also place a wedge between your mattress and box spring to elevate your mattress.

Try Some Supplements for GERD and Better Digestion

There are various herbs and supplements that may help to improve acid reflux, heartburn, and other symptoms of GERD. Here is what I recommend:

Probiotics

Since gut dysbiosis is a common issue behind GERD, you may benefit from improving your gut microbiome with the help of probiotics. According to a review published in Nutrients, probiotics may help to improve symptoms of GERD (18). I recommend taking a high-quality probiotic supplement. If you are also dealing with SIBO, select a soil-based probiotic blend as other forms may be triggering SIBO. Assessing SIBO and having it treated can be the best approach, since SIBO is associated with GERD.

Betaine HCL

Betaine hydrochloride (Betaine HCL) may help to improve stomach acid levels and stomach pH. It may also support protein and nutrient absorption. A 2016 case study published in Integrative Medicine (Encinitas) has found that betaine HCL may benefit those with GERD and other digestive issues (19). If your Baking Soda test (discussed in Part 1) shows probability of low stomach acid, I recommend trying betaine HCL for a couple of weeks to see if it’s right for you. Take betaine HCL with your meals. If you notice improvements, continue to use it. However, if you have no improvements even after two weeks or experience any burning or side effects, stop taking betaine HCL.

DGL

Deglycyrrhizinated licorice (DGL) is a common natural recommendation for acid reflux symptoms. According to a 2014 study published in the Asia-Pacific Clinical Journal of Oncology, DGL may help to improve mucus activity and allow tissue repair caused by acid reflux (20). A 2013 study published in Clinical and Experimental Gastroenterology has found that licorice root may be helpful for reflux disease (21). A 2018 study published in the Journal of the Australian Traditional-Medicine Journal Society has found that DGL may be more effective for GERD than acid-suppressive medications (22). You may benefit from supplementing with DGL to reduce your symptoms of acid reflux and heartburn.

Zinc

Zinc is an important mineral for your immune and overall health. Unfortunately, zinc deficiencies are common. A 2010 study published in the Journal of Nutrition has found that low zinc intake may play a role in certain esophageal conditions (23). A 2016 randomized clinical trial published in the Middle East Journal of Digestive Diseases has found that zinc may help to improve symptoms of GERD (24). If you are dealing with symptoms of GERD, I recommend taking zinc carnosine daily.

Bitters

Bitters are an infusion made from bitter ingredients, including herbs, roots, seeds, or other botanicals. Digestive bitters may help to improve stomach acid production, HCL balance, and digestive enzyme production. According to a 2012 review published in the International Journal of Food Sciences and Nutrition, bitter, aromatic, and pungent herbs may help to improve digestion (25). Some examples of bitters may include burdock, dandelion greens, citrus peel, wormwood, saffron, ginger, and turmeric. You may find digestive bitters liquid supplements for acid reflux and heartburn at health food stores and online. 

Mastic Gum

H Pylori overgrowth is one of the common underlying issues behind GERD (26, 27). Mastic gum is a resin from a Mediterranean tree. It can be found as a capsule, powder, or tincture, but also can be chewed like gum. Mastic gum has been used as a natural remedy for digestion, liver health, and oral health for centuries. It may help to reduce H pylori infections. According to a 2010 study published in Phytomedicine, mastic gum may help to clear H pylori overgrowth within only two weeks (28). Researchers found that mastic gum may be the most effective for H pylori when combined with antibiotics. You may benefit from using mastic gum if H pylori overgrowth is the reason behind your GERD symptoms.

Next Steps

To learn more about the symptoms and causes of GERD, look for Part 1 of this GERD series. If you are looking for personalized tips and dietary recommendations for GERD or want to improve your health, wellness, and mental well-being, I welcome you to start a personalized functional medicine consultation with me for further guidance to improve your health. You may book your consultation here.