Q & A: Herbs for Heartburn and Gastroesophageal Reflux Disease

My husband has acid reflux disease. He was on Prilosec for too long, and his enzyme levels became so high that he started to have liver failure, so they switched him to Nexium, and he’s doing much better. However, if he misses a pill, he’s miserable. Plus, these pills are very expensive. Are there any natural herbs or health ideas you can recommend to relieve or prevent his misery of acid reflux disease?
–K.C., Walton, Kentucky

Keville responds: Acid reflux disease, or gastroesophageal reflux disease (GERD), is better known to most people as heartburn. Those who suffer from it often turn to antacid drugs, which are designed to decrease the amount of acid in the stomach. This inhibits pepsin and the ability to digest protein, and promotes food allergies. The more alkaline environment created by the decreased stomach acid also encourages growth of Helicobacter pylori, the bacterial culprit thought to be responsible for causing stomach ulcers. Holistic practitioners argue that heartburn is just as likely caused by too little acid in the stomach as too much. If that is determined to be the case, practitioners tend to see excellent results with herbal bitters, such as gentian (Gentiana lutea).

Helpful herbs for acid reflux include marshmallow root (Althaea officinalis) and slippery elm bark (Ulmus rubra), which help absorb stomach acid. With these, your husband also can take herbs to decrease the acid: chamomile, licorice root (Glycyrrhiza glabra) and meadowsweet leaf (Filipendula ulmaria). All of these herbs are soothing to the lining of the stomach. They can be safely taken with drugs like Nexium, if he still needs to take the drug.

A dietary approach would include carrots, apples and lemon juice, which contain vegetable acids that neutralize stomach acid. Along with chamomile, catnip (Nepeta cataria) is good because it relaxes the digestive system, reducing spasms that cause reflux. All of these herbs taste good, so they can be blended into a nice tea (or you can buy a premade tea at a health-food store). The herbs also can be taken as capsules or in a nonalcoholic herbal extract.

Your husband should avoid drinking alcohol and coffee, and smoking cigarettes — they will contribute to the problem. Eating chocolate or fatty, especially fried, foods makes acid reflux worse for many people. So can drinking carbonated beverages. Overeating can be another cause of the problem. A simple suggestion his doctor may have already mentioned is to raise the head of the bed a few inches, so his head is slightly elevated at night.

I’m actually more concerned about the liver failure that resulted from taking the drug. Milk thistle seed (Silybum marianum) and turmeric root (Curcuma longa) are examples of herbs that help rebuild the liver. Herbs that enhance liver-enzyme production and regulate liver function are burdock root (Arctium lappa), fringe-tree bark (Chionanthus virginicus) and bupleurum root. Or, check your local natural food store for a remedy designed for the liver, and, as with all my herbal suggestions, follow the directions on the package.

Khalsa responds: Historically, herb-alists have divided indigestion into two categories. The “cold” type is characterized by feelings of fullness, slow stomach emptying and reduced secretions of the digestive organs. People with these symptoms are often constipated. The type you describe, the “hot” type of indigestion, or heartburn, is known medically as gastritis — inflammation or irritation of the inner lining (mucosa) of the stomach, which may precede an ulcer. Heartburn is a fiery feeling caused by stomach acid regurgitating into the esophagus.

GERD is a condition that causes a bit more concern. It is serious gastritis that affects the esophagus. When the lower esophageal sphincter weakens inappropriately, acidic stomach contents can flow back up, or “reflux,” into the esophagus, which does not have a protective barrier against the acid. The reflux can cause heartburn-like irritation and inflammation (esophagitis) to the esophagus. GERD is diagnosed if the heartburn sensation occurs two times a week or more.

Hot indigestion is common. Seven percent of Americans have daily heartburn, and 14 percent feel the burn at least once a week. The condition strikes about 20 percent of American adults, mostly those in their 40s or older. Men are twice as likely as women to develop esophagitis.

Current medical dogma is that most ulcers are due to infections of the bacterium Helicobacter pylori, but it is known that only some people get ulcers from bacterial infections. And antacid drugs actually make the stomach more hospitable to the bacteria the body is trying to kill. In 2002, researchers looked at omeprazole (Prilosec) for a study published in Gastroenterology. They concluded that such strong acid blockers are the most dangerous to use long term.

The theory stemming from this new information is that the damage that leads to ulcers and stomach cancer is probably due to the body’s response to this bacteria. Based on previous scientific research, researchers now believe some people may be genetically programmed to respond more strongly to bacteria. These researchers concluded that anti-inflammatory drugs were a better bet for the long run than acid blockers.

Soothing, demulcent herbs, including marshmallow root and slippery elm bark, are high in mucilage, a slimy plant component. Mucilage can be beneficial for people with hot indigestion, because its slippery nature soothes an irritated digestive tract.

Long used in Europe as a culinary plant, the orange flower petals of calendula (Calendula officinalis) are a vibrant addition to your medicine cabinet. Taken internally, calendula helps heartburn (gastritis). Fenugreek seed (Trigonella foenum-graecum) has been used historically for a collection of digestive complaints, including gastritis. Scientific evidence, published in the Journal of Ethnopharmacology in 2001, supports its use for ulcers.

Turmeric root curbs inflammation. One of its active ingredients, curcumin (the pigment that makes turmeric yellow), has anti-inflammatory effects comparable to cortisone and phenylbutazone, the standard in drugs for inflammation. Curcumin is nonsteroidal, so it has none of the damaging side effects of steroid anti-inflammatories.

Turmeric is widely use for indigestion, and there is some scientific evidence that curcumin treats dyspepsia. A 1989 double-blind placebo-controlled study with 106 patients measured the effects of 500 mg curcumin four times daily against a placebo. Seven days into the study, 87 percent of the curcumin group experienced full or partial symptom relief, compared to 53 percent of the placebo group.

Licorice root guards digestive mucous membranes by increasing production of mucin, a secretion that protects against stomach acid and other digestive juices. Deglycyrrhizinated licorice root (DGL) has the glycyrrhizic acid removed (glycyrrhizic acid is the ingredient in licorice root associated with the possibility of increasing blood pressure and causing water retention). The gastritis-benefiting part of the root, however, remains in DGL. One or two chewable wafers of DGL may provide relief, if you can stand the taste of licorice.

Carrot, cabbage and celery juice are naturopathic favorites to abort an acute attack. Banana is a widely mentioned folk treatment for heartburn. One Journal of Ethno- pharmacology study found some benefit from the flavonoid leucocyanidin, from unripe banana, for aspirin-induced stomach erosions. I have had good success clinically with all of these remedies.

Kathi Keville is director of theAmerican Herb Association and the author of eleven herb and aromatherapy books including Herbs for Health and Healing (Rodale, 1996). She teaches seminars throughout the United States.

Karta Purkh Singh Khalsa has more than twenty-five years of experience with medicinal herbs and specializes in Ayurvedic, Chinese, and North American healing traditions. He is a licensed dietitian/nutritionist, a massage therapist, and a board member of the American Herbalists Guild.

The information offered in “Q & A” is not intended to be a substitute for advice from your health-care provider.

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