How to Avoid the Long-Term Effects of Acid Reflux

• Acid Reflux|
• Long-Term Effects|
• Causes|
• Diagnosis|
• Treatment|

We’ve all probably overindulged at a meal, only to end up with that uncomfortable burning sensation of acid reflux 1. Periodic episodes like this aren’t much cause for concern, but when reflux symptoms are a routine occurrence, it’s time to take action. 

That’s because the long-term effects of acid reflux can be serious, causing issues like trouble swallowing and even cancer 1. The great news is that many natural solutions and medications can help heal the underlying causes of acid reflux and prevent serious complications. 

What is Acid Reflux?

“Acid reflux” is commonly used to describe everything from mild indigestion to more severe heartburn 1 2. To better understand what acid reflux is, we need some background on the digestive process. 

When we eat, food travels from the mouth through the esophagus and into the stomach. Once in the stomach, the food mixes with powerful acid before it empties into the small intestine.

However, when stomach contents flow back up into the esophagus, the stomach acid can cause a painful, burning sensation known as acid reflux or gastroesophageal reflux (GER) 1. In addition to heartburn, acid reflux can also cause these common symptoms 1:

• Regurgitation (when stomach acid with or without food backs up into the esophagus and finds its way to the bottom of the throat, just above the windpipe, or into the mouth)
• Pain with swallowing
• Belching
• Upper belly or chest pain
• Nausea
• Coughing, wheezing, or shortness of breath (if acid gets into the airway through the windpipe)

Acid reflux is never ideal, but occasional GER is normal, especially after eating a large, fatty meal or when lying down or exercising after eating 2. 

Frequent acid reflux (happening twice a week for several weeks) is known as gastroesophageal reflux disease (GERD), and it’s a warning sign from the body 2. If left untreated, GERD can cause serious health problems 1.

Can Acid Reflux Have Long-Term Effects?

It’s possible to have occasional acid reflux without having GERD or its long-term effects. 

But if you have GERD and leave it untreated, it can lead to or point to worse problems, including 1:

• Erosive esophagitis. The lining of the esophagus gets irritated and damaged—often from acid reflux—and causes pain, difficulty swallowing, and chest discomfort. 
• Barrett’s esophagus. Changes in the cells lining the esophagus increase the risk of esophageal cancer.
• Esophageal stricture. Scar tissue builds up in the esophagus, making it narrow and hard to swallow.
• Esophageal cancer. Cancer develops in the esophagus, causing difficulty swallowing, weight loss, and chest pain.
• Peptic ulcers. Sores form on the lining of the stomach or upper part of the small intestine, causing pain, burning, or other discomfort.
• Hiatal hernia. Part of the stomach pushes up through an opening in the diaphragm, worsening acid reflux and heartburn.

In general, red-flag symptoms of untreated GERD include 1:

• Difficulty swallowing
• Anemia
• Weight loss
• Vomiting blood 

What Causes Acid Reflux?

An occasional acid reflux episode could be caused by eating too much, by lying down or exercising after a meal, or even by a food intolerance. GERD, on the other hand, tends to develop along with certain physiological abnormalities such as 1:

• Esophageal dysmotility. Problems develop in the muscles in the esophagus that move food toward the stomach.
• Weakened muscle tone of the lower esophageal sphincter (LES). The muscle at the bottom of the esophagus that normally keeps food in the stomach and prevents it from coming back up loses its muscle tone and becomes weak.
• Periodic relaxation of the LES. The LES occasionally relaxes and allows stomach contents to flow back into the esophagus.
• Stomach muscle and nerve issues. Problems with the stomach muscles or nerves make it hard for the stomach to empty properly. This can cause food to stay in the stomach too long, increasing the chance of it moving back up. 
• Weakened esophagus defenses. The esophagus becomes less able to protect itself from stomach acid, especially after being exposed for a long time.
• Hiatal hernia. Part of the stomach pushes up into the chest through a hole in the diaphragm, weakening the LES and allowing stomach contents into the esophagus.
• Increased pressure in the abdomen. Carrying too much weight in the belly squeezes the organs and may push stomach contents upward into the esophagus.

Other risk factors for GERD include 1:

• Being older than 50
• Having lower income and fewer resources
• Smoking 
• Drinking too much alcohol
• Having connective tissue disorders, like scleroderma
• Being pregnant (reflux usually goes away after giving birth)
• Taking certain medications, such as benzodiazepines, NSAIDs or aspirin, nitroglycerin, albuterol, calcium channel blockers, certain antidepressants, or glucagon

How Do You Know If You Have GERD?

There isn’t a gold standard for diagnosing GERD. If you regularly have heartburn, acid reflux, chest pain, chronic coughing, or mild trouble swallowing, get in touch with your doctor quickly. 

If you have red-flag symptoms like painful swallowing, anemia, weight loss, or vomiting blood, seek immediate medical attention. 

Your doctor will likely check your symptoms and see how you react to treatments for acid reflux, like proton pump inhibitors (e.g., omeprazole) or H2 blockers (e.g., famotidine). If the treatments help, your doctor will probably diagnose you with GERD 1.

Your provider will probably then refer you to a gastroenterologist for tests, like an upper endoscopy or a barium swallow, to figure out exactly what’s causing your symptoms. It could be GERD or something more serious 1.

What Helps Acid Reflux Go Away?

If you only have acid reflux once in a while, like after eating too much or exercising right after eating, you can likely avoid more reflux by eating smaller meals and waiting before exercising. 

Treating GERD, on the other hand, isn’t usually that simple. If you’re diagnosed with GERD, your doctor will likely recommend some basic lifestyle strategies, including 1 3: 

• Avoiding large meals at least 3 hours before bending over much, doing intense exercise, or lying down
• Improving sleep habits 
• Losing weight, especially around the abdomen 
• Raising the head of your bed by 8–31 inches to help keep stomach acid down while sleeping

In addition to lifestyle changes, people with GERD are often advised to limit or avoid certain foods, such as 1 4:

• Fatty foods
• Chocolate
• Caffeine
• Spicy foods
• Citrus fruits
• Carbonated drinks

Along with diet and lifestyle changes, your doctor may recommend over-the-counter medications, like 1:

• Antacids (e.g., Tums or Rolaids)
• Alginate and antacid combinations (e.g., Gaviscon) 
• H2 blockers (e.g., Pepcid)
• Proton pump inhibitors (e.g., Nexium) 

Of these, alginate-based options are the most natural. They have also been well studied and are considered safe, so they may be the best choice if you prefer not to take proton pump inhibitors (PPIs), H2 blockers, or antacids 5 6.

However, when GERD is fairly severe or your esophagus has signs of damage, your doctor may suggest taking prescription PPI medications.  

What Are Proton Pump Inhibitors?

PPIs are medications that reduce the amount of acid your stomach makes. With less stomach acid, you can have less acid reflux and more tissue healing. PPIs take longer to work than fast-acting antacids, but they’re very effective.

For most people, PPIs are meant to be a short-term solution and shouldn’t be taken for more than one or two months. In the clinic, we often have clients who have been using PPIs for many months or even years, which can lead to some unwanted side effects.

The following table lists important pros and cons of PPI medications.

Unfortunately, PPIs can negatively impact gut health and nutrition over time. However, I don’t recommend stopping a PPI without speaking to a healthcare provider first. There are ways to reduce your need for these medications, but it’s important to have a safe plan for gradually cutting back.

Natural Strategies to Reduce the Need for PPIs 

Traditional diet changes, lifestyle adjustments, and PPIs or other medications can help many people with GERD, but they don’t always fully fix symptoms or inflammation in the esophagus 1. On top of that, the medications can have unwanted side effects. 

In our clinic, we focus on helping GERD clients build a healthy foundation to support better gut health by combining diet, lifestyle changes, and nutritional supplements. Typically, these actions get our clients off PPIs or keep them from having to consider taking them.

Anti-Inflammatory Diet 

Diet is, without question, one of the most impactful ways to improve gut health and heal GERD. 

Elimination diets are very effective for reducing symptoms of GERD because they can help people identify foods that could be triggering symptoms, and they remove foods that cause inflammation 4. In the clinic, we often start with a diet like the Paleo diet and track how symptoms change. 

We also use intermittent fasting as a proven strategy—GERD patients can reduce their reflux and heartburn by eating within an 8-hour window that is over well before bedtime 12. 

We aren’t tied to just one specific diet in our clinic. Instead, we encourage clients to pay attention to their symptoms and try different whole-foods approaches until they find what works best for them. 

Additional Lifestyle Strategies 

In addition to the healthy lifestyle changes most doctors recommend for GERD, other science-backed lifestyle treatments for reflux include:

• Breathing exercises (especially diaphragmatic breathing), which may help improve GERD symptoms, reduce the need for medication, and improve quality of life 13 14.
• Staying physically active, which may help prevent GERD 15.

Supplements 

When it comes to dietary supplements for acid reflux, there are many options. Two of the most beneficial are: 

1. Probiotics: We often use probiotics in our clinic to help with various gut and other symptoms. They may help with GERD, support gut health while using PPIs, and even improve the effects of PPIs 4 8 16. We prefer using a combination of probiotic categories to get the best results.
2. Curcumin: Research has found that curcumin may work as well as acid-lowering medications for treating indigestion (acid reflux in the lower esophagus), and it could also protect the esophagus from acid damage in people with GERD 17.

Get Treatment to Avoid Long-Term Effects of Acid Reflux 

An occasional episode of acid reflux can be annoying but is usually not harmful. However, untreated chronic acid reflux can lead to serious issues like difficulty swallowing and even cancer.

If you’re routinely experiencing GERD symptoms like heartburn, regurgitation, painful swallowing, belching, pain in your upper belly or chest, and nausea, it’s time to talk to your healthcare provider. 

For many people with GERD, changes in diet and lifestyle, along with probiotics, can be very effective and help prevent long-term problems from acid reflux. There are also many over-the-counter and prescription medications you can discuss with your doctor. 

I know it can be overwhelming to navigate through a GERD protocol. We’d be happy to help you create a comprehensive plan for healing, so contact us at the Ruscio Institute for Functional Health for an appointment.

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