Heartburn is a symptom of GORD or gastro-oesophageal reflux disease, also known as GERD. This burning sensation is due to liquid from the stomach rising up the gullet, or oesophagus. Which can also leave a nasty taste in the mouth. Heartburn can be an occasional nuisance or it can be a severe and lifelong problem.
It is important to be aware that over the long term GORD can cause complications. These include ulcers in the stomach and oesophagus. Or, even narrowing of the oesophagus, causing difficulty swallowing. These complications need more medical care than simple remedies can provide. Yet, if your symptoms are occasional or mild, research has shown that simple home remedies for heartburn may really help.
Orthodox medications for heartburn include antacids and acid blockers. They work by either neutralising stomach acid or blocking its production. This raises the pH of the stomach contents and helps reduce burning.
Yet stomach acid is vital for good digestion. Without an acidic environment the digestive enzymes can not work effectively. So, food is not broken down properly. Which can create problems such as poor absorption of vitamins and minerals.
Stomach acid also helps to prevent bacteria colonising the stomach and intestine. Bacteria can arrive in our digestive tract along with the foods we eat. They can also migrate from more distant parts of the intestines towards the upper digestive tract. When bacteria grow in the wrong parts of the gastrointestinal tract this is a form of dysbiosis, a condition called small intestine bacterial overgrowth (SIBO). Symptoms of SIBO might include stomach bloating, belching and bad breath.
So, antacids may provide quick relief from heartburn, but may cause other digestive problems over time. In addition, these medications don’t do anything to heal the irritated tissues. Or, to prevent further attacks. They may also have side effects such as constipation or diarrhoea.
The stronger medications such as proton pump inhibitors (PPI) work by reducing stomach acid production. Less acid means the pH in the stomach rises. The British Medical Journal published a large meta-analysis of the effect of PPIs. It concludes that using PPIs increases the risk of SIBO. Whilst a 2016 study found that PPIs affect the gut microbial composition, and change it to one that is less healthy and more at risk of infection by pathogens, specifically Clostridium difficile.
Whats more, low stomach acid and SIBO themselves can be a cause of acid reflux. As low stomach acid increases the risk of dysbiosis, which in turn can produce a build up of intestinal gas. The increase in pressure in the intestines causes stomach contents to be pushed up into the oesophagus, creating symptoms of heartburn.
Other studies point to long term PPI use damaging the gut, kidneys, heart and brain. They may also increase the risk of osteoporotic fracture in the elderly.
Self-help for heartburn
- Chilli peppers
- Citrus fruits and their juices
- Cow’s milk
- Fatty foods
Eating smaller meals can help. As can chewing food properly before swallowing. Then the stomach does not have to work so hard to digest food.
Avoid eating late at night, so the stomach is empty before you lie down to sleep. You could also raise the head of your bed around 6 to 8 inches (15 to 20 cm).
Some lifestyle changes can help to reduce heartburn. Try quitting or reducing smoking and lose some weight if you are overweight. Another tip is to avoid tight waistbands. These can squeeze the abdomen and increase the pressure on the stomach.
Liquorice is a demulcent and anti-inflammatory herb. This means that it soothes and reduces inflammation. Liquorice does not suppress acid production, rather it protects the stomach and oesophagus.
A European Medicines Agency report describes the traditional uses of liquorice. These include the relief of digestive symptoms such as burning sensation and dyspepsia. The describe the effectiveness of liquorice taken as a herbal tea or decoction.
A monograph, this time from the World Health Organisation, suggests using liquorice. This monograph explains using liquorice for prevention and treatment of ulcers and dyspepsia.
As well as soothing inflammation, liquorice improves mucous secretion. This secretion forms a barrier on lining of the stomach and oesophagus. Protecting the stomach lining from the effects of the stomach acid.
It is important to note that liquorice root is not suitable for everyone. One of the constituents of liquorice can raise blood pressure in susceptible people. Scientists found a way to remove most of this compound. Studies show that what remains is still effective. This product is known as DGL, or deglycyrrhizinated liquorice. 380mg DGL, three times a day, was as effective as an antacid or cimetidine for relief of chronic duodenal ulcers.
The WHO lists some other conditions where liquorice should be avoided. These are hypertension, cholestatic disorders, cirrhosis of liver, low potassium and chronic renal insufficiency. Liquorice is not suitable in medicinal quantities during pregnancy.
Honey has been used as a medicine and wound healer for centuries. It has known anti-inflammatory effects. Its high viscosity provides a protective covering to the oesophagus.
These are simple home remedies that might help to relieve mild and occasional symptoms of heartburn. If you have tried these or other home remedies for heartburn, let us know in the comments section.
If you have more than mild or occasional heartburn and would like to try and avoid conventional medications, it is best to ask a qualified herbalist.