It is estimated that Gasto-Oesophageal Reflux Disease (GORD) affects between 10% and 30% of the adult population in developed countries (1), and while common, can be a distressing symptom and left untreated progressive reflux can inflame the oesophagus leading to erosion and long-term inflammation.
When doctors assess a new presentation of reflux they take a full history excluding upper GI red flags such as associated weight loss, persistent vomiting, obstruction to swallowing/choking, followed by an examination to check for any masses or clinical signs. If the history suggests GORD, some patients are further tested for a bacteria in the stomach thought to cause up to 30-40% of cases of chronic gastritis and upper GI ulcerative disease called Helicobacter Pylori. A simple stool, breath or blood test can identify this issue and eradication therapy is available via a GP.
The stomach produces acid for a reason
PPIs (Proton Pump Inhibitors) are a class of drugs that reduce how much acid your stomach makes and include products such as Omeprazole, Lansoprazole, Pantoprazole and Esomeprazole. Many of these drugs are currently available over the counter (OTC) in the UK. PPIs are generally considered safe, but concerns about long-term use have been raised particularly if use becomes chronic. Research has associated these medications with an increased risk of fracture (2), cardiovascular disease (3), dementia (4), chronic kidney disease (5) vitamin/mineral deficiencies, and infection. Prolonged use can also lead to hypochlorhydria, which is a converse deficiency of stomach acid. If you don’t have enough stomach acid, you can’t digest food properly or absorb its nutrients. This leads to indigestion, malnutrition and sometimes bacterial overgrowth (3).
Multiple prescriptions and 'polypharmacy'
One of the current issues facing general practice is the phenomenon of 'polypharmacy', and one recent observation of my own and general clinical practice is an overuse of PPI drugs. Sometimes patients are put on PPIs as repeat prescriptions, and not being advised they are usually (dependent on severity) for short term periodic use only. The aim is to alleviate symptoms of heartburn and GORD and allow recovery of an inflamed section of the GI tract. Sometimes provided as a co-prescription for drugs known to irritate the stomach or increase bleeding.
Hard to stop taking PPIs. Rebound!!
Taking PPIs can be difficult to stop or give up due to the 'rebound' effect. PPI rebound, also known as rebound acid hypersecretion (RAHS), is when the symptoms and the acid return with a vengeance. The symptoms including heartburn, regurgitation, and dyspepsia can be extremely unpleasant and very painful.
There is therefore a huge need to try and find more natural, alternative solutions to these powerful drugs.
This led me into a deep dive into natural remedies for GORD and feedback from those that have tried some of these measures/natural alternatives and have had good positive results. The se findings are as follows:
Conservative measures:
Lifestyle changes may help such as weight loss, smaller more regular meals, reducing smoking and raising the head of the bed slightly have all proven helpful to many patients. Understanding and avoiding triggers such as spicy/acidic foods, alcohol, high fat or caffeine are a few examples of common triggers.
Natural alternatives to PPI:
- Over ripened papaya and banana:
Eating overly ripe banana/papaya can relieve stomach symptoms, alleviate bloating and indigestion, and stimulate the stomach.
- Apple cider vinegar:
Gastritis can be due to low hydrochloric acid and stimulating this as a home remedy made of apple cider vinegar mixed with honey and diluted in water boosts hydrochloric acid production, improving digestion and easing inflammation.
- Chamomile Tea:
Drinking chamomile tea is good for gastric conditions. It helps manage symptoms of stomach illness and prevent further damage, containing significant amount of essential oils which work to ease the underlying cause of digestive disease and relaxes stomach muscles (7).
- Cat nip (Nepeta cataria):
Catnip tea is most commonly used to treat symptoms related to gastrointestinal upset, including indigestion, cramping, and gas. It has additional benefits around anxiety and insomnia. (8)
- Pre and probiotics:
Probiotics are live microorganisms that when consumed orally in adequate amounts provide many health benefits. Currently, studies indicate that probiotics are promising for future applications in the management of gastric ulcers. They are thought to help by protecting the gastric mucosal barrier, increase prostaglandins, mucus, growth factors and anti-inflammatory cytokines, increased cell growth/healing and stimulating blood vessel growth (9).
- Marshmallow root powder:
Marshmallow root is high in mucilage, which may be advantageous for people with gastritis because its slippery nature soothes irritated mucus membranes. It is available in capsules, powders, syrups and teas (10).
- Slippery Elm:
People use the inner bark for of the slippery elm tree native to the USA for medicinal purposes. It contains “mucilage,” and when mixed with water it becomes a gel which can coat different parts of the body and may provide relief of inflamed tissues in the gastrointestinal tract, which could be useful if you have acid reflux. It can also help stimulate more mucus production in the intestines (11).
- Peppermint tea/oil:
Peppermint oil is a popular essential oil for treating gastritis. It has a cooling and soothing effect on the stomach, which can help to relieve the bloating/pain and discomfort associated with gastritis (12).
- Liquorice root:
Glycyrrhizin in liquorice root offers potent anti-inflammatory and antimicrobial properties, making it effective in treating ulcers and gastritis. It is an anti-inflammatory to the gastric lining, soothing irritation, and helping the body combat harmful bacteria. Also rich in flavonoids which are powerful antioxidants (13).
- Ginger:
Ginger treats gastritis effectively due to its antibacterial and anti-inflammatory properties, reducing inflammation and treating flare-ups (14).
Summary
I hope that this information makes it apparent that there are plenty of non-pharmaceutical options that are natural, cheap and efficacious alternative sources for treating gastritis.
*Please do consult your own doctor to discuss any of the above remedies in regards to possible interaction with other medications or specific to your individual comorbidities*
Feature pic: Image by Silvia from Pixabay
References:
- BMJ Best Practice (2022) Gastro-oesophageal reflux disease. BMJ Publishing Group. http://bestpractice.bmj.com
- https://my.clevelandclinic.org/health/diseases/23392-hypochlorhydria
- https://www.gov.uk/drug-safety-update/proton-pump-inhibitors-in-long-term-use-increased-risk-of-fracture
- https://www.mayoclinicproceedings.org/article/S0025-6196(21)00642-X/ful…
- https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.13477
- https://www.ajkd.org/article/S0272-6386(19)30939-4/fulltext
- https://www.healthline.com/health/digestive-health/chamomile-tea-acid-reflux
- https://www.healthline.com/health/catnip-tea#uses
- https://pmc.ncbi.nlm.nih.gov/articles/PMC4906699/
- https://www.naturopathic-health.co.uk/marshmallow-root-herbal-remedy.html
- https://www.healthline.com/health/digestive-health/slippery-elm-for-acid-reflux#benefits
- https://pmc.ncbi.nlm.nih.gov/articles/PMC5814329/
- https://www.longlifenutri.com/blogs/news/the-power-of-licorice-root-for-digestive-health-natural-remedies-for-a-healthy-gut
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6341159/
Gastro-oesophageal reflux disease (acid reflux). The regurgitation of acidic fluid from the stomach into the oesophagus.
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