Registered dietitian

Your stomach’s sphincters, or valves, hold food until it’s mixed with digestive juices into a liquid called chyme. Certain foods are thought to lead to reflux by causing relaxation of the lower esophageal sphincter, which allows stomach acid to flow upward and damage the sensitive lining of the esophagus. These foods include caffeinated beverages (coffee, tea, energy drinks, and cola), alcohol, chocolate, fatty foods (whole milk, cheese, yogurt, and lunch meats), fried foods, and butter. However, any food indirectly could cause irritation because the sight, smell, or taste of food stimulates the secretion of acid in the stomach.

Certain eating habits also can cause problems. Overeating, for example, can stress the stomach valve over time, and lying down after a big meal puts more pressure on the stomach sphincter to hold food and digestive juices where they’re supposed to be. This pressure increases the chance of acid leaking back up into the esophagus.

People with acid reflux should not eat within three hours of bedtime and should not nap after meals. It’s also best to eat smaller meals more frequently during the day and limit the amount of liquids at meals. Both of these habits will decrease your chance of overfilling, which puts additional stress on the stomach sphincter.

–Joanne Larsen, RD, LD, founder, dietitian.com, Chicago

Herbalist

In Chinese medicine, gastric reflux is called rebellious qi [pronounced “chee”], which means the digestive energy that is supposed to flow downward is going the opposite direction. Bitter herbs can treat rebellious qi because they help the energy descend. Take a simple bitter, which is any food that tastes bitter like arugula or broccoli rabe, five to ten minutes before meals to stimulate digestion, absorption, and elimination. Many companies manufacture liquid bitters too. Add between five and ten drops to a small amount of water and swish it around in your mouth and swallow before a meal. You can also try antispasmodic herbs, like wild yam and cyperus, which effectively stop spasms and reduce the risk of acid splashing back up into the esophagus. Chamomile, hops, valerian, and catnip naturally reduce stress and anxiety and therefore decrease stress to the gastrointestinal tract for people who develop gastrointestinal symptoms when stressed.

To deal with excessive stomach acid, I also recommend slippery elm or marshmallow, along with an herb called meadowsweet, which can all help neutralize extra acid. I often add small amounts of licorice, plantain, or calendula (pot marigold) to help heal the erosion and esophagus damage that can occur over time.

It’s best to take these herbs as teas or tinctures. Capsules are not as effective because the treatment needs to come into contact with the esophagus, and capsules do not break down until they are already in the stomach.

–David Winston, RH (AHG), founder and director, David Winston’s Center for Herbal Studies, Broadway, New Jersey

Naturopathic doctor

People tend to think that gastroesophageal reflux comes from having too much acid in the stomach, but often acid reflux can be the result of not having enough acid. When you’re constantly stressed, the body produces less stomach acid. The stomach then can’t properly break down or absorb food, which can cause gas, bloating, belching, constipation, or diarrhea and lead to food allergies that weren’t previously a problem. In these cases, I often prescribe digestive enzymes. As long as the lining of the stomach isn’t too damaged (then the lining would need to be healed first), which is the case with stomach-ulcer sufferers, those acids actually help with digestion.

First get tested for food allergies and intolerances or use an elimination diet to determine your specific “food triggers.” They could be common triggers like coffee, citrus, mint, and onions, but they may also be entirely different like wheat, dairy, or eggs. Avoid the foods that cause your symptoms to flare up. Also take digestive enzymes. But before starting on them, I recommend taking deglycyrrhizinated licorice (DGL) or the amino acid glutamine to heal the stomach lining. These can be very soothing because they essentially take the place of the gastrointestinal system lining that is being burned away and give the body a chance to heal itself.

It is good to find alternatives to strong prescription medications, which stop the stomach’s acid production and can hurt your ability to digest food. These medicines also can cause other food allergies and intolerances and can interfere with nutrient absorption.

–Ruth Galbraith, ND, president of the New Hampshire Association of Naturopathic Doctors, Granite State Natural Medicine, Keene, New Hampshire