Try these tips and remedies to ease your pain without taking a pill

Last year alone, Americans spent $942 million dollars on over-the-counter antacids, and a whopping 13.6 billion dollars on prescription acid suppressants. So how can we manage our acid reflux disease, and other similar symptoms? Are antacids always a good idea? Dr. Leo Galland, a medical advisor to the consumer newsletter "Bottom Line Personal" and author of the book “The Fat-Resistance Diet,” offers tips and natural remedies that could make us stop popping those pills.

Millions of Americans take drugs to relieve excess stomach acid. In fact, acid-suppressing drugs are among the most frequently prescribed medications in the US. They fall into two categories:

Proton-pump inhibitors like Prilosec, Prevacid, Nexium, Aciphex and Protonix. What they do is inhibit the enzymes that transport acid from the acid-secreting cells into the lining of the stomach.

H2 blockers like Zantac, Pepcid, Axid and Tagamet. H2 blockers inhibit the activity of histamine in the stomach. Histamine stimulates stomach cells to secrete more acid.

Although these drugs can be effective at relieving symptoms like heartburn and abdominal pain, they may have serious long-term side effects. Regular use of acid-suppressing drugs is associated with increased risk of hip fractures, probably because of impaired calcium absorption. Taking acid-suppressors also increases your risk of acquiring a food-borne intestinal infection or experiencing the overgrowth of bacteria in the stomach and small intestine. Overgrowth of bacteria in the stomach probably explains some other risks associated with regular use of acid suppressors including pneumonia, stomach cancer and vitamin B12 deficiency.

Gastroesophageal reflux vs. gastritis

Acid suppressing therapy is primarily used to treat two kinds of problems — gastroesophageal reflux (GERD) and gastritis (inflammation of the stomach lining). In gastroesophageal reflux, contents of the stomach flow backward up the esophagus and may reach all the way to the mouth. Symptoms include heartburn, chest pain, regurgitation of food, sore throat, hoarse voice and cough. Although acid suppressors are commonly prescribed, GERD is not caused by excess production of acid. It is caused by failure of the valve that separates the esophagus from the stomach (the LES or lower esophageal sphincter valve).

The good news is that there are natural remedies for these GERD problems that work even better than drugs and without the side effects:

Don’t stuff yourself. When you eat a lot at one time it causes stomach distension, which triggers relaxation of the LES.

Avoid high fat foods such as fried foods and cream sauces. These weaken the LES.

Don’t smoke. This also weakens the LES.

Don’t eat for three hours before lying down. When you’re upright, gravity works with you.

Maintain a normal weight. Being overweight increases your risk of GERD.

Don’t eat just before strenuous exercise. Strenuous exercise increases the tendency to get GERD.

Avoid foods that you know cause you discomfort until you’re better. So-called “acid” foods, like oranges and tomatoes, do not cause GERD, but they may irritate an already inflamed esophagus

These simple steps prevent symptoms of GERD in the majority of people and may allow you to avoid the use of acid-suppressing drugs. If not, try:

Calcium. Calcium tightens the LES valve. This is not an antacid effect. In fact, the best type of calcium, because it is the most soluble, is calcium citrate, which is itself mildly acidic. The most effective preparation is calcium citrate powder. Take 250 mg, dissolved in water, after every meal and at bedtime (for a total daily dose of 1,000 mg). Swallowing calcium pills does not prevent reflux because the calcium is not instantly dissolved.

Digestive enzymes. These appear to work by decreasingdistension of the stomach. The enzymes should be acid-resistant, so they work in the stomach itself, not in the small intestine. A powdered enzyme preparation (1/2 teaspoon) can be mixed together with the calcium powder above and taken after each meal. Digestive enzymes are available in health food stores and pharmacies.

Gastritis

The leading cause of gastritis (inflamed stomach lining) in the U.S. is the regular use of aspirin and anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve). Other causes include cigarette smoking, regular use of alcohol and the irritant effects of other medications, especially antibiotics.