Alternative treatment for acid reflux
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Alternative Treatments for Acid Reflux: A Comprehensive Review
Introduction to Acid Reflux and Its Challenges
Gastroesophageal reflux disease (GERD) is a chronic condition where stomach acid frequently flows back into the esophagus, causing irritation. Traditional treatments primarily involve proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs), which suppress acid production. However, these treatments are not always effective, especially for non-erosive reflux disease (NERD) or atypical GERD symptoms 47. This article explores various alternative treatments for acid reflux, focusing on complementary and alternative medicine (CAM) and other innovative therapies.
Complementary and Alternative Medicine (CAM) for Acid Reflux
Anti-Reflux Diet and Alkaline Water
Diet modification is a widely recommended approach for managing acid reflux. An anti-reflux diet, which includes avoiding trigger foods and eating smaller, more frequent meals, is beneficial for all patients . Additionally, there is some low-quality evidence suggesting that alkaline water may help alleviate symptoms .
Herbal Medicines
Traditional herbal medicines (THM) have been used for GERD for a long time, though clinical evidence remains limited. Studies indicate that therapies like Ligan Hewei and Jianpi, either alone or combined with PPIs, show promise in improving GERD symptoms such as acid regurgitation and heartburn . Another herbal formulation, Mastic pill (Habb-e-Mastaki), has demonstrated significant efficacy in reducing GERD symptoms in a double-blinded randomized clinical trial .
Alginate Therapy
Alginates are another alternative treatment that works by displacing the postprandial gastric acid pocket. Systematic reviews and meta-analyses have shown that alginate-based therapies are more effective than placebo or antacids in resolving GERD symptoms 46. However, they appear less effective compared to PPIs or H2RAs, though the difference is not statistically significant 46.
Other CAM Modalities
Other CAM modalities include prokinetics, respiratory retraining, voice therapy, rikkunshito (RKT), hypnotherapy, and sleep positioning. For patients with predominant vocal symptoms, voice therapy is supported by evidence . Alginate, RKT, and relaxation strategies may be beneficial for patients with globus symptoms when used alongside acid-suppressing medications .
Innovative Therapies
C-BLART (Clip Band Ligation Anti-Reflux Therapy)
C-BLART is a novel endoscopic treatment for refractory GERD. Short-term studies have shown that C-BLART significantly improves esophageal acid exposure, LES pressure, and GERD-Q scores compared to traditional PPI therapy . However, some patients may still require additional surgical interventions like laparoscopic fundoplication .
Natural Remedies
A formulation based on sodium alginate/bicarbonate combined with extracts from Opuntia ficus-indica and Olea europaea (Mucosave®) has shown significant efficacy in reducing GERD symptoms in a double-blinded randomized-controlled study . This natural remedy provides a well-tolerated alternative for managing GERD symptoms.
Conclusion
While traditional acid-suppressing medications remain the cornerstone of GERD treatment, various alternative treatments offer promising results for patients with refractory symptoms. Dietary modifications, herbal medicines, alginate therapy, and innovative treatments like C-BLART and natural remedies provide viable options. Further research and well-designed clinical trials are necessary to validate these alternative treatments and integrate them into standard GERD management protocols.
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