Does water help acid reflux
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The Role of Water in Managing Acid Reflux
Introduction to Acid Reflux and Water
Acid reflux, also known as gastroesophageal reflux disease (GERD), is a common condition where stomach acid flows back into the esophagus, causing discomfort and potential damage to the esophageal lining. Various treatments are available, including lifestyle changes, medications, and dietary adjustments. One area of interest is the potential role of water, particularly alkaline and mineral waters, in managing acid reflux symptoms.
Alkaline Water and Pepsin Inactivation
pH 8.8 Alkaline Water Benefits
Research has shown that pH 8.8 alkaline water can be beneficial for individuals with reflux disease. Pepsin, an enzyme that plays a crucial role in the pathophysiology of reflux disease, requires an acidic environment to remain active. Alkaline water with a pH of 8.8 has been found to irreversibly inactivate pepsin, rendering it permanently inactive1. This inactivation can potentially reduce the damage caused by pepsin in both laryngopharyngeal reflux (LPR) and GERD.
Acid-Buffering Capacity
In addition to inactivating pepsin, pH 8.8 alkaline water has a superior acid-buffering capacity compared to conventional drinking waters. This means it can neutralize stomach acid more effectively, providing relief from acid reflux symptoms1. This dual action of inactivating pepsin and neutralizing acid makes alkaline water a promising adjunct therapy for reflux disease.
Mineral Waters in GERD Treatment
Clinical Studies on Mineral Waters
Mineral waters have also been studied for their potential benefits in treating GERD. A study involving 90 GERD patients compared the effects of standard treatment alone to standard treatment combined with either boric highly mineralized bicarbonate sodium water or highly mineralized sulfate-bicarbonate sodium-magnesium water. The results indicated that both types of mineral water significantly improved symptoms of dyspepsia and abdominal pain, with the sulfate-bicarbonate sodium-magnesium water also normalizing liver function2. These findings suggest that mineral waters can be a valuable component of a comprehensive GERD treatment plan.
Alkaline Water and Laryngopharyngeal Reflux (LPR)
Clinical Improvement in LPR
A study investigating the effect of alkaline water on LPR patients found that while both the control group (receiving standard therapy and mineral water) and the treatment group (receiving standard therapy and alkaline water) showed clinical improvements, there was no significant difference between the two groups3. This suggests that while alkaline water may contribute to symptom relief, it may not be significantly more effective than standard treatments alone.
Water Infusions and Acid Clearance During Sleep
Esophageal Responses to Water and Acid Infusions
Another study explored the effects of water and acid infusions on esophageal clearance during sleep. It was found that acid infusions led to greater arousal responses and increased swallowing rates compared to water infusions. However, the peristaltic parameters (amplitude, velocity, and duration) were not significantly different between acid and water infusions or between sleep and waking states4. This indicates that while water may help clear acid from the esophagus, its impact on esophageal motility during sleep is limited.
Conclusion
In summary, water, particularly alkaline and mineral waters, can play a beneficial role in managing acid reflux. Alkaline water with a pH of 8.8 can inactivate pepsin and neutralize stomach acid, providing relief from reflux symptoms. Mineral waters have also shown promise in improving GERD symptoms and overall digestive health. However, while these waters can be helpful, they should be considered as part of a broader treatment strategy rather than a standalone solution. Further research is needed to fully understand the extent of their benefits and to optimize their use in reflux disease management.
Sources and full results
Most relevant research papers on this topic
Potential Benefits of pH 8.8 Alkaline Drinking Water as an Adjunct in the Treatment of Reflux Disease
pH 8.8 alkaline water instantly denatures pepsin, rendering it permanently inactive, and has good acid-buffering capacity, potentially offering therapeutic benefits for patients with reflux disease.
In Vitro StudyApplication of mineral waters in the complex treatment of patients with gastroesophageal reflux disease.
Highly mineralized mineral waters can effectively reduce abdominal pain and dyspeptic symptoms in gastroesophageal reflux disease patients, improving stomach acid-forming function and liver function.
RCTEffectivity of alkaline water on the clinical improvement in laryngopharyngeal reflux
Alkaline water has an effect on clinical improvement in laryngopharyngeal reflux patients, but there is no significant difference in improvement between control and treatment groups.
RCTEffect of sleep on swallowing, esophageal peristalsis, and acid clearance.
Acid infusions during sleep increase arousal responses and swallowing rates, but do not significantly affect esophageal peristalsis or peristaltic parameters.
Non-RCT
Highly CitedEffect of alginate in patients with GERD hiatal hernia matters.
Alginate significantly decreases acid reflux within the first hour after intake, both in patients with and without hiatal hernia, but has no effect on the height of reflux events along the esophagus.
Non-RCTSalivary response to esophageal acid in normal subjects and patients with reflux esophagitis.
Saliva flow increases with the onset of heartburn, potentially acting as an endogenous antacid to protect against symptomatic gastroesophageal reflux.
Non-RCTHighly CitedHabit of proper and adequate food chewing, avoiding water during meals and drinking water 1-2 hours after meals in patients of gastroesophageal reflux diseases (GERD).
Proper and adequate food chewing and water drinking habits can significantly reduce symptoms and acid suppressive drug ingestion in patients with gastroesophageal reflux diseases (GERD).
Non-RCTStrongly acidic gastroesophageal reflux and esophageal lumen pH before and after esophageal lavage with water or two bicarbonate concentrations in anesthetized dogs.
Bicarbonate 1% and 2% effectively increased esophageal lumen pH to more than 4 in dogs with strongly acidic gastroesophageal reflux during anesthesia, while water lavage was mildly effective but required large volumes and predisposed to further regurgitation after anesthesia.
Non-RCT
Animal StudyGastroesophageal reflux in children: evaluation of the water siphon test.
The water siphon test is an appropriate initial examination for symptomatic children with gastroesophageal reflux, but the false-positive rate is high.
Observational Study[Alkalizing activity of a calcium-bicarbonate-containing water, evaluated for pH, in patients with gastroesophageal reflux].
Bicarbonate-calcic water Ferrarelle significantly increases esophageal and gastric pH levels, improving heartburn and acidity in patients with gastroesophageal reflux disease.
Non-RCT