Grace from Houston sent us this question: “Hi, I have reflux at night, and I am on a mixture of zinc, digestive enzymes, and slippery elm. This helped and I just was on zinc. But just recently it has flared up again, but with heartburn as well. I had reintroduced coffee and small amount of dark chocolate. I saw you have said food doesn’t cause reflux. How do I strengthen the weak anti-reflux barrier, is this the sphincter and what if I have low stomach acid? I really appreciate your help, thank you.”
Dear Grace,
The most reliable approach to strengthening acid reflux barrier is hiatal hernia repair and Nissen fundoplication. Laparoscopic hiatal hernia repair and Nissen fundoplication safely and effectively restores the anti-reflux barrier, leading to immediate cessation of acid reflux from stomach into esophagus. Following Hiatal hernia repair and Nissen fundoplication you can enjoy a regular diet including coffee and dark chocolate.
There are no medications or natural supplements that can strengthen or restore the anti-reflux barrier. Zinc, digestive enzymes, and an endless number of folk remedies do not address the complex underlying pathophysiology of acid reflux.
By the same token, prescribed medications for acid reflux like proton pump inhibitors, PPIs, do not strengthen the anti-reflux barrier. These medications reduce stomach acid secretion. However, PPIs do not stop gastric content reflux into esophagus and throat. PPIs are therefore a Band-Aid for acid reflux. PPIs reduce GERD symptom severity without curing acid reflux.
Furthermore, certain exercises, stretching techniques and chiropractic adjustments do not strengthen or restore the anti-reflux barrier. Hiatal hernia repair can only be achieved through surgery. There is no musculoskeletal maneuver that can reverse a hiatal hernia or strengthen the anti-reflux valve.
Finally, diet and certain social habits like smoking and alcohol consumption affect the strength of the lower esophageal sphincter. We do recommend weight loss, smoking cessation and reduced alcohol consumption. A reflux friendly diet can help lessen the severity and frequency of acid reflux symptoms in early stages of the disease. However, as GERD progresses and acid reflux barrier weakens, dietary changes become less effective at controlling acid reflux.