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Gastric reflux is the regurgitation of stomach content into the esophagus and is accompanied by persistent, troublesome symptoms and complications (1).

Gastric reflux occurs in the presence of these factors: (2,3)

  • The transient, spontaneous relaxation of the muscle called the lower esophageal sphincter (LES): The LES expands or relaxes to allow food to enter the stomach then contracts or tightens to prevent the back-up (reflux) of food and stomach acid into the esophagus. At times, fluid retracts into the esophagus.
  • A Hiatus hernia: The upper part of the stomach is pushed into the chest area from an opening in the diaphragm. As a result, stomach acid has an easier way of entering the chest cavity.
  • Weakened basal LES pressure: A study evaluating the effects of intraabdominal pressure on LES showed that there was a direct correlation between the pressure exerted by the LES and the gastric pressure induced (3). Factors affecting the pressure include being obese/overweight, pregnant, prescribed certain medication (e.g. asthma, calcium channel blockers for high blood pressure, painkillers, sedatives, antidepressants, antihistamines).
  • Esophageal peristalsis dysfunction: The esophageal peristalsis assists with the clearance of the esophageal and prevents reflux from occurring. There may be some low-amplitude contractions which result in prolonged clearance and in turn occurrences of reflux.


  • Increase in age
  • Increase in body mass index (BMI)
  • Lower educational level
  • Diet or consumption of specific foods
  • Tobacco smoking (4,5,6)
  • Gender (females are at a higher risk of having gastric reflux than males)
  • Psychological factors like anxiety and depression (7)


Symptoms of gastric reflux can be subdivided into two categories. The first is esophageal, which includes typical and atypical symptoms of gastric reflux.


  • Acid regurgitation
  • Heartburn


  • Dyspepsia (indigestion)
  • Mild to severe chest pains
  • Epigastric pain
  • Epigastric pressure
  • Nausea
  • Bloating
  • Belching
  • Sleep disorders (2)

The second category is extra-esophageal(also known as laryngopharyngeal reflux). These symptoms arise when the reflux of gastric content (which contains acid, pepsin and bile) travel passed the upper esophageal sphincter and enter the pharynx, larynx and upper respiratory system. Sometimes it is hard to diagnose these as extra-esophageal symptoms especially when typical gastric reflux symptoms (e.g. heartburn and regurgitation) are absent. Common symptoms of extra-esophageal reflux include (8,9,10):

  • Hoarseness
  • Chronic cough
  • Reflux dental erosion

For more information about gastric reflux: 1. Talk with your doctor  2. Visit the Mayo Clinic website 3. Visit the American College of Gastroenterology website


Approximately 40 percent of the population in the U.S. report symptoms of gastric reflux as its prevalence is steadily increasing. More than 9 million patients are seen in outpatient centers annually for gastric reflux. As a result, gastric reflux complaints are imposing a financial burden on both healthcare systems and employers as patients’ health, and quality of life is greatly affected (11).


Pharmacological treatments for gastric reflux have emerged over the years as research and studies seek new ways to minimize the complications associated with the condition. Treatments include (12):

  • Antacids (neutralize acids): Side-effects include nausea, constipation, diarrhea, or headache (13,14).
  • Histamine-2-receptor antagonists (suppress acid production): Common side-effects include constipation, diarrhea, difficulty sleeping, dry mouth, dry skin, headaches, ringing in the ears, runny nose, and trouble urinating (15).
  • Proton pump inhibitors (suppress acid production): Omeprazole, Lansoprazole, Rabeprazole, Pantoprazole, Esomeprazole. Possible side effects include depression, muscle cramps, nausea/vomiting, dry mouth, impaired vision or eye pain, fever, sore throat, cough, kidney problems, diarrhea, and enlarged ankles, hands or feet (16,17,18,19).
  • Surgical therapy: Corrects any physical defects related to components of the anti-reflux barrier


Practices That Support a Healthy Stomach:

  • Limit the intake of fatty foods
  • Quit smoking or avoid second-hand smoke
  • Avoid certain foods that tend to trigger gastric reflux (e.g. chocolate, alcohol, coffee, onions, garlic, alcohol)
  • Elevate the head of the bed
  • Exercise and weight loss especially for obese patients
  • Yoga (20,21,22)

Natural Supplements That Support a Healthy Stomach:


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