As a doctor, I recommend against baking soda for reflux

Heartburn is a common condition, I suffered from it myself and often treat patients for it.

In response to a recommended diary, which suggested gargling with and swallowing sodium bicarbonate, I want to drop a quick note to advise against this.

Antacids such as Tums, or baking soda are very effective at neutralizing stomach acid and can bring on immediate relief for reflux symptoms.  

But there is a cost to this.  To put simply, the stomach does not like having its acid neutralized, and over time will respond by producing more and more acid to overcome the antacid.  

In medicine, this is called a rebound effect.

I have seen rebound reflux spiral out of control, and my first piece of advice to reflux sufferers, is to stop using antacids, except occasionally in small doses.

Here are some quick lifestyle tips to reduce or eliminate symptoms:

Take a proton-pump inhibitor such as over-the-counter omeprazole.  These drugs reduce acid by reducing acid production, rather than neutralizing it, and therefore no rebound.  They do not work immediately, unlike antacids, so use prior to symptoms when you can, usually once a day for a week or two.   Protip: omeprazole is usually much cheaper by prescription than buying it over the counter.  It can interfere with drug absorption, so clear with your doctor if on prescription meds or needed for more than a few weeks. 

Do not eat or drink at least 4 hours before bed.  Reflux usually occurs when people are laying down, and while you may be aware of it happening while awake, it is generally unnoticed while sleeping.  Keep your stomach empty before bed.  This includes drinking anything but little sips of water.  Even a glass of water can bring on reflux.  Of course some things are worse than others, so definitely avoid high caloric or fatty foods, alcohol, caffeine and peppermint.

Do not prop your head up with pillows.  Counterintuitively, this increases reflux by putting more pressure on the muscle than keeps acid in your stomach.  If you want to elevate, elevate the head of the bed and not your own head.

Eat small portions and small meals.  Smaller loads allow the stomach to process and move food more quickly.  Eating more calories at one time increases risks.

Weight loss.  If overweight, losing weight is highly effective at reducing symptoms and in itself, may be a cure.

I am traveling, so these are just some quick thoughts, and I won’t be able to regularly check comments.

Standard disclaimers apply, these are standard lifestyle tips, and may not be appropriate for all people.

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