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Do probiotics help with acid reflux? | BY HEIDI


 


Research suggests that probiotics may help ease symptoms of acid reflux — and some side effects of acid reflux medications.


While the evidence is promising, further large, placebo-controlled trials are necessary to confirm these effects.


Probiotics are living bacteria or yeasts that may benefit health, particularly digestive health. This article investigates how probiotics may benefit people with acid reflux and notes which bacterial strains may be best.


It also looks at important considerations when choosing probiotics and explores the risks. Finally, this article lists some alternative acid reflux treatments.


How could they help? 

Acid reflux involves stomach acid leaking upward, into the esophagus. Depending on how frequent it is, this may be uncomfortable, painful, or even debilitating.


Emerging research suggests that probiotics may be a viable complementary treatment, whether a person has occasional bouts of acid reflux or more prolonged gastroesophageal reflux disease (GERD).


There is also evidence that probiotics may ease side effects of medications that help manage the condition.


Which acid reflux symptoms could they ease?

A 2020 systematic review investigated the effects of probiotics on GERD. The authors looked at 13 studies of varying quality, 11 of which found that probiotics had some benefit for acid reflux. The specific benefits are below:


One study noted improvements in reflux or heartburn.

Five studies noted improvements in shortness of breath.

Three studies noted a reduction in regurgitation.

Nine studies noted improvements in other gastrointestinal symptoms, such as:

nausea

abdominal pain

belching or intestinal gurgling

While these findings are promising, the review did not include more rigorous, placebo-controlled trials, which will be necessary to confirm the effects of probiotics.


Do they help with side effects?

Another potential benefit of probiotics is that they may ease some side effects of proton pump inhibitors (PPIs)Trusted Source. These prescription medications reduce the production of stomach acid and help heal the lining of the esophagus.


Taking PPIs can cause small intestine bacterial overgrowth (SIBO). Symptoms of SIBO include:


abdominal pain and bloating

nausea

diarrhea

appetite loss

weight loss

malnutrition


At 12 weeks, the researchers assessed the participants with cured esophagitis. The group that had received the probiotic had lower rates of SIBO and decreased diarrhea.



At the end of the trial, the children who took probiotics had lower rates of SIBO, compared with those who took a placebo. These lower rates were similar to those of children without GERD.


The best probiotics for acid reflux


The American Gastroenterological Association offers the following advice about choosing probiotic supplements:


Opt for probiotics that list their strains of bacteria.

Buy them from an established company.

Ask a doctor for a recommendation.

Beware of buying fake probiotics online.


Taking probiotics and antacids together

Antacids are medications that neutralize stomach acid and alleviate acid reflux and heartburn. It is safe to take probiotics and antacids together, though each can interact with other medications. For this reason, a person should speak with a doctor before taking any kind of supplement.


Probiotics may increase the effectiveness of antacids and may even be a viable replacement.


A large 2021 study investigated different approaches for people with indigestion and acid reflux. Each participant received one of the following treatments:


probiotics with antacids

probiotics with PPI drugs

probiotics with prokinetics

probiotics alone

All groups experienced improvements in their indigestion symptoms. However, the group that received the probiotics alone had the greatest improvements.


Risks and considerations


Some risks of taking probiotics include:


bloating and discomfort

allergic reactions, which are serious in rare cases

exposure to microorganisms not listed on the label

bacterial or fungal infections

harmful interactions with other medications

harm from counterfeit products

In addition, research into the effects of probiotics on SIBO has had mixed results. Some studies show a benefit, while others have found that probiotics may make SIBO worse.


It is important to use probiotics as a complementary treatment, not a substitute for standard treatment.



Other acid reflux treatment options


Self-care strategies: These can help ease mild-to-moderate cases. A person can try:

avoiding fatty, spicy, or acidic foods

eating more frequent small meals, rather than fewer large meals

not eating before bed

elevating the head higher when sleeping

losing any excess weight

quitting smoking

Medications: A doctor may prescribe:

Antacids, to reduce the production of stomach acid and alleviate mild symptoms.

H2 blockers, which also help reduce stomach acid production.

PPIs, which have the same effect and can also heal the lining of the esophagus. A doctor may prescribe these when chronic acid reflux does not respond to antacids.

Surgery: A doctor may recommend surgery for people with severe GERD that does not respond to other treatment. Options include:

bariatric surgery to help with weight loss

fundoplication, which involves sewing around the top of the stomach to prevent stomach acid leaking into the esophagus

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