Acid reflux is one of the most commonly diagnosed digestive conditions in adults. In this article, we'll look at whether probiotics help with acid reflux.
Research suggests that probiotics can help to ease some symptoms of acid reflux and some of the side effects of acid reflux medication.
1 in 5 adults in the US suffers from gastroesophageal reflux disease (GERD), also known as chronic acid reflux. (Source)
Acid reflux sometimes referred to as heartburn or indigestion, is caused by acid from the stomach moving up into the oesophagus.
This occurs when the lower oesophageal sphincter, a valve that is in charge of letting food into the stomach and keeping it there, does not close fully.
This hydrochloric acid in our stomach is so powerful, it could even strip paint from a car.
This may be shocking to some, but anyone who has suffered from the extreme discomfort experienced with acid reflux will likely not be surprised at that fact.
Acid reflux is a condition that can have a significant impact on a person’s quality of life.
Symptoms Of Acid Reflux
Acid reflux is not a condition likely to go unnoticed.
Typical symptoms include: a burning sensation in the chest (heartburn), regurgitation of food or sour liquid, burping, a frequent need to clear your throat, and difficulty swallowing.
It is not uncommon to experience these symptoms occasionally, especially if lying down after a large meal.
However, if these symptoms occur regularly, more than a couple of times a week, consult your healthcare practitioner as you may be suffering from GERD.
If left untreated, GERD can lead to further health conditions.
Such as:
- Damage to the throat and oesophagus.
- Inflammation or narrowing of the oesophagus.
- Dental erosions.
- Chronic cough.
- Asthma.
- Barrett oesophagus.
Related: Check out whether you can take Probiotics and Prebiotics together
Causes Of Acid Reflux
There is currently no known cause for the development of GERD but several factors that may increase a person’s risk of suffering from the condition have been identified over the years.
These include:
Overeating
A common and obvious trigger for acid reflux is overeating.
When we overeat food our stomachs become overfilled.
When the stomach is full of food, it is harder for the lower oesophageal sphincter valve to close fully, making it easier for stomach acid to creep into the esophagus.
Eating Habits
The type of food you eat can also have an impact on your likelihood of experiencing acid reflux.
Food that is fried, spicy food and acidic foods are commonly associated with heartburn, as are drinks such as coffee and alcoholic beverages and the use of tobacco products.
Eating too quickly can also bring on a bout of acid reflux, as can laying down too soon after a meal.
Obesity
Research suggests that those who are obese or carrying extra weight are more likely to deal with acid reflux and GERD, with the incidence of symptoms of the conditions rising as BMI increases. (Source)
This is likely due to increased pressure in the abdomen caused by the extra weight, pushing food up towards the opening of the stomach.
This is also seen in pregnant women, another group that commonly suffers from acid reflux and heartburn.
Chronic Stress
Our digestive system and our nervous system are constantly in contact with each other and so, a change in one system can result in a change in the other.
Studies show that those dealing with long-term or chronic stress and anxiety experience worse reflux symptoms. (Source)
Stress and anxiety may increase stomach acid production and reduce tension in the lower oesophageal sphincter valve, increasing the chance of experiencing acid reflux.
Gut Health
An imbalance in gut bacteria can affect the breakdown of carbohydrates in the gut causing fermentation which can lead to stomach acid bubbling up and potentially moving into the oesophagus.
Gut Infection
H. pylori, a stomach infection that typically starts in childhood, is connected with acid reflux.
While many people have H. pylori bacteria present in their gut, it only affects a few of us adversely.
These bacteria lower the acidity in the stomach in order to survive.
This lowering of our stomach acid leads to food not being fully digested which in turn causes fermentation.
This fermentation can cause bubbling which pushes the lower oesophageal sphincter open, leading to acid reflux.
The Role Of Probiotics In Alleviating Acid Reflux Symptoms
Probiotics are the friendly bacteria that naturally live in our gut but can also be found in certain foods and in supplement form.
These bacteria are known to be beneficial to our gut health.
Although there is not currently much research in to the effect of probiotics on acid reflux, a 2020 review of studies on the topic did conclude that probiotics provide some benefit on GERD symptoms. (Source)
The research shows the following effect of probiotics on GERD symptoms:
- Reduction in the number of GERD episodes.
- Reduction in the frequency of GERD episodes.
- Improvement in acid reflux and heartburn.
- Improvement in shortness of breath.
- Reduction in regurgitation.
- Reduction in gastrointestinal issues including nausea, abdominal pain, and burping.
Probiotic research has focused mainly on the effect of probiotics on the lower digestive tract, so the activity of probiotics in the upper digestive tract, where GERD issues take place, is still largely unknown.
It is thought that the reason probiotics are helpful in alleviating acid reflux symptoms is because they work to balance the bacteria in the small intestine.
In doing this, they exert antibacterial and anti-inflammatory effects while also having a beneficial effect on stomach acid secretion.
Probiotics also interact with receptors in the stomach lining that trigger the opening and closing of the lower oesophageal sphincter valve, which plays a large role in acid reflux, as mentioned previously.
Probiotics And Acid Reflux Medication
A common treatment for those diagnosed with GERD is a prescription for medications called proton pump inhibitors (PPIs).
PPIs reduce the production of stomach acid and help heal the oesophageal lining.
Unfortunately, taking PPIs can lead to another condition called small intestine bacterial overgrowth (SIBO).
Symptoms of SIBO include abdominal pain and bloating, nausea, diarrhea, loss of appetite, and malnutrition.
Research has found that taking probiotics alongside PPIs can lower the rate of SIBO in patients, allowing them to enjoy the benefits of the medication without the side effects.
Probiotics For Acid Reflux
Most studies that have examined probiotics for GERD have investigated Lactobacillus bacterial strains.
Some have also looked at Bacillus subtilis and Enterococcus faecium, all of which may help with acid reflux.
However, some strains may be better suited depending on the cause or symptoms of the reflux.
For those whose acid reflux is due to an imbalance in gut bacteria, also known as dysbiosis, caused by antibiotic use or poor diet, Saccharomyces boulardii has been seen to work well and may be a good choice.
S. boulardii is found in the fruits mangosteen and lychee but outside of these foods is hard to find in natural substances and so is most commonly consumed through over-the-counter supplements.
Lactobacillus acidophilus, one of the most common types of probiotics that can be found in fermented foods, yogurt, and supplements, may also be beneficial in restoring balance in gut bacteria.
Studies show that the probiotic strain Bifidobacterium lactis can reduce certain gastrointestinal issues commonly associated with GERD, including regurgitation, nausea, and vomiting. (Source)
These are symptoms commonly reported by pregnant women suffering from GERD. Bifidobacterium lactis has been clinically trialed and deemed safe for pregnant women to take.
However, not all probiotics are safe to take during pregnancy so it is recommended to consult your healthcare practitioner before including probiotics in your diet while pregnant.
Probiotic supplements often contain a combination of bacterial strains that work together for the specific purpose of that supplement.
Some supplements also contain prebiotics and added vitamins which may be helpful to those whose gut issues result in a lack of nutrient absorption.
Consult with your healthcare practitioner for advice on the best probiotic for you.
Probiotics And Antacids
Antacids are medications that neutralize stomach acid and alleviate acid reflux and heartburn.
It can take a while to see results when taking probiotics and so there may be a period of time where you might need to take antacids and probiotics together.
It is safe to take probiotics and antacids together.
A study in 2021 investigated the various treatment approaches for people suffering from indigestion and acid reflux.
Participants received one of the following treatments:
- Probiotics with antacids.
- Probiotics with PPI drugs.
- Probiotics with prokinetics.
- Probiotics alone.
While all four groups experienced improvements in their symptoms, the group taking probiotics alone were found to have the greatest improvements. (Source)
Summary
Although there is not yet a wealth of research on probiotics and their effects on acid reflux, the evidence so far suggests that probiotics are beneficial in alleviating symptoms of acid reflux and some side effects of acid reflux medication.
If you are suffering from acid reflux, consult your healthcare practitioner to discuss the best treatment options for you.