There are two basic types of reflux. One, the more typical and well-known form, is called gastroesophageal reflux disease (GERD). This is caused by acid and digestive enzymes that (rather than stay in the stomach as they should) travel upwards into the esophagus. The most common symptom is heartburn.
The other form of reflux
The other main reflux type is called “laryngopharyngeal reflux”, which is caused mostly by the digestive enzyme pepsin traveling even further up the esophagus, all the way into the upper part of the throat. The symptoms are: throat clearing, chronic cough, feeling of a lump in the back of the throat, hoarseness, and swallowing problems. This type of reflux is more difficult to diagnose, because most patients and doctors don’t think of it. But an exam by an otolaryngologist can usually confirm the diagnosis.
Both types of reflux are often treated by avoiding foods that trigger the symptoms, and medications. Typical triggers are coffee, tea, chocolate, soda, greasy or fatty foods, and alcohol. The most common medications used are called proton pump inhibitors, such as omeprazole and lansoprazole.
The problem is that sometimes medications don’t work, and also, long-term use of these medications is not advisable. While more research is needed, long-term use is suspected to raise the risk of bone fractures, heart attacks, stroke, and kidney problems. So, treatment without medications (or with less strong medications, such as ranitidine) is a better approach. And a new research study from New York suggests that treatment with diet change alone is better than treatment with medication.
The research involved 184 people with laryngopharyngeal reflux, studied over a 6-week period, with two different treatments. 85 of the patients were treated with the standard proton pump medication, along with avoiding trigger foods. The other 99 were treated with mostly a vegetarian diet, which the authors called a “Mediterranean diet”.
This diet was 90% food from plants, and 10% food from meats and dairy. This diet emphasizes fruits, vegetables, beans, nuts, and legumes, such as beans. They restricted meat to 2 to 3 small servings per week, and limited dairy. The other thing the diet group did was drink “alkaline water” during the day instead of regular water.
Alkaline water, which is less-acidic than standard water, has been shown to neutralize the enzyme pepsin, that is the main irritant in upper throat reflux. Most bottled mineral water is alkaline (check the label that the pH is above 7.0), or you make alkaline water yourself. One way is to dissolve ½ teaspoon of baking soda in 1 liter of filtered water.
Results of study
After 6 weeks, 54% of the people treated with medications showed a very significant improvement in their symptoms. But the results from the dietary change group were better—63% showed marked improvement. As a bonus, the people in the diet group lost on average 3 kg. of weight over the 6 weeks.
This research suggests that if you have reflux, you should strongly consider the option of dietary change—to a mostly vegetarian “Mediterranean diet”— instead of medications. It may be that this diet helps GERD as well as the upper throat reflux type. And, if you find you can’t fully transition to a Mediterranean diet, you may well get some improvement by decreasing your meat intake and increasing consumption of vegetables, nuts, and legumes.
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