Does peppermint worsen acid reflux?

GERD is when the stomach acid frequently flows back in to the food pipe connecting the mouth and stomach (Source: Getty Images/Thinkstock)

GERD or Gastro-Esophageal Reflux Disease, a serious form of acid reflux, is a digestive disorder that leads to heartburn, regurgitation of food, wheezing, and even difficulty in swallowing. While it is often treatable with antacids, many people also swear by certain herbal remedies for relief. One such common solution is peppermint, which is known to be cooling and soothing for the body. However, should you really have peppermint in the case of acid reflux? According to nutritionist Pooja Palriwala, it might actually worsen the symptoms.

“You might think this refreshing herb would cool down heartburn and soothe reflux. Surprisingly, it does just the opposite. Mint relaxes the muscles in your esophagus, including the sphincter, so acid and other food remnants can flow back up to worsen reflux,” Palriwala wrote on Instagram.

 

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Here’s what happens

GERD is when the stomach acid frequently flows back into the food pipe that connects the mouth and stomach. This causes symptoms like burning in the chest after a meal, bitter or sour taste in the mouth, difficulty swallowing, bad breath, nausea, and in some cases vomiting.

How does peppermint impact?

Since ancient times, peppermint has been used in traditional folk medicine to treat indigestion, nausea, and vomiting. This is as a result of peppermint’s soothing, calming, and relaxing effects, which aid in stomach relaxation, said Dr Jinal Patel, dietitian, Apollo Spectra Hospital, Mumbai. “It also has some antifungal and antibacterial properties, which help prevent stomach infections. However, it can be a challenging herbal remedy for people with acid reflux,” Dr Patel told indianexpress.com.

Peppermint may not really work for acid reflux; here’s why (Source: Getty Images/Thinkstock)

“Since peppermint ‘relaxes’ the intestines, taking it in larger doses might be harmful, especially for people with GERD. The lower esophageal sphincter, or LES, a muscle flap between the esophagus and stomach, can relax in response to high amounts of peppermint. Acid reflux is brought on by a loosened LES, which permits acid and other stomach substances to flow back up the oesophagus and into the mouth. One of the main causes of persistent acid reflux in the majority of cases is this mechanical defect,” added Dr Patel.

So, consult an expert before you consume peppermint to get relief from acid relief next time.

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Lack of effect of spearmint on lower oesophageal sphincter function and acid reflux in healthy volunteers

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Clinical Trial

. 1999 Jun;13(6):805-12.

doi: 10.1046/j.1365-2036.1999.00528.x.

R Bulat 
¹
, E Fachnie, U Chauhan, Y Chen, G Tougas

Affiliations

Affiliation

• ¹ Division of Gastroenterology and Digestive Diseases Research Program, McMaster University Medical Centre, Hamilton, Ontario, Canada.

• PMID:

  10383511

• DOI:

  10.1046/j.1365-2036.1999.00528.x

Free article

Clinical Trial

R Bulat et al.

Aliment Pharmacol Ther.

1999 Jun.

Free article

. 1999 Jun;13(6):805-12.

doi: 10.1046/j.1365-2036.1999.00528.x.

Authors

R Bulat 
¹
, E Fachnie, U Chauhan, Y Chen, G Tougas

Affiliation

• ¹ Division of Gastroenterology and Digestive Diseases Research Program, McMaster University Medical Centre, Hamilton, Ontario, Canada.

• PMID:

  10383511

• DOI:

  10.1046/j.1365-2036.1999.00528.x

Abstract

Background:

Spearmint is commonly used as an antispasmodic and as a flavouring in several medications including antacids. It can produce heartburn, presumably by lowering lower oesophageal sphincter (LES) tone, but the mechanism has not previously been objectively examined.

Aim:

To study the effect of spearmint on LES function, acid reflux and symptoms.

Methods:

In healthy volunteers, a Dent Sleeve and a pH electrode were placed in the distal oesophagus. They were then given spearmint either in a flavouring (0.5 mg), or a high (500 mg) dose, or a placebo, using a double-blind randomized crossover design. LES pressure, oesophageal pH and symptoms were recorded for 30 min before and after administration.

Results:

LES pressure was not affected by spearmint, either high dose (19.6 vs. 16.0 mmHg), flavouring dose (20.2 vs. 19.8 mmHg) or placebo (20.5 vs. 19.2 mmHg, all N.S.). There were no differences in reflux occurrence following high dose (mean = 0. 65 vs. 0.85 episodes), low dose (0.4 vs. 0.5 episodes) or placebo (0.7 vs. 1.10 episodes, all N.S.). There was a significant increase in mean symptom scores following high-dose spearmint (0 vs. 0.35, P = 0.03), but not low dose (0 vs. 0.2) or placebo (0 vs. 0.5, both N.S.). One subject reported symptoms with placebo, one with low dose, and six with high dose; all without increased reflux episodes or decreased sphincter pressure.

Conclusion:

Spearmint has no effect on LES pressure or acid reflux. Flavouring doses of spearmint do not produce more symptoms than placebo while high doses can be associated with symptoms, presumably from direct mucosal irritation but not reflux.

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Treatment and prevention of gastroesophageal reflux disease

Treatment and prevention of gastroesophageal reflux disease (GERD)

Gastroesophageal reflux disease (GERD) therefore, not treated or treated independently and incorrectly, which is undesirable since GERD usually responds well to treatment.

GERD is treated gradually. The doctor will help you choose the right course of treatment. If the disease is mild, it will be enough for the patient to follow a certain diet, give up certain activities, and sometimes take over-the-counter medications.

In cases where symptoms are more persistent (daily heartburn, symptoms that come on at night), prescription medication may be required. Surgery is a reasonable alternative to permanent medication, especially if the disease is acquired at an early age.

Surgery is also recommended if medication does not help. However, today there is a new generation of drugs that can effectively control gastroesophageal reflux.

If symptoms are still uncomfortable after taking strong drugs, GERD is most likely not the cause. Most gastroenterologists and surgeons do not recommend surgery in such cases, since the symptoms still continue to disturb after it.

Lifestyle changes

Gastroesophageal reflux treatment begins with lifestyle changes. First you need to understand what affects the occurrence of symptoms.

If you have symptoms of GERD, use the following tips:

• Avoid foods and drinks that stimulate the lower esophageal sphincter to relax, such as foods flavored with mint, chocolate, and alcohol.

• Lose weight if you are overweight. Being overweight and obese contributes to GERD because being overweight increases pressure on the stomach and lower esophageal sphincter, causing acidic stomach acid to reflux into the esophagus and irritate the esophageal mucosa.

• Do not lie down for at least two or three hours after eating. After eating it is good to take a walk. This not only prevents the onset of GERD symptoms, but also burns extra calories.

• Avoid foods that trigger GERD symptoms. Do not eat fatty or fried foods, creamy sauces, mayonnaise or ice cream. Other foods that may exacerbate symptoms include coffee, tea, sodas, tomatoes, and citrus fruits.

• Stop smoking. Smoking disrupts the digestive system and, according to some studies, relaxes the lower esophageal sphincter. Smoking also reduces the amount of bicarbonate in saliva and reduces its ability to protect the esophagus from stomach acid. Some types of nicotine replacement therapy (nicotine patch, nicotine gum) can cause indigestion, stomach pain, and vomiting. Talk to your doctor about possible side effects of these products before use.

• Do not wear clothes that put pressure on your belly, such as tight belts, tight jeans, and elastic waistbands that put pressure on your stomach and lower esophageal sphincter.

• Raise the head of the bed 15-20 cm or use a wedge-shaped pillow to force acid into the stomach by gravity.

• Do not bend over after eating. If you need to pick something up from the floor, it’s better to squat on half-bent knees and try not to bend at the waist. Do not engage in sports and physical labor after eating.

• Check your medications. Some medications can make symptoms worse. These drugs include theophylline, calcium channel blockers, alpha and beta blockers, anticholinergics that may be present in drugs used to treat Parkinson’s disease, asthma, and some over-the-counter cold and cough medicines. If you think a drug you are taking is affecting your symptoms, talk to your doctor about alternatives. Do not interrupt the prescribed treatment without consulting a doctor.

Medication for gastroesophageal reflux

Your doctor may prescribe medication for GERD. Because GERD is often a chronic condition, you will need to take medication for the rest of your life. In some cases, long-term treatment is not required.

Be patient, it takes time to find the right drug and dosage. If the symptoms do not go away even after taking the drugs, or if they reappear immediately after completing the course, consult your doctor. If GERD symptoms appear during pregnancy, contact your obstetrician before starting medication.

The following is information about drugs commonly prescribed to treat GERD:

Over-the-counter antacids and rare symptoms. Their action is to neutralize the acidic gastric juice. Antacids are usually fast-acting and can be taken as needed. Because they do not last long, they do not prevent heartburn and are less effective for symptoms that often occur.

Most antacids contain calcium carbonate (Maalox) or magnesium hydroxide. Sodium bicarbonate, or baking soda, helps with heartburn and indigestion. It should be mixed with at least 120 ml of water and taken one to two hours after meals so as not to overload a full stomach. Talk to your doctor about the need for this treatment. Do not use this method for more than two weeks and use it only in extreme cases, since soda can lead to metabolic disorders (pH) and the formation of erosions in the esophagus and stomach. Before using it on children under 12 years of age, consult a doctor.

Another type of antacid contains alginate or alginic acid (eg Gaviscon). The advantage of such an antacid is that it does not allow fluid to seep back into the esophagus.

Antacids can interfere with the body’s ability to absorb other drugs, so if you are taking other drugs, check with your doctor before taking antacids.

Ideally, you should take antacids at least 2-4 hours after taking other drugs to minimize the chance of them not being absorbed. People with high blood pressure should avoid taking high sodium antacids (Gaviscon).

Finally, antacids are not a reliable treatment for erosive esophagitis, a disease that must be treated with other drugs.

Hydrochloric Acid Suppressants

These drugs reduce the amount of acid produced by the stomach and are available with or without a prescription. Usually, the same drugs are dispensed on prescription, but in a larger dosage. They may help those who are not helped by antacids. Most patients get better if they take drugs that suppress the production of hydrochloric acid and make lifestyle changes.

According to the mechanism of action, two groups of such drugs are distinguished:

– H blockers 2 – Proton pump inhibitors

Most likely, the doctor recommends taking the drug for several weeks at first in a standard dose, and then if it is not possible to achieve the desired effect, prescribe a drug with a higher dosage.

Traditional h3 blockers include:

– nizatidine (Axid AR Axid AR)

– famotidine (Pepcid AS Pepcid AC)

– cimetidine (Tagamet HB Tagamet HB)

– wounds idine (“Zantac 75” Zantac 75)

Pepcid Complete is a combination of famotidine, calcium carbonate and magnesium hydroxide found in antacids.

Conventional proton pump inhibitors include:

– lansoprazole (Prevacid)

– omeprazole (Prilosec, Prilosec)

– rabeprazole (AcipHex, AcipHex, Pariet)

– pantoprazole (Protonix Protonix, Nolpaza Nolpaza)

– esomeprazole angry (“Nexium” , Nexium)

– omeprazole + sodium bicarbonate (Zegeride)

– dexlansoprazole (Dexilant)

Proton pump inhibitors (PPIs) also reduce acidity, but are more powerful than h3 – blockers. Proton pump inhibitors are most commonly prescribed to treat heartburn and acid reflux.

These drugs block the secretion of acid from the cells of the gastric mucosa and significantly reduce the amount of stomach acid. They don’t work as fast as antacids, but they can relieve reflux symptoms for hours.

PPIs are also used to treat inflammation of the esophagus (esophagitis) and erosions of the esophagus. Studies have shown that the majority of patients with esophagitis who took these drugs recovered after 6-8 weeks. It is likely that your doctor will re-evaluate your health after 8 weeks of taking proton pump inhibitors and, according to the results, reduce the dosage or stop treatment. If symptoms do not return within three months, you will only need to take medication occasionally. People with liver disease should consult their doctor before taking these drugs.

Prokinetics

Prokinetics, e.g. They also increase the contractions of the esophagus and stomach to some extent, so that the stomach is emptied more quickly. These drugs may be used as an adjunctive treatment for people with GERD.

Surgical treatment of GERD

Surgery is an alternative to conservative treatment of GERD. Surgery is most commonly performed on young patients (because they would otherwise require long-term treatment) with typical GERD symptoms (heartburn and belching) who are helped by medication but are looking for an alternative to daily medication.

Patients with atypical symptoms or patients who are not responding to medical treatment should undergo surgery only when there is no doubt about the diagnosis of GERD and the relationship between symptoms and reflux is confirmed by research results.

Fundoplication is used in most cases. During this operation, the upper part of the stomach is wrapped around the lower esophageal sphincter, which increases its tone. These days, minimally invasive (laparoscopic) techniques are commonly used instead of traditional “open” surgery. One of the benefits of a fundoplication is that the hiatal hernia can also be repaired during the operation.

Surgery is not always effective and some patients still need to take medication after surgery. The results of this surgery are usually positive, but complications can still occur, such as difficulty swallowing, bloating and gas, difficult recovery after surgery, and diarrhea that occurs due to damage to the nerve endings that are adjacent to the stomach and intestines.

Prevention of GERD

First of all, you need to pay attention to lifestyle and avoid situations that can trigger the onset of the disease.

Remember that GERD happens when stomach acid backs up into the esophagus, which connects the throat to the stomach.

To keep the lower esophageal sphincter functioning properly, follow these guidelines:

Avoid bending over and other physical exercises that increase pressure on the abdominal cavity. Don’t exercise on a full stomach.

Do not wear clothes that are tight around the waist, such as elastic waistbands and belts, which can increase pressure on the stomach.

Do not lie down in the field of food. If you lie on your back after a large meal, it will be easier for the contents of the stomach to pass into the esophagus. For a similar reason, don’t eat before bed. The head of the bed should rise 15-20cm so that gravity keeps the acid in the stomach where it should be while you sleep.

Do not overeat. Due to the fact that there is a large amount of food in the stomach, pressure on the lower esophageal sphincter increases, as a result of which it opens.

To keep your lower esophageal sphincter and esophagus functioning properly, follow these tips:

Quit smoking and avoid products containing tobacco. Smoking relaxes the lower esophageal sphincter, reduces the amount of acid-neutralizing saliva in the mouth and throat, and damages the esophagus.

Avoid foods that aggravate symptoms, such as tomato sauces, mints, citrus fruits, onions, coffee, fried foods, and carbonated drinks.

Do not drink alcoholic beverages. Alcohol causes the lower esophageal sphincter to relax, and the esophagus may begin to contract unevenly, causing acid to reflux into the esophagus and cause heartburn.

Check your medications. Some medications can make symptoms worse. Do not interrupt the prescribed treatment without consulting your doctor. Drugs that have this effect include asthma and emphysema drugs (such as theophylline), anticholinergics for Parkinson’s disease and asthma, sometimes found in over-the-counter drugs, some calcium channel blockers, alpha blockers, and beta-blockers to treat heart disease or high blood pressure, some drugs that affect the nervous system, iron supplements.

While some drugs exacerbate GERD symptoms, others can cause drug-induced esophagitis, a condition that causes the same symptoms as GERD but is not due to reflux. Drug esophagitis happens when a pill is swallowed but does not reach the stomach because it sticks to the wall of the esophagus. Because of this, the mucous membrane of the esophagus is corroded, chest pain, esophageal ulcers and pain during swallowing occur.

Drugs that cause drug-induced esophagitis include aspirin, non-hormonal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Mortin Motrin, Aleve Aleve), alendronate (Fosamax Fosamax), potassium, and some antibiotics (especially tetracycline). and doxycycline).

You can get more detailed information about the symptoms of gastroesophageal reflux disease from the gastroenterologists of the Health 365 clinic in Yekaterinburg.

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Gastroenteritis

Recommendations on lifestyle in gastroesophagial reflux

September 6, 2021

Repina Nadezhda Arkadievna

Gastroenterology

Have you been diagnosed with GERD (gastroesophageal reflux)?
Gastroesophageal reflux is manifested by a number of unpleasant symptoms that significantly reduce the quality of life. Heartburn, burning and pain behind the sternum, difficulty in swallowing food… However, timely diagnosis, treatment and lifestyle changes can neutralize these manifestations.

So, here are some recommendations for lifestyle modification for gastroesophageal reflux: reflux symptoms occur at night).

Foods consumed must be neither too hot nor too cold. To determine the temperature of drinks, use the “bowl” rule: if you can hold the cup by the walls, and not by the handle, when drinking, then everything is fine – the temperature of the drink is not high.

Dietary advice for gastroesophageal reflux

Certain types of foods can exacerbate the symptoms of gastroesophageal reflux. To identify foods that aggravate symptoms (heartburn, belching), it is you who need to keep a food diary.

The most common triggers to avoid from the diet:

• Coffee and other caffeinated drinks (black tea, hot chocolate) – help to relax the lower esophageal sphincter.
• Citrus fruits (oranges, limes, lemons, grapefruits, tangerines, pomelo), as well as juices from them – contain a large amount of acids.
• Tomatoes and tomato-containing sauces, dishes (eg lecho) have a high level of acidity.
• Carbonated drinks (cola, kvass, lemonade, energy drinks, carbonated mineral water, etc.) create increased pressure in the stomach cavity, due to which reflux symptoms increase.
• Chocolate, due to the content of a caffeine-like substance – methylxanthine, helps to relax the lower esophageal sphincter.
• Peppermint, onion and garlic help relax the lower esophageal sphincter.
• When chewing gum, a large amount of air is swallowed, and the presence of sweeteners in its composition provokes belching and bloating.
• Slowdown of evacuation from the stomach is provoked by an abundance of fatty foods, which include 20% cream, butter, margarine, cakes with cream filling, fatty fish – herring, mackerel, trout; fatty meat: pork, beef
• Spicy (mustard, pickles, pickles, vinegar) and fried foods have a direct damaging effect on the mucosa of the esophagus.

Follow these rules and the unpleasant manifestations of the disease will recede. And if the correction of lifestyle and nutrition does not bring relief, this is a reason to turn to a gastroenterologist.

The memo was prepared by gastroenterologist Repina Nadezhda Arkadyevna.

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