March 28, 2018 7 min read

If you have tried PPI medications without much relief, you are not alone. Here, we’ll explain how acid reflux medicine works and why it’s ineffective for some individuals. Plus, we’ll explore some non-pharmacological treatments for acid reflux that you may consider under the guidance of your physician. Use the links below to jump ahead to the section you’re most interested in, or read end to end for a complete overview on the topic.

  1. Acupuncture
  2. Melatonin
  3. Hypnotherapy
  4. Baking soda
  5. Herbal remedies
  6. Lifestyle changes to help with acid reflux

How Acid Reflux and PPI Medications Work

Before we can uncover why your acid reflux medication is not working, let’s start with a brief explanation of how acid reflux medications are supposedto work.

How antacids work

Antacids are one of the most common types of medications used for immediate acid reflux relief. If you’ve struggled with heartburn, you’re probably familiar with antacids such as:

  • Tums
  • Mylanta
  • Rolaids

These acid reflux medications can provide relief by helping to neutralize your stomach acid. Antacids can be a convenient option because they’re offered over-the-counter and, when effective, can provide quick relief from symptoms.

How PPIs work

PPIs, also known as proton pump inhibitors, take a different approach than antacids, which react to acid reflux symptoms. Instead, PPIs attempt to stop the production of stomach acid from the start. PPIs are generally supposed to be taken right after eating so that the stomach won’t produce acid, thereby making it less likely that you’ll experience reflux symptoms.

PPIs may be prescribed or offered over-the-counter. Common PPI brands include:

  • Omeprazole (Prilosec), also available over-the-counter (without a prescription)
  • Esomeprazole (Nexium), also available over-the-counter (without a prescription)
  • Lansoprazole (Prevacid), also available over-the-counter (without a prescription)
  • Zegerid (omeprazole with sodium bicarbonate), also available over-the-counter (without a prescription)
  • Rabeprazole (AcipHex)
  • Pantoprazole (Protonix)
  • Dexlansoprazole (Dexilant)

While some individuals find these medications to be helpful, others have issues with their pantoprazole, lansoprazole, and omeprazole not working, which can be frustrating, and, even worse, potentially result in some dangerous side effects with long-term use.

Mild and severe side effects associated with PPIs include:

  • Headaches
  • Diarrhea
  • Constipation
  • Nausea
  • Itching
  • Kidney disease
  • Bone fractures
  • Infections
  • Vitamin deficiencies

Why Antacids and PPI Medications Don’t Always Work

If you’re wondering why your heartburn isn’t responding to Tums or why your omeprazole isn’t working, you’re probably desperately looking for answers, and more importantly, results. Who typically falls into the GERD treatment gap? While doctors struggle to predict exactly who will be unresponsive to PPIs, there do seem to be some trends. Studies show that certain patients are more likely to be unresponsive (partially or completely) to PPIs if they suffer from certain conditions:

  1. Issues with indigestion (dyspepsia)5
  2. Regurgitation6
  3. Atypical symptoms such as cough, chest pain, or sleep disturbances7
  4. Non-erosive reflux disease (NERD)8

Studies show that certain patients are more likely to be unresponsive to PPIs if they suffer these conditions.

Patients who continue to suffer from nighttime acid reflux symptoms often wonder if surgery might help. Studies actually show that GERD surgery, such as laparoscopic fundoplication, is less effective for refractory GERD patients than for those patients who are responsive to PPI medications9. How can you get out of the gap? If your GERD is worsening with PPI or other reflux medications, you’ll want to look for an alternative treatment plan — more on that in a moment.

What Happens if Acid Reflux Symptoms Persist?

Besides leaving you with uncomfortable symptoms, untreated acid reflux can potentially lead to more serious issues, such as:

  • Chronic acid reflux (GERD)
  • Esophagitis
  • Esophageal bleeding, ulcers
  • Barrett’s esophagus
  • Strictures
  • Increased risk of esophageal cancer

Untreated acid reflux can lead to potentially more serious issues.

Needless to say, treating your acid reflux is critical; but what should you do when your acid reflux medication isn’t working? Next, we’ll take a look at six alternative treatments for acid reflux so that you can work toward treating your acid reflux symptoms without medication.

6 Alternative Options for Acid Reflux

Left untreated, acid reflux symptoms can lead to a number of consequences and general discomfort. But what do you do when your acid reflux medications aren’t working for you? Below, we’ll discuss six different approaches, including homeopathic treatments for acid reflux, home remedies, and lifestyle modifications.

Acupuncture

1. Acupuncture

Acupuncture theory and practice originated in China, and was first mentioned and registered a few hundred years before the Common Era in records. The ancient practice uses a combination of herbal remedies, massage, needles, and pressure points to modify the body’s energy, called “qi,” which is pronounced, “chee.” The rebalancing of qi is believed to help naturally treat ailments, including acid reflux and other digestive health issues.

In a study by Xinxiang Medical College, sixty patients with acid reflux were treated with acupuncture once per day for a week, while the control group was administered omeprazole and mosapride. The study’s conclusion suggested that acupuncture can successfully prevent intraesophageal acid and bile reflux in GER patients, alleviating symptoms safely and with high patient acceptance.

Melatonin graphic

2. Melatonin

Melatonin, a supplement most commonly associated with sleep-promotion, may also be used as an alternative for acid reflux. In a study conducted by Mansoura University, melatonin was used to treat GERD symptoms alone, and in combination with omeprazole. In both instances, melatonin was considered a promising option for patients to find relief from epigastric pain and heartburn.

More studies need to be conducted before melatonin can be recommended for regular clinical use, so be sure to discuss melatonin with your physician before integrating it into your treatment plan.

Hypnotherapy graphic

3. Hypnotherapy 

According to the Mayo Clinic, hypnosis is guided therapy that aims to get you to a trance-like state during which you have increased attention and concentration. Hypnosis is typically conducted with the aid of a psychiatrist and requires the use of verbal repetition and mental images. When you're hypnotized, you're normally calm and comfortable, and you're more receptive to suggestions. Hypnosis can help you gain control over unwanted habits or cope more effectively with anxiety or pain.

In addition to its applications in behavioral therapy, hypnotherapy may be an option in acid reflux management. One study conducted by the University of Michigan suggested that hypnotherapy was effective in the treatment of gastrointestinal disorders, with a 60-50% chance of significant reduction in symptoms and long-term results.

Like all alternative treatments, it’s a good idea to consult with your physician before moving forward.

Baking soda graphic

4. Baking soda

As one of the main ingredients used in over the counter antacids, baking soda can be diluted in water to achieve the same effect as acid reflux medications. Baking soda neutralizes stomach acid, reducing the chance of stomach acid flowing back into the esophagus and inducing heartburn. You should be aware of dosage and the potential side effects of using baking soda for acid reflux and heartburn relief, as with any home care.

For guidelines on how to use baking soda for acid reflux relief, check out our blog post on baking soda for heartburn.

Herbal remedies

5. Herbal remedies

Herbal remedies have been used for centuries to treat a variety of physical and emotional ailments. Herbal medicine is centered on the use of natural ingredients. According to Harvard Health, herbal remedies for heartburn include:

  • Chamomile
  • Ginger
  • Licorice
  • Fennel
  • Marshmallow root
  • Papaya tea

The federal government does not monitor herbal remedies for protection and efficacy. They are not FDA-approved and do not have to follow the same production and packaging requirements as medications.

Lifestyle changes that help with acid reflux heading graphic

1.   Lifestyle changes to help with acid reflux

In addition to home remedies and homeopathic treatments for acid reflux, there are several lifestyle adjustments you can make to mitigate your symptoms. Specifically, how you sleep and eat.

Adjust your sleeping posture

Learning how to sleep with acid reflux is a struggle many GERD patients face. A recent study by Cleveland Clinic studied the effectiveness of sleep positioning, specifically with refractory GERD patients. The study, “Use of a Sleep Positioning Device Significantly Improves Nocturnal Gastroesophageal Reflux,10” used the MedCline Reflux Relief System with patients who had nighttime reflux symptoms despite daily PPI usage. Study participants were asked to sleep on a MedCline GERD pillow for 2 weeks. Using MedCline, refractory GERD patients reported a:

  • 72% reduction in nighttime GERD symptoms
  • 65% reduction in the morning impact of GERD
  • 62% reduction in overall concerns about nocturnal GERD

MedCline offers an effective, natural solution for those whose acid reflux is worsening with PPI use, or those who wish to avoid long-term usage of PPI medications.

Learn which foods trigger your symptoms

In addition to the above lifestyle changes and alternative medicines for acid reflux, you can also mitigate acid reflux symptoms by learning which foods trigger your reflux, and avoiding them. Some common acid reflux triggers include:

  • Spicy foods
  • Fatty and fried foods
  • Citrus fruits
  • Tomato-based products
  • Alcohol
  • Caffeine

In addition to avoiding certain foods, you may also find relief by incorporating foods that aren’t likely to trigger your acid reflux symptoms—check out our GERD diet post for some specific recommendations.

Takeaways

If your acid reflux medication isn’t working, we hope this guide to alternative medicine for acid reflux can help you find relief. Whether you opt for non-drug treatment for acid reflux through lifestyle changes or homeopathic treatment for acid reflux, MedCline’s Reflux Relief System can easily integrate into your wellness plan. 

To learn more about how MedCline’s Reflux Relief System can improve your symptoms, check out our FAQ page or speak to a Sleep Specialist today.

References:

[1] S, Johnson DA, Stålhammar NO, Zerbib F.Brook RA, et al. Burden of gastro-oesophageal Toghanian reflux disease in patients with persistent and intense symptoms despite proton pump inhibitor therapy: A post hoc analysis of the 2007 national health and wellness survey. Clin Drug Investig. 2011 Oct 1;31(10):703-15.

[2] Chey WD, Mody RR, Wu EQ, et al. Treatment patterns and symptom control in patients with GERD: US community-based survey. Curr Med Res Opin. 2009;25:1869-78.

[3] Fass R, Gasiorowska A. Refractory GERD: What is it? Curr Gastroenterol Rep 2008; 10: 252–257.

[4] Subramanian, Charumathi Raghu, Triadafilopoulos, George. Refractory gastroesophageal reflux disease. Gastroenterology Report (2014) 1–13, doi:10.1093/gastro/gou061.

[5] Kahrilas PJ, Howden CW, Hughes N. Response of regurgitation to proton pump inhibitor therapy in clinical trials of gastroesophageal reflux disease. Am J Gastroenterol. 2011;106:1419-1425.

[6] Kahrilas PJ, Howden CW, Hughes N. Response of regurgitation to proton pump inhibitor therapy in clinical trials of gastroesophageal reflux disease. Am J Gastroenterol. 2011;106:1419-1425.

[7] Dickman R, Boaz M, Aizic S, et al. Comparison of clinical characteristics of patients with gastroesophageal reflux disease who failed proton pump inhibitor therapy versus those who fully responded. J Neurogastroenterol Motil 2011; 17:387–394.

[8] Bytzer P, van Zanten SV, Mattsson H, Wernersson B. Partial symptom response to proton pump inhibitors in patients with nonerosive reflux disease or reflux oesophagitis – a post hoc analysis of 5796 patients. Aliment Pharmacol Ther 2012; 36:635–643.

[9] Lundell L. Surgical therapy of gastro-oesophageal reflux disease. Best Pract Res Clin Gastroenterol. 2010;24:947-959.

[10] Allampati, S., Lopez, R., Thota, PN., Ray, M., Birgisson, S., Gabbard, SL..Use of a Sleep Positioning Device Significantly Improves Nocturnal Gastroesophageal Reflux Symptoms. Dis Esophagus. 2016 Sep 15. doi: 10.1111/dote.12495148, Issue 4, Supplement 1, Page S-617.