Gastroesophageal Reflux Disease
PATIENT HANDOUT 4
University of Wisconsin Integrative Medicine
www.fammed.wisc.edu/integrative
2. Nutrition and Exercise
Both exercise and nutrition can reduce GERD symptoms. If you have GERD, try to eliminate
the foods, drinks, and other substances listed in Table 1 for at least two weeks. Pay close
attention to your symptoms. If your symptoms improve, you can either 1) continue to avoid
these things, or 2) each week add a different food or item back into your life. Watch closely to
see if any of your symptoms recur. See our handout GERD Elimination Diet for more
information.
Diets high in fiber seem to decrease GERD. Most experts recommend eating fewer foods
that contain cholesterol, saturated fatty acids, and total fat if you have GERD. Studies,
however, have shown mixed results. It may be that heavier body weight, rather than fat in the
diet per se, causes GERD. Studies also show mixed results regarding drinking alcohol or
coffee. Some studies found more GERD symptoms with alcohol and coffee, some showed
less, and others showed no difference.
Regular activity is important for the health of your body and to aid in
digesting your food. People who do physical activity regularly during their
leisure time seem to have fewer GERD symptoms. It is better to exercise
during leisure time rather than during the workday. This may be because
people are eating and exercising within a short span of time. Exercising
right after you eat increases your chance of developing GERD. Some
people who exercise strenuously, especially running, weight lifting, and,
cycling, may actually have an increase in GERD. This may be due to
decreased blood flow in the digestive system, increased contractions of
the esophagus, and more pressure on the LES.
3. Herbal Medicine
Licorice. Some herbal medicines can be used to soothe and protect irritated tissues and
promote healing. Licorice (Glycyrrhiza glabra) is one example. It can be used for GERD,
stomach upset or pain, and ulcers. For long-term use, it should be prescribed as
deglycyrrhizinated licorice (DGL) in order to avoid side effects. A common dose is two to
four 380 milligram lozenges before meals.
Slippery Elm. Slippery elm (Ulmus fulva) root bark powder is also helpful for GERD. One
to two tablespoons of the powder can be mixed with a glass of water and taken after
meals and before bed. If you add too much powder, it can become very thick and difficult
to tolerate. You can sweeten it slightly with honey or sugar if you prefer. Slippery elm
appears to be very safe. Avoid taking it at the same time as other medications. Its fibers
may bind to medications taken at the same time, and you will not get their full effect.
Marshmallow. Marshmallow (Althea officinalis) (the herb, not the white fluffy sweet) can
also provide symptom relief. It is helpful for sore throat, cough, bronchitis, and wound
healing. The usual dose is 5-6 grams daily, which is about 2-3 tablespoons. Make a tea
from the leaves or roots and drink it three times daily using 1 tablespoon (or less) of
marshmallow each time.
As with slippery elm, do not take it at the same time as other
drugs or you may not get the full effect of your medications.
Charlene Luchterhand
UW-Madison Integ. Med.