- Probiotics can be effective for acid reflux when used as stand-alone therapy or alongside antacids.
- Probiotics for GERD may especially help those with IBS and SIBO.
- Probiotics offer benefits by restoring the gut microbiome.
- When using PPIs, probiotic supplements can improve symptom control and reduce unwanted side effects.
Reflux disorders, such as gastroesophageal reflux disease (GERD), affect nearly 20% of the general population , with many people experiencing symptoms that are resistant to conventional treatments. Fortunately, research supports that probiotic supplements are highly effective at resolving acid reflux and indigestion, offering some much needed relief.
As antacids can come with a host of unwanted side effects, such as small intestine bacterial overgrowth (SIBO), it is no wonder that people are turning to alternative treatments. The success of probiotics in relieving reflux symptoms is likely due to their remarkable ability to restore the gut microbiome and speed up digestion. They improve your overall gut health and reduce your heartburn without disturbing your natural acid levels or gut flora.
Let’s dive in to see if probiotics can help you resolve your acid reflux symptoms.
Probiotics for Acid Reflux
The benefits of using probiotic strains for reflux are strongly supported by recent research. In fact, in one of the most comprehensive research studies to date, the use of probiotics was highly effective in treating gastroesophageal reflux disease (GERD). This 2020 systematic review found that nearly 80% of patients experienced relief when using probiotics for acid reflux .
Probiotic supplementation successfully alleviated their symptoms of GERD, including :
- Excessive burping
Adults are not the only population who appear to benefit from probiotics for acid reflux, as infants with reflux symptoms showed significant reduction in their episodes after taking a probiotic, Lactobacillus reuteri, for three months .
But why are probiotics so effective at resolving these symptoms? In order to answer this question, we first need to understand the contributing factors behind GERD and how they contribute to acid reflux symptoms.
What Causes Acid Reflux?
Acid reflux is the hallmark symptom of GERD, and it occurs when the barrier between the stomach and esophagus is disrupted. This causes acid and other stomach contents to pass back up into the esophagus, creating the typical discomfort associated with this condition.
This upper GI disruption is attributed to many different possible issues in the digestive system, such as H. pylori infection (although some research on reflux has actually found H. pylori to be protective), lower esophageal sphincter dysfunction, and a deficiency in stomach acid .
Some common risk factors of developing GERD include :
- Increased body mass (BMI)
- Tobacco use
- Being over the age of 50
- The use of several medications, such as NSAIDS, antidepressants and some heart medications
One major contributing factor is decreased gut motility, meaning that food is digested and passed more slowly through the GI tract. This slowing in digestion allows for undigested food to hang out in the stomach for longer periods of time. The increased pressure in the stomach can cause its contents to reflux back up into the esophagus. This creates symptoms of heartburn and regurgitation of foods or drinks. Decreased gut motility also leads to conditions like chronic constipation, gas, and bloating.
Probiotics can help reverse this process, kick-start the digestive tract, and relieve symptoms of indigestion. So far, researchers have studied and seen benefits with using Lactobacillus reuteri and Bifidobacterium lactis [4, 5]. However, other types of probiotics are likely as beneficial in speeding up the digestive tract and reducing symptoms of GERD.
Acid Reflux and the Gut Microbiome
Another likely reason that probiotics are so effective in reducing acid reflux is their innate ability to restore the natural balance of bacteria in the gastrointestinal tract. Research shows that nearly two-thirds of patients who suffer from GERD have an imbalance in their microbiomes, particularly in the esophagus [6, 7, 8, 9, 10].
Little is known about the role that stomach microbiota play in the prevalence of acid reflux and GERD-related symptoms . However, clinical trials show that patients who have functional dyspepsia — a condition which has significant symptom overlap with reflux disorders — have lower stomach flora biodiversity than healthy populations.
Thankfully, the same research shows that supplementation with a probiotic can effectively restore the stomach microbiota after three months . After just two months of probiotic use, symptoms of reflux and heartburn in functional dyspepsia patients significantly improved .
These findings indicate that probiotics can likely reduce GERD-related symptoms and improve overall digestive health by balancing the microorganisms in the GI tract.
How Do GERD, IBS, and SIBO Relate?
Chronic indigestion and acid reflux are often linked to other gastrointestinal disorders. Laryngopharyngeal reflux, also known as LPR or “silent reflux,” and GERD commonly occur alongside irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO).
In one study, nearly 60% of patients diagnosed with GERD also had SIBO and reported symptoms of bloating, belching, and reflux . It is well-known that IBS and SIBO are both associated with gut flora dysbiosis, and both these conditions show significant symptom improvement with probiotic use.
By treating the underlying imbalance in good bacteria, the benefits of probiotic supplements in these patients may likely further improve their gut health by addressing any stubborn acid reflux symptoms.
Can Probiotics for Acid Reflux Replace My Heartburn Medication?
There is currently no research directly comparing the benefit of probiotics versus antacids in treating acid reflux or regurgitation. But there is evidence that probiotics can be used alongside traditional reflux medications and can even reduce unwanted side effects of these drugs.
Plenty of evidence shows that standard treatments for acid reflux, such as proton-pump inhibitors and H2 blockers, are effective in resolving symptoms for many people [13, 14]. Sadly, these medications do not work for all and can fail to provide complete symptom control. They may also come with side effects.
However, one study found that the use of probiotics alongside these medications may help to reduce symptoms of post-meal fullness and stomach burning in patients with diagnosed functional dyspepsia and epigastric pain syndrome . And the use of soil-based probiotics, like Bacillus subtilis, with PPIs significantly reduces the risk of relapse in reflux symptoms .
Probiotics May Reduce the Side Effects of Acid Reflux Medications
Not only can probiotics improve symptom control when used with heartburn medications. They may actually reduce complications of these popular drugs.
The use of PPIs is linked to the development of SIBO, as normal stomach acidity helps prevent the overgrowth of bacteria in the small intestine. PPIs work by reducing stomach acid levels, allowing gut bacteria to grow unchecked and increasing the likelihood of pathogens taking up residence in the gut [10, 17, 18]. This effect can create a vicious cycle of GERD medications creating more acid reflux symptoms.
Fortunately, in patients with GERD, the use of probiotics alongside PPIs significantly decreases the likelihood of developing SIBO when compared to placebo. Additionally, probiotics reduce the associated symptoms of gas, bloating and diarrhea [16, 19, 20].
Final Thoughts on Probiotics for Acid Reflux
As GERD and other reflux conditions are very common, it is clear that more treatment options are needed. Especially since common treatments, such as PPIs and H2 blockers can cause problems of their own, further contributing to reflux symptoms.
Thankfully, probiotics can be used safely and effectively as stand-alone therapy or alongside over-the-counter and prescription antacids. They can even reduce the undesirable side effects associated with these medications.
While research supports the benefits of probiotics for acid reflux, they are often just one part of the entire picture. It is often necessary to address many different factors. These include dietary and lifestyle changes, and resolving any underlying conditions, such as IBS or SIBO.
If you are struggling with symptoms of acid reflux or indigestion, and suspect that poor gut health may be at the root of your problems, reach out and schedule a consultation today. You may also refer to my book Healthy Gut, Healthy You for additional insights into your gut health.