Can reflux diseases be cured?
It depends. Sometimes the answer is a resounding “YES” and other times the answer is a probable “NO.”
Curability of a reflux condition will vary depending upon 3 factors:
1. Underlying cause(s) of the reflux condition
This varies among sufferers. For one person it might be obesity, for another it might be hiatal hernia, and for a third person it might be a combination of factors (acidic foods, genetics, obesity, hiatal hernia).
In most cases of reflux disease, the underlying etiology is multifactorial (overweight/obese, other medical conditions, genetics, hiatal hernia, dietary choices, meal sizes, caffeine/cannabis/alcohol use, etc.).
2. Whether it’s possible to correct, fix, or reverse these cause(s)
I am NOT claiming that every single case of GERD/LPRD can be cured. However, I am claiming that a subset of cases can be cured if it’s possible to fix the root/underlying causes.
3. Whether the sufferer is willing to do what is necessary to fix the underlying causes
In some cases, a person with reflux might know the underlying cause(s) and these may be reversible with some effort and/or monetary investment.
However, some individuals may be unwilling to do whatever it takes to fix the issue (or lack monetary resources to afford surgery if necessary).
“Disease” = incurable? Incorrect.
Some may argue that because GERD & LPRD are “disease” diagnoses that curability is impossible.
Not every case of reflux disease can be cured – this is true for a variety of reasons.
For example, someone might have a grossly atypical internal anatomy that not even surgery could correct.
However, a subset of “disease” diagnoses can in fact be cured (the term disease does not mean cure is impossible).
By definition, the term “disease” means:
Disorder of structure or function in a human that produces specific signs or symptoms – or that affects a specific location and is not simply a direct result of physical injury.
The term “cure” means to relieve a person of the symptoms of a disease or condition.
Well by that definition PPIs are a “cure” for reflux disease. But what about a “permanent cure” that doesn’t require medication?
In many cases it is still possible to permanently cure a subset of GERD/LPR cases.
Variables that influence likelihood of “cure” from reflux diseases (GERD & LPR)
Individual anatomy: Are there any specific anatomical abnormalities present that might be contributing to these conditions? A common anatomical abnormality is excessive adiposity which increases intragastric pressure to promote “reflux” episodes.
GI mechanics & function: Is there anything mechanically/functionally abnormal within your GI tract? If so, what is specifically abnormal? For example, a gastroenterologist may identify abnormal esophageal motility or contractions/spasm.
Chronicity of the disease: The longer you’ve had the condition and failed to manage it properly – the stronger and/or more permanent the physiological feedback loops associated with reflux disease will likely become.
Physiological feedback loops associated with damage: Some may be irreversible with current medications/interventions in a subset of persons. Feedback loops may have significant or subtle differences between individuals with GERD/LPRD.
Comorbid medical conditions: Common comorbidities in reflux disease include: obesity and sleep disorders (e.g. sleep apnea, UARS, etc.), anxiety and depressive disorders.
Lifestyle factors: Diet composition & meal frequency. Sleep position. Sleep disorders. Exercise (intense cardio & weight lifting = risk factors). Alcohol. Smoking. Caffeine. Meds & Drugs (pharmaceutical, OTC, recreational, etc.). Supplements (acidic and/or alter esophageal sphincter function/pressure). Circadian rhythm.
Other possible factors… (select cases)
- Central & peripheral nervous system: Anything atypical regarding function?
- Neurochemistry: Psychiatric conditions? Neurological conditions? Functional esophageal or neurological disorder?
- Nutrient levels: Ensure no significant nutrient deficiencies or abnormalities.
- Hormones: Anything abnormal with levels?
- Autonomic nervous system (ANS): Any abnormalities? (e.g. Dysautonomia)
- Genetic factors (?): Might play a role in reflux susceptibility. Somewhat irrelevant considering gene editing/therapy is not yet possible for reflux.
- Immune function: Potential abnormalities that may occur in response to an allergen (e.g. food allergy or environmental allergen) that cause a condition like eosinophilic esophagitis which induces reflux until exposure to the allergen ceases.
How to Cure GERD & LPRD…
Included below is a basic strategy template that can be used to cure GERD & LPRD.
Treat and/or fix all other medical conditions
If you have reflux disease as a direct or partial byproduct of an untreated medical condition (e.g. obesity) – you should treat or cure the condition if possible (e.g. weight loss in obesity to reach a normal level of body fat).
Common medical conditions associated with GERD/LPR…
- Obesity: Aggressive weight loss is necessary if obese and have reflux. Goal should be to achieve a normal BMI as rapidly as safely possible.
- Sleep disorders (sleep apnea & UARS): Bidirectional relationship here… can cause and be worsened by acid reflux disease.
- Neuropsychiatric disorders: Can worsen reflux and may even cause reflux in rare cases (e.g. functional esophageal disorder).
Even if you don’t think a medical condition is related to your reflux – it should be treated. Although you may be correct in that your condition is unrelated to reflux – oddly enough many conditions can worsen reflux (including things like anxiety disorders, depressive disorders, etc.).
Endoscopic examination
Have a gastroenterologist evaluate your internal anatomy and determine:
- Reflux severity: This is based off of internal signs that can be observed via the endoscope. Subjective symptoms reported by patients also matter – but to a lesser extent. We want to know the objective damage.
- Anatomical abnormalities: Are there any unexpected or obscure anatomical features inside your body and/or GI tract that might be contributing to the reflux? If so – it might be possible to fix with surgery. (A very common anatomical abnormality found among reflux sufferers is hiatal hernia.)
- GI dysfunction (e.g. LES, UES, etc.): Evaluate the function of your esophageal clearance mechanisms, esophageal sphincters, etc. If dysfunction is found, determine why dysfunction is occurring (particularly in the absence of other disease) and ask whether this can be fixed via any modalities.
If anatomical abnormalities are found – consult a surgeon and determine whether surgery is likely to provide significant long-term benefit without significant risk.
Note: It also wouldn’t hurt to get tested for H. Pylori if you have fitting symptoms. Many people with H. Pylori aren’t tested in a timely manner.
Aggressively treat the reflux (reverse feedback loops)
Regardless of how long you’ve had the reflux condition – it is important to aggressively treat the reflux.
Why? Long-term and/or chronic reflux may enhance the permanence of various physiological feedback loops involved in reflux – which in turn may reduce odds of cure.
Essentially you need to hit the reflux hard and fast from all angles with a combination of lifestyle changes (e.g. low acid diet, small meals, finishing all food before 7 PM, sleeping on left side, etc.) and medical interventions (e.g. PPIs, H2 antagonists, sucralfate, etc.).
Most people with reflux aren’t even willing to make basic changes like giving up coffee… Seriously.
Read almost any forum online and you’ll see people moaning/groaning and complaining about the giving up coffee and soda or spicy foods – LOL!
You’ll also see that most people with this condition do not adhere to most of the recommendations given by doctors – particularly those associated with lifestyle changes.
As a result, the reflux stagnates, becomes chronic, and/or worsens (in some cases) until the physiological feedback loops become permanent.
Gastric surgery (?)
If you have an underlying anatomical abnormality that is causing your reflux disease (or contributing to a significant degree) – it is recommended that you consult a surgeon and discuss all surgical options (e.g. different surgical procedures).
Evaluate efficacy, safety, risks, possible complications, long-term outcomes, and cost associated with the specific surgery that you think will be most beneficial given your present symptoms.
Also discuss whether there will be any permanent lifestyle modifications required post-surgery (e.g. smaller meals, zero weight lifting, no MRIs, etc.).
Self-experimentation (?)
If absolutely NOTHING seems to help your reflux and you’ve done every lifestyle change, medication, surgery, etc. – then it may be worth experimenting with various other interventions that aren’t as well researched.
You should still talk to a medical doctor about the potential benefits vs. risks – and ask whether such interventions make sense given the underlying cause(s) of your particular reflux. For example, some people have experimented with the peptide BPC-157 – which is thought to help restore normative gastroesophageal function and integrity.
Note: Self-experimentation can sometimes do significantly more harm than good. This should be done cautiously with awareness of risks vs. potential benefits.
Curing GERD & LPRD (Common Questions)
What’s the difference between “reflux” and “reflux disease”?
Nearly everyone has experienced “reflux” and/or “heartburn” from time to time – whether it be from overeating, spicy foods, etc.
However, a reflux disease implies significantly greater chronicity and severity – which is generally much more difficult to manage/treat/fix.
Someone with mere “reflux” may only experience this when eating hot peppers or binge eating at the buffet – whereas someone with reflux disease (e.g. GERD) might experience reflux every day, all day, even if eating the blandest, lowest acid (most alkaline) foods on the planet.
Do you need surgery to cure your reflux disease?
Who should get surgery? (A) Surgery-eligible patients that have (B) rigorously adhered to every prescribed/recommended intervention without adequate symptomatic relief – for 6-12 months.
Surgery-eligible means that a patient is: (1) fit for surgery AND (2) the surgery is likely to provide significant benefit. If either of these variables are untrue – surgery cannot be considered.
- Note #1: Some people respond fantastically to surgery (complete cure) whereas others respond partially to surgery (varying degrees of improvement) – and another subset of patients experiences zero relief.
- Note #2: There can be complications and/or lifestyle restrictions associated with surgery. Make sure that you are aware of these potential complications (i.e. risks) and lifestyle restrictions prior to undergoing any surgical procedure for reflux disease.
What can we learn from online “GERD” and “LPRD” cure anecdotes? (Common on Reddit, Quora, etc.)
Not much. Always be skeptical and/or do a little bit of basic critical thinking whenever someone posts about how they “cured” condition X, Y, Z.
Zero medical verification (GERD & LPRD)
Most people don’t even mention whether they were formally diagnosed with GERD or LPRD.
I took time to direct message (DM) many of those who posted about “curing” their GERD/LPR. Not everyone responded, but most that did respond (~90%) were: (A) self-diagnosed and/or (B) admitted to probably not having GERD/LPRD – and/or (C) had other medical conditions.
One individual (no joke) claimed that their LPRD was cured after a series of chiropractic adjustments (this is physiologically impossible).
I then asked whether this individual was formally diagnosed with LPRD and the reply was something along the lines of: “No, and looking back I don’t think I actually had LPR.”
That said, some individuals likely did experience “heartburn” which is different from an actual reflux disease. In many cases, “heartburn” goes away with simple lifestyle tweaks.
However, because most individuals don’t “follow up” posts with disclaimers (e.g. not formally diagnosed, likely didn’t have this condition) – they linger on forums and other people think following absurd interventions will work (e.g. “drinking ACV with every meal”).
Underlying causes differ
Even if the poster online did in fact have GERD or LPRD (the same condition as you) and legitimately “cured” the condition – this does NOT mean that the underlying causes for their condition are the same as for your condition.
Therefore, doing whatever that person did might not yield the same results for you – and could even be harmful (in certain cases).
Most commonsense interventions like eating smaller meals, earlier dinner, raising the head of the bed 6-inches, zero caffeine/alcohol/smoking, drinking only water, and consuming a low acid diet will generally provide some degree of benefit (if not implemented already) and shouldn’t be harmful.
However, suggested cures like “D-Limonene” or “Betaine HCL + Pepsin” should be avoided altogether or pursued with extreme caution. Why? There’s no evidence supporting usage and it’s possible that it could exacerbate symptoms.
Note: It isn’t necessarily “bad” to read how some individuals managed to cure their GERD/LPRD – as this may provide some hope/optimism (which is generally a good thing for most people to have). However, might be dumb to assume that what worked for them is worth a random experiment (particularly if the intervention involves increasing acidity).
Cure is NOT possible for every case of GERD & LPRD
Complete “cure” is NOT possible for every case of GERD & LPRD.
However, even those that cannot “cure” their condition can usually find some degree of relief via a combination of pharmacological treatment (e.g. PPIs) and lifestyle modifications (e.g. low acid diet) – assuming consistent implementation.
Cure is possible for some cases…
Cure is certainly possible for a subset of GERD & LPRD cases – particularly if diagnosed and treated in a timely manner and if there’s no underlying anatomical abnormalities.
Aggressive early treatment has been shown to effectively cure LPR in pediatrics (many infants experience LPR and with treatment/management they eventually overcome it and have no relapse later in life).
Although anecdotal, I’ve read countless cases of individuals simply following PPI therapy for a while with lifestyle modifications (no late night eating, no acidic foods) – maintaining this for 3-6 months – then never having GERD or LPR ever again (even with acidic foods reintroduced).
I’ve read about other cases wherein surgery to fix a hiatal hernia effectively cured GERD such that these individuals can now have spicy, highly-acidic foods and drinks with zero further symptoms.
What was the point of writing this article?
To emphasize that cure from reflux is possible in some cases and to promote optimism around GERD & LPRD.
If you hang out on various forums and communities (e.g. Reddit) – you’ll likely convince yourself that curing these conditions (or even getting relief) is impossible for most people – which isn’t true.
It is true that the condition will be impossible to cure for those unwilling to treat the condition aggressively and rigidly for a specific duration and/or for those unwilling to get surgery (if necessary).
That said, most people who have been cured of reflux diseases (GERD & LPRD) do NOT bother hanging out on GERD/LPR forums to continue chatting about the condition – they’re sick of this and simply move on with their lives.