Reflux and heartburn

Gastro-oesophageal reflux is acid moving the wrong way past a sphincter that should be closed. Two consequences follow, and they set the household response:

Anything that relaxes smooth muscle relaxes that sphincter too. Peppermint, chocolate, alcohol, and large fatty meals all do it. So a remedy that is excellent for a cramping gut can be the wrong thing for a burning one, and people notice this as "peppermint makes my heartburn worse" — which is exactly what the mechanism predicts.

The physical measures are what actually work, and they are free. Weight loss, not eating in the three hours before lying down, raising the head of the bed by 15-20 cm (blocks under the bedposts — extra pillows do not work, because the whole torso has to be inclined), and identifying personal trigger foods. These are the interventions with the clearest benefit and they are consistently under-used relative to tablets.

What is reasonable from the kitchen. A demulcent — slippery elm, marshmallow root cold infusion, or oatmeal — coats and soothes without changing the sphincter. Chamomile and ginger tea are gentle and harmless. Sodium bicarbonate relieves quickly and briefly, and it is a poor chronic answer: the rebound acid and the sodium load both matter. Alginate preparations (from brown seaweed) form a raft on top of the stomach contents and are a genuine physical intervention with trial support, not a herbal folk remedy.

What is not reasonable. Long-term self-treatment of frequent reflux with kitchen remedies when the standard treatment is a proton pump inhibitor and the real risk being unmanaged is oesophageal change. Frequent reflux over years is a risk factor for Barrett's oesophagus.