INTRODUCTION TO THE PROBLEM OF ACID REFLUX

The digestive system is an important part of the human body’s complex symphony, coordinating the breakdown and absorption of nutrients fundamental to our health. Yet, amidst this peaceful process, there exists a dissonant note that many are all too familiar with – the discomfort of heartburn and acid reflux. Heartburn, that fiery sensation in the chest, and its more chronic counterpart, Gastroesophageal Reflux Disease (GERD), are ailments that plague a significant portion, a whopping 20% of the global population. While heartburn is sometimes written off as an inconvenience, GERD is characterized by persistent stomach acid reflux that can have more serious repercussions if ignored. This is why understanding the roots of these digestive disturbances is crucial for anyone seeking relief.
Lifestyle factors, dietary choices, and underlying health conditions all weave into a complex web that exacerbates the discomfort. From spicy indulgences to stress-induced acidity, the causes are diverse and multifaceted.

Why Prevention is Important

A fundamental fact becomes clear as we explore the complexities of heartburn and GERD: prevention is key. Beyond the immediate discomfort lies the potential for long-term complications. Acid reflux that is left untreated can have serious implications, including breathing problems and damage to the esophagus. This book aims to increase the general awareness of the critical elements that enable people to take charge of their digestive health. A life free from the shackles of acid reflux and persistent heartburn is possible only when we implement preventive steps in our lifestyle.
Read ahead as there are 21 effective ways to prevent heartburn and acid reflux discussed in this Ebook, enough to change your quality of life.

Heartburn is a painful condition marked by a burning sensation in the chest. It is often caused by excess abdominal fat. This connection arises from the increased pressure that excess abdominal fat exerts on the stomach, causing the release of acidic contents into the esophagus. The esophagus, not equipped to handle such acidic exposure, reacts with a sensation commonly known as heartburn. Scientific investigations have also revealed a clear and direct correlation between obesity and Gastroesophageal Reflux Disease (GERD). Therefore, individuals with higher body mass indexes (BMIs) tend to experience a higher incidence of GERD symptoms. As a result, given the connection between digestive health and weight control, keeping a healthy weight becomes essential to reducing heartburn. Ultimately, people who lose weight can lessen the strain on their stomachs, which can lessen the chance of acid reflux and, as a result, relieve heartburn symptoms.

According to the latest research, going to bed after eating a large meal can worsen the symptoms of GERD. Lying down, actually, inhibits the effective gravity-driven movement of food through the digestive tract. Consequently, stomach acid is more likely to flow back into the esophagus, causing irritation and inflammation. Moreover, the types of food consumed during late-night snacking play a pivotal role in exacerbating acid reflux. Foods that are spicy, fatty, or acidic can relax the lower esophageal sphincter, the muscle that separates the stomach from the esophagus. A weakened sphincter allows stomach acid to escape into the esophagus, intensifying the risk of heartburn. Additionally, the body’s reduced production of saliva at night contributes to a diminished ability to neutralize stomach acid. Saliva contains bicarbonate, a natural antacid that helps maintain a balanced pH in the stomach. With lower saliva production during sleep, the buffering effect is diminished, leaving the esophagus vulnerable to the corrosive effects of gastric acid. Therefore, to prevent heartburn and acid reflux, it is recommended by the International Foundation of Gastrointestinal Disorders (IFGDs) to eat your last meal of the day at least a few hours before going to bed. This practice allows the body sufficient time to initiate digestion and reduce the likelihood of acid reflux during the night. By adopting such habits, individuals can safeguard their digestive health and promote a restful night’s sleep.

Alcohol’s physiological effects on the digestive tract are the basis of the complicated link between alcohol use and heartburn. Through several different processes, alcohol may both cause and worsen heartburn. First, alcohol can relax the muscle ring that divides the esophagus and stomach, known as the lower esophageal sphincter (LES). In its normal state, the LES functions as a valve to stop stomach acid from flowing backward into the esophagus. When the LES relaxes, stomach acid can flow back into the esophagus, leading to symptoms of heartburn. Additionally, alcohol can stimulate the production of gastric acid, further increasing the likelihood of symptoms. Additionally, alcohol may damage the stomach’s protective lining, increasing its vulnerability to the corrosive effects of stomach acid. This compromised defensive system raises the possibility of esophageal injury and the emergence of heartburn symptoms. Therefore, quitting alcohol is paramount for maintaining digestive health, particularly in preventing and managing heartburn. By eliminating alcohol, individuals can help prevent the relaxation of the LES and reduce the production of excess gastric acid. This, in turn, can alleviate the frequency and severity of heartburn episodes. Additionally, abstaining from alcohol promotes the healing of the stomach lining, reducing the risk of complications such as gastritis or more severe forms of acid reflux. Moreover, excessive alcohol consumption is associated with a myriad of other digestive issues, including inflammation of the pancreas and liver diseases, which can further compromise overall digestive health. Making the decision to quit or moderate alcohol intake is a significant step towards promoting a healthy digestive system and minimizing the risk of heartburn and related complications.
Note: A big step in promoting a healthy digestive system and reducing the risk of heartburn and related issues is deciding to reduce or limit your alcohol use.

Wearing tight attire can contribute to the symptoms of heartburn, particularly in individuals experiencing Gastroesophageal Reflux Disease (GERD). The mechanism through which tight clothing influences GERD symptoms involves various aspects. Tight clothing, such as belts, waistbands, or constrictive garments, increases intra-abdominal pressure. This elevated pressure can compel stomach contents, including acidic substances, to travel upward into the esophagus. The result is irritation and the onset or worsening of heartburn. Additionally, constrictive attire may impede the natural process of gastric emptying. When the stomach cannot efficiently empty its contents, there is a prolonged interaction between stomach acid and the lining of the esophagus. This extended contact heightens the likelihood of acid reflux and subsequent heartburn. Furthermore, tight clothing can influence the function of the lower esophageal sphincter (LES). As discussed several times before, if this sphincter doesn’t function properly, it may allow stomach acid to move back into the esophagus, leading to discomfort. Therefore, people with GERD should think about wearing looser-fitting clothing to reduce the chance of heartburn. Wearing loose-fitting clothing lowers intra-abdominal pressure and encourages more spontaneous stomach emptying, which lessens the possibility of GERD symptoms getting worse.

The habit of smoking has a tremendous influence on one’s health and is a pernicious threat that affects every part of the human body. Beyond the well-documented respiratory issues, smoking compromises the integrity of the digestive system, unveiling a cascade of health concerns. One notable consequence is Gastroesophageal Reflux Disease (GERD). Yes, individuals who smoke are at an elevated risk of experiencing heartburn, a burning sensation in the chest that often worsens after eating or lying down. Regrettably, the adverse impact doesn’t stop there. Smokers with GERD may also experience regurgitation, where stomach contents flow back into the mouth, leading to a sour or bitter taste. Persistent coughing, difficulty swallowing, and the sensation of a lump in the throat are additional symptoms that can significantly diminish one’s quality of life.
The relationship between smoking and GERD lies in the detrimental effects of tobacco on the lower esophageal sphincter (LES). Smoking weakens the LES, compromising its ability to function effectively and contributing to the development and exacerbation of GERD. Remarkably, giving up smoking offers the potential to lessen these detrimental consequences on the digestive system. Studies show that quitting smoking significantly reduces GERD symptoms, which offers concrete motivation for smokers who are struggling with their addiction. Even though giving up smoking might seem difficult, there are a lot of possible advantages that go well beyond just feeling less GERD symptoms right away.

One important dietary change to try to lessen the effects of GERD involves transitioning from traditional three-meal structures to consuming smaller, more frequent meals throughout the day. The goal of this tactical modification is to address the biological roots of acid reflux episodes.
Large meals exert increased pressure on the stomach, triggering the release of more stomach acid and potentially leading to its reflux into the esophagus. People can lessen the chance of acid reflux episodes by preferring to eat smaller, more frequent meals, which will encourage a regular and regulated flow of stomach acid.
This dietary approach aligns with the principles of maintaining optimal digestive function, promoting comfort, and minimizing the occurrence of heartburn. The benefits of adopting this eating pattern extend beyond immediate symptom relief. Consuming smaller meals at regular intervals aids in regulating blood sugar levels, preventing the spikes and crashes associated with larger, infrequent meals. This can promote a more stable and sustained energy supply, promoting overall well-being.
The effective use of this dietary modification is largely dependent on practical factors. The temptation to overeat at any particular meal is lessened when a planned meal schedule is established, ensuring a consistent approach. A crucial element is portion control, which motivates people to watch what they eat and refrain from overindulging.

Effective management of GERD through dietary changes involves finding and steering clear of foods that can worsen symptoms. Common triggers include acidic foods and spicy or high-fat items. These can increase stomach acid production or relax the lower esophageal sphincter, leading to more acid reflux. The trigger foods can vary from person to person. Hence, building a personalized list helps individuals make dietary choices that minimize these risks.
Creating a personalized list involves keeping a food diary, recording meals, and noting symptoms. This systematic approach helps identify patterns, allowing individuals to pinpoint specific foods causing discomfort. Further, collaboration with healthcare professionals improves this process, offering expert guidance on individualized triggers.
While eliminating certain foods from the diet might seem challenging, the benefits of avoiding trigger foods go beyond immediate symptom relief. Taking proactive measures can prevent GERD-related complications and improve overall quality of life.

Meals high in fat can slow down the emptying of the stomach, keeping its contents in the lower esophagus for longer periods. This delay raises the chances of experiencing acid reflux. Therefore, it’s important to focus on low-fat foods to ease symptoms of heartburn and GERD.
Examples of low-fat food choices include lean meats, poultry, fish, avocados, and nuts. Incorporating these options into daily meals not only contributes to a diet that’s kind to GERD but also enhances overall nutritional balance.
Selecting low-fat options requires careful consideration of food choices and cooking methods. Swapping high-fat ingredients for lean proteins and healthier oils helps maintain the nutritional value of meals while lessening the impact on digestion.
Checking food labels is a key practice in this process. Nutritional information on packaged foods reveals the fat content, enabling informed decisions about what we eat. This attention to detail supports the idea of mindful eating, emphasizing individual responsibility in managing GERD through dietary adjustments.

Fiber not only supports overall digestive health but also plays a crucial role in preventing heartburn and acid reflux. Fiber helps with digestion by promoting regular bowel movements, preventing constipation, and reducing pressure on the stomach. This lower pressure is significant for GERD because it decreases the chances of stomach acid moving into the esophagus.
A fiber-rich diet contributes to overall wellness by addressing various aspects of digestive health. You can find high-fiber foods in whole grains, fruits, vegetables, and legumes. Adding these fiber-rich options to your meals supports digestion and brings many other health benefits.
Building balanced and fiber-rich meals involves choosing a variety of foods for a diverse and nutritious diet. By diversifying your sources of fiber, you can optimize your nutritional intake and create a digestive environment that helps prevent acid reflux.
Knowing the recommended daily fiber intake is crucial for managing GERD. While general guidelines exist, individual needs may vary, so a personalized approach is necessary. Working with healthcare professionals can offer valuable insights into the optimal fiber intake tailored to individual circumstances.

A simple and often overlooked way to manage GERD involves chewing gum, which has been proven to provide relief from heartburn and reduce acid reflux incidents. Chewing gum stimulates saliva production, which has alkaline properties that neutralize acid, creating a protective barrier for the esophagus. This also helps clear acid from the esophagus, lowering the chances of reflux.
Chewing gum has benefits beyond acid reflux relief. It promotes oral health by increasing saliva flow, maintaining optimal pH levels in the mouth, and preventing tooth decay.
When using gum as part of a GERD-friendly routine, it’s best to choose sugar-free options to avoid the potential negative effects of added sugars. Incorporating gum-chewing into post-meal habits is a convenient and accessible practice in daily life.

Limiting or regulating the use of carbonated drinks is vital when it comes to managing GERD through dietary modifications. These fizzy and acidic beverages are linked to an increased risk of heartburn and acid reflux, so understanding why this happens is key to making informed choices for digestive health.
Carbonated drinks contribute to GERD symptoms in several ways. The bubbles in these drinks can raise gastric pressure, releasing stomach acid and potentially causing reflux into the esophagus. Additionally, the acidity of carbonated beverages can directly irritate the lining of the esophagus, making heartburn worse.
While many people enjoy these drinks, it’s advisable to limit their intake for relief from GERD. Switching to alternative beverages like herbal teas, still water, or infused water can significantly decrease the risk of acid reflux. These alternatives not only keep the body hydrated but also create a more alkaline environment, promoting digestive comfort.
Practical strategies for reducing or eliminating carbonated drinks include gradual changes. Individuals can dilute carbonated drinks with water, choose reduced or sugar-free versions, or slowly shift to alternative beverages. These steps ensure a sustainable and realistic adjustment to dietary habits.

In managing GERD, practicing mindful eating is a powerful and holistic strategy. Mindful eating involves being fully aware and focused on the entire eating experience, from choosing food to the act of eating. This intentional approach prevents heartburn and acid reflux while promoting overall digestive well-being.
The importance of mindful eating lies in its ability to address factors that can trigger or worsen GERD symptoms. By staying present and attentive during meals, individuals can control portion sizes, reduce the risk of overeating, and create a more relaxed eating environment. This approach aligns with the broader goal of maintaining optimal digestive function.
Mindful eating goes beyond the physical aspects of food to include emotional and psychological components. Stress and emotions can contribute to GERD symptoms, and mindful eating serves as a tool to manage these factors. Techniques like mindful breathing before meals and a calm dining environment help reduce stress-related triggers for heartburn.
Incorporating mindfulness into eating habits also means paying attention to taste, texture, and satiety cues. This heightened sensory awareness lets individuals savor and appreciate each bite, making the eating experience more conscious and enjoyable. By connecting with the sensory aspects of food, individuals can improve their relationship with meals and, in turn, support digestive health.

Sleeping on the left side is often recommended to help prevent GERD (gastroesophageal reflux disease) and heartburn at night due to the anatomical positioning of the stomach and esophagus. This sleep position is believed to promote better digestion and reduce the likelihood of stomach acid flowing back into the esophagus, which is a common cause of heartburn.
The anatomy of our digestive system plays a crucial role in understanding why left-side sleeping is beneficial.
The stomach is positioned on the left side of the body, and the esophagus enters the stomach from the right. When you sleep on your left side, gravity works in favor of keeping the stomach’s contents where they belong, preventing them from easily flowing back up the esophagus.
Additionally, the lower esophageal sphincter (LES), a muscular valve that separates the esophagus from the stomach, is positioned at the bottom of the esophagus. Sleeping on the left side may help keep the LES above the level of stomach acid, reducing the likelihood of acid reflux.
Furthermore, left-side sleeping may help improve digestion by facilitating the smooth passage of food through the stomach and small intestine. This position encourages the stomach and pancreas to hang naturally, allowing for the effective flow of digestive juices and enzymes. It’s a simple yet effective strategy that aligns with the natural anatomy of the digestive system.
While individual responses may vary, many people find relief from GERD symptoms and heartburn by adopting a left-side sleeping position.

Elevating the head during sleep is a simple yet another effective strategy to prevent GERD (gastroesophageal reflux disease) and minimize the occurrence of heartburn at night. When you sleep with an elevated head, gravity works in your favor. By keeping the head and upper body elevated, gravity helps prevent stomach acid from moving up into the esophagus. This inclination facilitates the natural flow of digestive juices downward, reducing the likelihood of acid reflux.
Additionally, elevating the head can help maintain the integrity of the lower esophageal sphincter (LES), a muscular ring that separates the esophagus from the stomach. When lying flat, the LES may be more prone to relaxation, allowing stomach acid to escape into the esophagus. Elevating the head provides additional support to the LES, helping to keep it closed and preventing the reflux of acidic contents.
Furthermore, sleeping with an elevated head may enhance overall digestion. When the upper body is raised, it can promote a smoother and more efficient digestive process, minimizing the chances of undigested food and stomach acid backing up into the esophagus.
The combination of gravity’s assistance in preventing acid reflux, the support it provides to the LES, and the promotion of optimal digestion makes this sleeping position a valuable strategy for individuals seeking relief from nighttime GERD symptoms.

Relaxation techniques play a pivotal role in preventing stress, which, in turn, can be instrumental in averting the onset of gastroesophageal reflux disease (GERD) and heartburn. As discussed before, stress is a well-known contributor to various health issues, and its impact on the digestive system is particularly noteworthy. By engaging in relaxation techniques, individuals can mitigate the physiological response to stress, thereby reducing the production of stomach acid and lowering the likelihood of acid reflux.
Deep breathing exercises, progressive muscle relaxation, and meditation are among the myriad relaxation techniques that can positively impact both mental and physical well-being. These practices promote a state of calmness and help regulate the autonomic nervous system, which plays a crucial role in the functioning of the digestive system. As stress levels diminish, the likelihood of experiencing GERD-related symptoms, such as heartburn, also decreases.
Furthermore, relaxation techniques contribute to overall better health by fostering improved sleep quality and reducing muscle tension. Adequate sleep and relaxed muscles contribute to a more resilient and efficient digestive process. When the body is well-rested and tension-free, it is better equipped to handle daily challenges, including potential stressors that may arise.

Adequate sleep plays a climactic role in maintaining overall health and well-being, with its positive effects extending to various aspects of physiological and psychological functions. One significant benefit of obtaining sufficient sleep is its ability to prevent stress, subsequently reducing the risk of developing gastroesophageal reflux disease (GERD) and heartburn.
When the body experiences chronic sleep deprivation, it triggers a cascade of hormonal and physiological responses that contribute to heightened stress levels. Elevated stress levels, in turn, have been linked to the exacerbation of GERD and heartburn symptoms.
Making sleep a priority and sticking to a regular sleep pattern helps people greatly lower their vulnerability to stress and the health hazards that come with it. A well-rested body is better equipped to cope with daily challenges and stressors, promoting emotional resilience and mental well-being.

Ginger is known for calming inflammation and easing stomach troubles. Therefore, making ginger tea by steeping fresh ginger in hot water can help prevent GERD and heartburn. The active compounds in ginger, like gingerol, reduce inflammation and neutralize stomach acid. Enjoying a warm cup of ginger tea before or after meals might ease indigestion and keep the digestive system healthy.

While it may seem counterintuitive to consume an acidic substance to combat acid reflux, apple cider vinegar is believed to balance stomach acid levels. Diluting a tablespoon of raw, unfiltered apple cider vinegar in a large glass of water and drinking it before meals may help prevent GERD symptoms. The acetic acid in apple cider vinegar is thought to enhance digestion and promote the production of digestive enzymes, reducing the likelihood of acid reflux.

Keeping a good balance of gut bacteria is super important for digestion, and probiotics are like the heroes in this story. Probiotics are tiny living organisms that bring good vibes to health when you eat enough of them. These friendly bacteria create a happy home in your gut, helping with digestion and stopping the bad bacteria from taking over and causing things like GERD. You can get

Baking soda, or sodium bicarbonate, is a versatile substance that can be used as a natural antacid to neutralize stomach acid. Mixing half a teaspoon of baking soda in a glass of water and drinking it when symptoms arise may provide temporary relief from heartburn. However, it’s essential to use baking soda cautiously, as excessive consumption can lead to electrolyte imbalances and other health issues. It’s advisable to consult with a healthcare professional before using baking soda as a home remedy for GERD.

Zemaflux, a reflux resistance trainer, offers a groundbreaking solution for individuals suffering from the discomfort of heartburn and GERD. Unlike traditional methods that rely on medications, Zemaflux employs a unique approach by strengthening the muscles associated with acid reflux, providing natural and instant relief without the need for medicines.

ZEMAFLUX Reflux Resistance Trainer

Zemaflux stands out as an innovative device designed to target the root cause of acid reflux. The device operates on the principle of airflow resistance, specifically focusing on strengthening the Lower Esophageal Sphincter (LES) muscles with every breath. This resistance aids in the thickening of the diaphragm, contributing to enhanced resistance against acid reflux.

Key Features

Adjustable Pressure

Zemaflux incorporates a rotating cap that allows users to select resistance levels ranging from 10 to 45 cm H2O. This flexibility ensures a personalized experience, accommodating various user preferences and comfort levels.

Versatile Usage

Whether sitting down or standing up, Zemaflux caters to different user preferences. This adaptability makes it a convenient and accessible solution for individuals with diverse lifestyles.

Comfortable Mouthpiece

The device features a comfortable and hygienic mouthpiece, ensuring a pleasant user experience. This ergonomic design encourages regular use, which is essential for the effectiveness of the training program .

Working Principle of Zemaflux

Zemaflux’s innovative approach revolves around strengthening muscles to prevent acid reflux, offering natural relief without reliance on medications. By engaging in a targeted breathing exercise with the device, users can experience long-term relief from the symptoms associated with heartburn and GERD.

User Guide

Breathing Technique

Inhale deeply through your mouth, imagining your stomach and lungs filling with air. Then, hold your breath for 2 seconds. Finally, exhale forcefully in one quick blast, focusing on the movement of the diaphragm with each breath.

Verification of Correct Breathing

To ensure proper technique, place one hand on your abdomen. It should rise on inspiration and fall on expiration, indicating the correct engagement of the diaphragm.

Daily Routine

Use Zemaflux twice a day, in the morning and evening. • Perform 30 breaths each time, organized into 5 breath cycles. Complete 6 cycles during each session .

8-Week Program

While Zemaflux often shows benefits within two to three days, for long-term results, follow an 8-week program. During this program, gradually increase the intensity of training each week, allowing for a progressive adaptation of the muscles.

References

1. Boulton KHA, Dettmar PW: A narrative review of the prevalence of gastroesophageal reflux disease (GERD). Annals of Esophagus 2021, 5.

2. Khan A, Kim A, Sanossian C, Francois F: Impact of obesity treatment on gastroesophageal reflux disease. World J Gastroenterol 2016, 22(4):1627-1638.

3. Thalheimer A, Bueter M: Excess Body Weight and Gastroesophageal Reflux Disease. Visceral Medicine 2021, 37(4):267-272.

4. Newberry C, Lynch K: The role of diet in the development and management of gastroesophageal reflux disease: why we feel the burn. J Thorac Dis 2019, 11(Suppl 12): S1594-s1601.

5. Diet Changes for GERD – About GERD. In.; 2021.

6. Ganesan P, Boominathan P, Arunachalam R, Mahalingam S, Vijayakumar DS: Gastroesophageal reflux disorder: Lifestyle, symptomatology, and voice profile. Journal of Laryngology and Voice 2017, 7(1).

7. Pan J, Cen L, Chen W, Yu C, Li Y, Shen Z: Alcohol Consumption and the Risk of Gastroesophageal Reflux Disease: A Systematic Review and Meta-analysis. Alcohol Alcohol 2019, 54(1):62-69.

8. Kohata Y, Fujiwara Y, Watanabe T, Kobayashi M, Takemoto Y, Kamata N, Yamagami H, Tanigawa T, Shiba M, Watanabe T et al. Long-Term Benefits of Smoking Cessation on Gastroesophageal Reflux Disease and Health-Related Quality of Life. PLOS ONE 2016, 11(2):e0147860.

9. Taraszewska A: Risk factors for gastroesophageal reflux disease symptoms related to lifestyle and diet. Rocz Panstw Zakl Hig 2021, 72(1):21-28.

10. Fox M, Gyawali CP: Dietary factors involved in GERD management. Best Pract Res Clin Gastroenterol 2023, 62-63:101826.

11. Anderson JW, Baird P, Davis RH, Jr., Ferreri S, Knudtson M, Koraym A, Waters V, Williams CL: Health benefits of dietary fiber. Nutr Rev 2009, 67(4):188-205.

12. Moazzez R, Bartlett D, Anggiansah A: The effect of chewing sugar-free gum on gastroesophageal reflux. J Dent Res 2005, 84(11):1062-1065.

13. Johnson T, Gerson L, Hershcovici T, Stave C, Fass R: Systematic review: the effects of carbonated beverages on gastro-oesophageal reflux disease. Aliment Pharmacol Ther 2010, 31(6):607-614.

14. Khoury RM, Camacho-Lobato L, Katz PO, Mohiuddin MA, Castell DO Influence of spontaneous sleep positions on nighttime recumbent reflux in patients with gastroesophageal reflux disease. Am J Gastroenterol 1999, 94(8):2069-2073.

15. Huang HC, Fang SY: [A Systematic Review of the Literature Related to Elevating the Head of the Bed for Patients With Gastroesophageal Reflux Disease: Applications in Patients After Esophageal Cancer Surgery]. Hu Li Za Zhi 2016, 63(3):83-93.

16. Tack J, Pandolfino JE: Pathophysiology of Gastroesophageal Reflux Disease. Gastroenterology 2018, 154(2):277-288.

17. Huestis MJ, Keefe KR, Kahn CI, Tracy LF, Levi JR: Alternatives to Acid Suppression Treatment for Laryngopharyngeal Reflux. Ann Otol Rhinol Laryngol 2020, 129(10):1030-1039.

18. Dent J, Holloway RH, Eastwood PR: Systematic review: relationships between sleep and gastro-oesophageal reflux. Aliment Pharmacol Ther 2013, 38(7):657-673.

19. Nikkhah Bodagh M, Maleki I, Hekmatdoost A: Ginger in gastrointestinal disorders: A systematic review of clinical trials. Food Sci Nutr 2019, 7(1):96-108.

20. Cheng J, Ouwehand AC: Gastroesophageal Reflux Disease and Probiotics: A Systematic Review. Nutrients 2020, 12(1).

21. Al-Abri SA, Olson KR: Baking soda can settle the stomach but upset the heart: case files of the Medical Toxicology Fellowship at the University of California, San Francisco. J Med Toxicol 2013, 9(3):255-258.