Acid reflux, the backward flow of stomach acid into the esophagus, is a common symptom of eosinophilic esophagitis (EoE). That’s not surprising, given that the chronic immunologic disease causes the esophagus to become inflamed in response to an allergen. This can lead to swelling and scarring of the esophagus, making it hard for food and liquids to move smoothly to the stomach.

Conventional medical and dietary treatments directed at EoE can help relieve and prevent reflux. But when those methods aren’t 100 percent effective, a handful of home remedies are sometimes recommended as additions to traditional treatment to help ease reflux symptoms. As with most complementary and alternative treatments, these have less scientific support in regards to efficacy but are safe for most people — with a doctor’s guidance, of course.

How EoE Causes Reflux

The relationship between EoE and reflux is complex and bidirectional, meaning one can worsen the other. It’s something researchers are still learning about.

EoE develops when inflammatory cells (eosinophils) infiltrate the esophageal lining in response to an allergen. Food is usually the culprit (wheat and dairy are common offenders), but pollen and other airborne allergens can also be triggers.

In response, the immune system releases eosinophils, which are white blood cells that support the immune system and help defend the body against allergens. Eosinophils aren’t normally present in the esophagus. As the cells build up, they cause the lining to swell and narrow, blocking the smooth passage of food.

Certain components of eosinophils can also cause the lower esophageal sphincter (LES) — located between the esophagus and stomach — to relax. This area of muscle opens and closes to allow swallowed food to go into the stomach and prevent digestive acids from coming up. If the sphincter isn’t functioning properly, acid (and nonacid contents such as bile and food) can wash up into the esophagus, causing acid reflux. In addition, eosinophils in the esophagus may affect motility, or how well the muscles of the tube contract to move food and fluids through after swallowing.

Typically, EoE is treated with proton pump inhibitors, oral steroids, or an injectable biologic drug. Any of these may relieve reflux, as well as other symptoms of the condition, such as dysphagia (trouble swallowing).

But some people may also benefit from non-pharmaceutical approaches to reflux management.

Natural Remedies for Reflux

There’s not a lot of science behind most complementary and alternative treatments, says Jeremy Matloff, MD, a gastroenterologist at Yale New Haven Hospital in Connecticut.

But several nonmedical options for reflux have been studied enough to suggest they’re safe and have the potential to help some people with EoE and reflux.

Dietary Changes

“Dietary modifications can help — specifically, avoiding coffee, chocolate, peppermint, alcohol, large meals, and fatty foods,” says Dr. Matloff. Another common culprit? Citrus. So you may want to consider cutting back on these trigger foods.

The timing of meals also matters. Eating later at night, before you lie down and go to sleep, can trigger reflux.

Research shows that eating a high-fiber diet may also help, especially when combined with moderate levels of physical activity.

Exercise

Staying active may help improve reflux — with a few caveats.

The key is to stick to moderate activity levels. In particular, it’s important to avoid vigorous exercise after meals. Instead, opt for a walk after dinner. Or you may want to eat after your workout instead.

Weight Loss

If you’re carrying extra weight, taking steps to lower your body mass index (BMI) may help reduce reflux. Weight loss is thought to reduce pressure on the LES, which can then cut down on reflux.

Implementing a healthy, reflux-friendly eating plan and exercising regularly can help promote weight loss. You can track your progress as you work toward achievable goals.

Consider enlisting the support of friends and family to keep yourself motivated to stick with it.

Smoking Cessation

Tobacco is known for its negative impact on health, and that holds true for people with acid reflux.

That’s because smoking relaxes the LES and lowers the production of a type of saliva known as salivary bicarbonate, which helps neutralize stomach acid. Combined, this can worsen reflux.

But research shows that quitting smoking can help normalize pressure on the LES and the production of salivary bicarbonate. And that can help improve reflux.

Diaphragmatic Breathing

Belly breathing focuses on using the diaphragm — the muscle that separates the organs in the chest from the organs in the abdominal cavity — to move air in and out of the lungs. This strengthens the diaphragm and helps it do one of its other important jobs more efficiently: applying pressure to the LES to prevent the reflux of stomach contents into the esophagus.

There’s evidence that diaphragmatic breathing and a strong diaphragm can help stave off reflux and heartburn.

There’s more than one way to belly breathe. Try this method, which is done lying down:

Lie on your back, with one pillow under your head and another under your knees for support.
Place one hand on your upper chest and the other on your belly, just below your rib cage.
Breathe in slowly through your nose, allowing the air to fill your belly. The hand on your belly should rise as your lungs expand, but the one on your chest should stay in place.
Purse your lips and exhale slowly from your mouth, tightening your abs as you breathe out. As in step 3, the hand on your chest shouldn’t move, but the one on your belly should go down.
Do this for 5 to 10 minutes, three or four times per day. Increase the duration as it becomes easier.

Yuying Luo, MD

Medical Reviewer

Yuying Luo, MD, is an assistant professor of medicine at Mount Sinai West and Morningside in New York City. She aims to deliver evidence-based, patient-centered, and holistic care for her patients.

Her clinical and research focus includes patients with disorders of gut-brain interaction such as irritable bowel syndrome and functional dyspepsia; patients with lower gastrointestinal motility (constipation) disorders and defecatory and anorectal disorders (such as dyssynergic defecation); and women’s gastrointestinal health.

She graduated from Harvard with a bachelor's degree in molecular and cellular biology and received her MD from the NYU Grossman School of Medicine. She completed her residency in internal medicine at the Icahn School of Medicine at Mount Sinai, where she was also chief resident. She completed her gastroenterology fellowship at Mount Sinai Hospital and was also chief fellow.

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Jennifer Kelly Geddes

Author

Jennifer Kelly Geddes is a New York City-based freelance writer and editor, who covers health, wellness, pregnancy, and parenting. She has held positions at Food & Wine, Parenting, Seventeen, and Airbnb magazines and was a research editor at Parenting for more than a decade. Jennifer has also worked as a research editor for Kiwi, Scholastic Parent & Child, Dr. Oz: The Good Life, Modern Farmer, CR Fashion Book, V, VMan, Parents, and National Geographic Kids. She has created custom content for dozens of websites, including Care, SafeBee, Fisher-Price, Mastercard, the National Sleep Foundation, Realtor, Working Mother, Grandparents, Time Out New York KIDS, Good Housekeeping, and Chewy. She holds a BA from Mount Holyoke College and an MA from Columbia University. And she is the mom of two teen girls and a rescue pup named Django. An avid tennis player, cross-country skier, and yoga enthusiast, she divides her time between West Harlem in Manhattan and Ghent, New York.