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How to Use Melatonin to Ease Reflux

Although melatonin is usually sold over the counter as a sleep aid, research indicates it can also help ease symptoms of acid reflux.

Millions of Americans experience heartburn, either occasionally or on a regular basis. Most people are aware of OTC medicines to treat this uncomfortable condition. However, some would prefer an alternative way to address their reflux. Could melatonin help?

Does Hormone Work Against Heartburn?

Q. Did a guest on your radio show talk about using melatonin for heartburn? I think I heard that melatonin was equally effective as a PPI for reducing acid reflux. I seem to recall that this supplement acts by tightening the sphincter between the stomach and the esophagus. Is it worth trying?

A. You recall correctly. Dr. Tieraona Low Dog mentioned that melatonin improves the mucosal barrier of the stomach and esophagus. More importantly, it also increases the muscle tone of the lower esophageal sphincter (LES) that separates the stomach from the esophagus.

This is particularly important because the LES keeps stomach acid and other irritating substances from harming the esophagus. This may in part explain how this natural compound protects the esophagus (International Journal of Molecular Sciences, July, 2018).

Melatonin Successful for Nighttime Reflux:

Q. You have written about a study comparing PPIs with melatonin. Apparently, melatonin was as effective as acid-suppressing drugs, with one difference: Melatonin tightens the sphincter between the stomach and the esophagus, thus reducing reflux.

I started using melatonin for my occasional reflux at night and have had excellent results. In addition, a couple of my adult children also had severe problems with reflux. They too started taking melatonin, happily seeing a great benefit.

A. A review article in the journal Nutrients (Feb. 5, 2022) concluded that melatonin looks promising in the treatment of gastroesophageal reflex disease (GERD). It appears to work just as you describe, by keeping acid in the stomach where it belongs.

If you wish, you can learn more about a variety of strategies to reduce heartburn, gas, constipation and diarrhea in our eGuide to Overcoming Digestive Disorders.

Alternatives to Treat Acid Reflux:

Q. You’ve written about melatonin maybe helping to restrict gastric juices from splashing back up into the esophagus. Can you give me a link to that article? I have an appointment with my gastroenterologist soon and I would like to discuss the information with him.

A. A recent review article characterizes the evidence on melatonin to ease GERD (gastroesophageal reflux disease) as of moderate quality (Nutrients, Feb. 5, 2022).  The full text is available without a payment, so both you and your doctor can read it. Beyond melatonin, the authors cite the herbs ginger, peppermint and caraway as supported by good evidence.

There are some individual studies, including one that concluded melatonin plus certain vitamins and phytonutrients was better than omeprazole against heartburn symptoms (Journal of Pineal Research, Oct. 2006).

Pros & Cons of PPIs:

Doctors recommend proton pump inhibitors (PPIs) such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec) and pantoprazole (Protonix) for acid reflux. Although such drugs usually ease heartburn and other symptoms quite well, they can have downsides, particularly over the long term. PPIs increase the risk of pneumonia, diarrhea due to Clostridium difficile (Expert Review of Clinical Pharmacology, July, 2013), bone fractures (Annals of Epidemiology, April, 2014) and nutritional deficiencies. Kidney damage (JAMA Internal Medicine, Feb., 2016) and dementia (JAMA Neurology, April, 2016) are frightening long-term consequences that have come to light more recently. If interested, you could read more about these problems here.

Given such problems, it is little wonder that people are looking for alternatives to calm their symptoms. Could they use melatonin?

Might You Use Melatonin for Barrett’s Esophagus?

Q. As I understand it, Prilosec is useful for Barrett’s (and GERD). It helps heal irritation in the esophagus that could lead to cancer. But it seems there is no conclusive evidence that using Prilosec prevents cancer.

Today I read that melatonin does just as good a job at healing the body. Apparently, it takes about 30 days.

You can even take it with Prilosec, and that will make it easier to get off the acid suppressor. I plan to gradually reduce my dose of Prilosec by taking melatonin. I’ll use an H2 blocker or an antacid like Tums instead if I have symptoms. This seems to be working for me.

The Research Findings on Melatonin for Digestive Problems:

A. We usually think of melatonin in connection with the brain, especially for sleep. However, that is not its only function in the body.

A pilot study found that melatonin, alone or in combination with omeprazole

“is a promising therapeutic agent for the treatment of GERD. It is an effective line of treatment in relieving epigastric pain and heartburn” (BMC Gastroenterology, online Jan. 18, 2010).

For this study, patients took as little as 3 mg or as much as 6 mg of melatonin before bedtime. The results showed that combining it with omeprazole was most effective at healing esophageal injury.

In addition, a review of other studies concludes that melatonin supplements can speed ulcer healing (Current Pharmaceutical Design, vol. 20 #30, 2014). Moreover, melatonin may ease stress-induced symptoms of irritable bowel syndrome (Journal of Physiology and Pharmacology, Dec. 2011).

Learn More:

There are a number of other natural approaches to easing heartburn symptoms that may be useful for people who would like to discontinue taking a PPI or would prefer not to start taking such a drug. You can learn more about ginger, persimmon tea and deglycyrrhizinated licorice (DGL) in our eGuide to Digestive Disorders.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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  • Majka J et al, "Melatonin in prevention of the sequence from reflux esophagitis to Barrett’s esophagus and esophageal adenocarcinoma: Experimental and clinical perspectives." International Journal of Molecular Sciences, July, 2018.
  • Schulz RM et al, "Effectiveness of nutritional ingredients on upper gastrointestinal conditions and symptoms: A narrative review." Nutrients, Feb. 5, 2022. DOI: 10.3390/nu14030672
  • de Souza Pereira R, "Regression of gastroesophageal reflux disease symptoms using dietary supplementation with melatonin, vitamins and aminoacids: comparison with omeprazole." Journal of Pineal Research, Oct. 2006. DOI: 10.1111/j.1600-079X.2006.00359.x
  • Wilhelm SM et al, "Perils and pitfalls of long-term effects of proton pump inhibitors." Expert Review of Clinical Pharmacology, July, 2013. DOI: 10.1586/17512433.2013.811206
  • Kandil TS et al, "The potential therapeutic effect of melatonin in gastro-esophageal reflux disease." BMC Gastroenterology, online Jan. 18, 2010. doi: 10.1186/1471-230X-10-7
  • Brzozowska I et al, "Mechanisms of esophageal protection, gastroprotection and ulcer healing by melatonin. implications for the therapeutic use of melatonin in gastroesophageal reflux disease (GERD) and peptic ulcer disease." Current Pharmaceutical Design, vol. 20 #30, 2014. DOI: 10.2174/1381612819666131119110258
  • Konturek PC et al, "Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options." Journal of Physiology and Pharmacology, Dec. 2011.
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