Millions of Americans experience heartburn, either occasionally or on a regular basis. Most people are aware of OTC medicines to treat this discomfort, but some would prefer an alternative way to address their reflux. Could melatonin help?
Alternatives Against 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. In addition to 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). Finally, this summary suggests that melatonin can prevent the worst outcomes of GERD (International Journal of Molecular Sciences, July 2018).
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 recently been revealed. You could read more about these problems here.
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).
A review of other studies concludes that melatonin supplements can speed ulcer healing (Current Pharmaceutical Design, vol. 20 #30, 2014). In addition, melatonin may ease stress-induced symptoms of irritable bowel syndrome (Journal of Physiology and Pharmacology, Dec. 2011).
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 Guide to Digestive Disorders.