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The Best Probiotics for Acid Reflux in 2021

When it comes to the best probiotic for acid reflux, the strains of bacteria used in these probiotic supplements matter.

Probiotics for acid reflux are relatively new on the scene, but new research shows that certain types of beneficial bacteria may help with many aspects of digestive health, including reflux and heartburn.  

To date, 8 major strains of probiotics have been studied for use in acid reflux, and I will review those for you here along with brands that have these strains and also are high-quality brands of probiotics. 

I will also review the potential benefits of probiotics in gastroesophageal reflux disease. 

This post contains affiliate links.  Visit the disclosure page for more information. 

Best probiotics for acid reflux: a quick overview

Don’t have time to read the whole post? Here are the top recommended probiotic brands for acid reflux:

What is acid reflux?

According to the  World Gastroenterology Organization, gastroesophageal reflux disease (GERD) is “troublesome symptoms sufficient to impair an individual’s quality of life or injury or complications that result from the retrograde flow of gastric contents into the esophagus, oropharynx, and/or respiratory tract” [R].

In contrast, acid reflux can occur occasionally and isn’t as serious as GERD; most people experience acid reflux symptoms at least a few times a year due to lifestyle factors.

Acid reflux symptoms include:

  • Feelings of heartburn
  • Indigestion
  • Bloating
  • Burping
  • Swallowing difficulties
  • Nausea
  • Cough
  • Sore throat
  • Burning in the esophagus
  • Need to clear the throat frequently
  • Ulcers and bleeding

GERD can be serious and should be evaluated by your doctor or healthcare practitioner.  

However, there are some important lifestyle habits that can naturally reduce acid reflux symptoms. And the fact is, reflux isn’t always caused by too much stomach acid and common medications like proton pump inhibitors (PPIs) may not be needed. 

It can be caused by many factors other than too much stomach acid.  

Just so you know, functional dyspepsia and acid reflux are often one in the same thing as far as symptoms go.

Related: Do you have low stomach acid? Signs and simple remedies

What causes acid reflux?

Acid reflux or heartburn, is really common, but not for the reasons many people think. 

According to the National Institute of Diabetes and  Digestive and Kidney Diseases (NIDDK), about 1 in 5 people have this frustrating condition of GERD, while even more people have occasional acid reflux or heartburn [R].

These conditions can be caused by hiatal hernia, medications like Ibuprofen, and genes, but there is definitely more to the story for most people. 

It’s tempting to blame heartburn and acid reflux on genes, but the truth is, the reason GERD is so common now is that it often boils down to foods that you are eating or stress (or both) [R, R]. 

Food triggers and eating habits

Some of the obvious food triggers for acid reflux are hot peppers, spicy foods, caffeine, and tomato sauces. However, it is often other foods or beverages that are causing reflux like dairy, gluten, fried foods, sugar, and alcohol. 

These foods and beverages can cause the lower esophageal sphincter, or valve, to relax and open up, which causes acid and food contents to back up into the esophagus.  They can also throw the microbiome out of balance.

Food sensitivities can cause inflammation and result in indigestion. When foods aren’t properly digested, they are more likely flow back into the esophagus.

Many people also eat too fast, too, causing the stomach to be overloaded, resulting in reflux. Thoroughly chewing your foods will help reduce your heartburn and indigestion by simply helping to break down your food before it hits your stomach.  

Chewing foods well and avoiding trigger foods eases all aspects of digestive health, by the way. 

Related post: The Best Tea for Acid Reflux

A new cause of acid reflux?

Another emerging cause of reflux is an imbalanced microbiome, or gut bacteria and flora. 

Many experts in the field of probiotics have conducted research to show that acid reflux can be a result of small intestinal bacterial overgrowth (SIBO) [R].

Both SIBO and GERD may be caused by an altered microbiome. This is where probiotics start to come in to focus on acid reflux. 

How do probiotics help acid reflux?

14 clinical studies have evaluated the effects of probiotics on acid reflux and 79 percent of these studies concluded that probiotics may be a beneficial add-on for people who suffer from heartburn and reflux symptoms. 

Both single-strain probiotics and multi-strain probiotics seem to be helpful for acid reflux and functional dyspepsia according to research. 

Probiotic benefits for gut health

By balancing out the gut microbiome, probiotics can have far-reaching effects.  Research shows that probiotics may help:

  • Improve bowel function
  • Enhance all aspects of digestive function
  • Alleviate many kinds of digestive discomfort
  • Reduce upper GI symptoms
  • Reduce gas and bloating
  • Improve mood
  • May improve gastric motility

Probiotics help break down our food to ease the digestive process as well. This is part of why probiotics can be part of a natural treatment for acid reflux and heartburn.

Research summary of probiotics in acid reflux

Here is a summary table of some of the research on the effect of various probiotic strains for people with upper GI symptoms. 

ObjectiveProbiotics usedLength of studyResultsReference
Extra-virgin olive oil enriched with probiotics in people with functional dyspepsiaLactobacillus reuterii, Lactobacillus rhamnosus, Saccharomyces boulardi   28 daysDecreased abdominal pain, bloating, nausea, and vomiting[Ref]
Fermented milk containing Bifidobacterium bifidum YIT 10347Bifidobacterium bifidum 6 weeksDecreased gastric symptoms and lower abdominal symptoms[Ref]
Dose response effect on functional gastrointestinal symptomsB. lactis HN019 17 Billion or 1.8 billion CFUs vs placebo14 daysSpeed of bowel movement improved, 8 of 9 gastrointestinal symptoms improved[Ref]
Effects of Lactobacillus gasseri OLL2716 enhanced yogurt on functional dyspepsiaLactobacillus gasseri vs placebo12 weeksImproved elimination of dyspepsia symptoms[Ref]
Effects of probiotic on people with reflux esophagitisEsomeprazole 20 mg twice daily and combined Bacillus subtilis and E. faecium enteric-coated capsules three times daily vs Esomeprazole only8 weeksDecreased SIBO, decreased diarrhea, and decreased relapse of symptoms[Ref]
Effects of fermented milk on functional GI symptoms and mood100 mL/day of B. bifidum fermented milk4 weeksAbdominal pain, diarrhea, constipation and mood scores improved [Ref]
Gastric fluid in people with functional dyspepsiaLactobacillus gasseri fermented yogurt vs control4 weeksFasting gastric fluid volume decreased in the patients and symptoms improved[Ref]
Prevention of colic, regurgitation, and functional constipationLactobacillus reuteri 3 monthsReduced crying time, reduced vomiting, increased bowel movement frequency[Ref]
Types of probiotic strains and their effects on functional dyspepsia, colic, and acid reflux according to clinical studies.

Research interpretation of probiotics for GERD

All in all, these probiotic strains are very well tolerated and improve various reflux symptoms.  Some of these probiotic varieties even reduce SIBO. 

It is important to note that the studies first ruled out helicobacter pylori (H. Pylori) infections, which can be a source of acid reflux. 

One study used probiotics as an add-on to proton pump inhibitors (PPIs), which are the standard of care for treatment for treating GERD-related symptoms.  The added benefit of probiotics was impressive. 

The use of probiotics in this study had superior benefit to PPI alone [R].

Another PPI study in children found that adding probiotics to their treatment helped to ameliorate almost all of the dysbiosis that resulted from the medication [R].

Gastric benefits of probiotics in healthy adults

People who are healthy experience gastric benefits of probiotics too.

For example, a follow-up study of Bifidobacterium bifidum YIT 10347 fermented milk in healthy adults found that this supplement reduced gastric pain and overall post-meal comfort compared to a placebo too. 

This particular strain of probiotic is helpful at alleviating gastric pain because the results have been duplicated in two different clinical studies [R].

Interesting Tip: Another perk to the probiotic Lactobacillus gasseri yogurt is that it may reduce abdominal fat by as much as 8-9 percent compared to conventional yogurt over a 12 week period [R].

Lactobacillus gasseri also reduced waist circumference and abdominal fat according to another study especially when using a higher dose (10 billion CFU) [R].

Types of probiotic strains that help acid reflux

To summarize, the probiotic strains that help with GERD are:

  • Lactobacillus gasseri-may help to eliminate dyspepsia and reflux symptoms as well as reduce abdominal fat and waist circumference.
  • Bifidobacterium bifidum-may decrease abdominal pain, diarrhea, and constipation.
  • Lactobacillus reuteri-may reduced colic, reduce vomiting, increase bowel movement frequency.  Also decreased abdominal pain, distention, nausea, and vomiting.
  • Lactobacillus rhamnosus GG-decreased abdominal pain, distention, nausea, and vomiting.
  • Bifidobacterium lactis HN019-Increased stomach emptying and speeds up transit time, 8 of 9 belly symptoms improved.
  • Saccharomyces boulardii-along with L. reuteri may help reduce colic, vomiting, and alleviate constipation.
  • Bacillus subtilis-may decrease SIBO and many GI symptoms
  • E. faecium-could be helpful for many aspects of GI health. Not currently available commercially.

Related post: Soil based probiotics: Do they help your gut health?

The strains of bacteria are important as you can see.  While common probiotic strains like lactobacillus acidophilus may be good for overall digestive function, targeted probiotic strains may be more effective for GERD and heartburn.

Why type of probiotics matter and adding prebiotics could help

Probiotic strains can have different effects on the upper and lower digestive tract.

For example, infants given the probiotic strains called Bifidobacterium infantis M-63, breve M-16V, and B. longum BB536 helped with symptoms of irritable bowel syndrome but did not help with functional dyspepsia symptoms [R].

Bifidobacterium longum BB536 and Lactobacillus rhamnosus HN001 are useful in functional constipation but haven’t shown benefit for acid reflux disease [R].

Another possible factor that could improve the effectiveness of all probiotic strains is prebiotics, which are fermentable fibers.

Emerging research shows that using prebiotics along with probiotics may have more benefits than using probiotics alone for acid reflux, but more research is needed [R].

Until then, eating a diet rich in prebiotics is probably a smart idea. 

Probiotics for H. pylori

Probiotics may be helpful in combatting stomach infections like H. pylori too.

Using probiotics plus antibiotic was better than treatment with antibiotic alone in a study of people who had helicobacter pylori infections [R].

Antibiotics-only treatment eradicated the H.Pylori at 69% while pre-treatment with the probiotic Bifidus infantis for 2 weeks and during antibiotic treatment led to a 91% eradication of H. Pylori. 

Fermented yogurts that are rich in probiotics reduce H. Pylori infections as well [R].

Best probiotics for acid reflux criteria

It is important to find high-quality probiotic brands for the best effectiveness because probiotics are live organisms.  Here are the criteria used for best probiotic for acid reflux:

  • Certified Good Manufacturing Practices (cGMP)-meaning that the companies undergo voluntary third-party inspection
  • Contains targeted GERD probiotic strains supported by research
  • Rated at least 4.5 stars by over 100 reviewers (most have over 1000 reviews)
  • Reviews discuss specific acid reflux benefits
  • Soy Free, Gluten Free, Dairy Free, Egg Free, Nut Free
  • Shelf-stable for ease of use

Probiotics that are shelf stable make for ease of use.  In my experience, refrigerated probiotics are less likely to be consumed because they are out-of-sight-out-of-mind. 

If you are looking for a more all-encompassing probiotic, it is a good idea to get those that contain multiple beneficial probiotic strains.  After all, GERD is related to IBS and other digestive conditions that may be helped by other probiotic types. [R].

Just make sure it has some of the GERD-researched strains listed above as well.

For some people, it is best to start with a lower dose, or lower colony-forming unit count (CFU).  Other people do much better with a higher CFU. Because of this, I give you a range of doses and strains.  

Best probiotics for acid reflux brands-multiple strain

I highlighted the probiotics in the ingredients that have research to support their use for gastric acid reflux for your convenience. 

Here are a few good probiotic options that meet all of the quality criteria:

  • Garden of Life Dr. Formulated Probiotics Platinum Series Immune+ 90 Billion CFU Guaranteed, formulated by Dr. Perlmutter. Contains the key probiotics lactobacillus gasseri, lactobacillus rhamnosus, bifidobacterium bifidum, bifidobacterium lactis, and 12 other beneficial strains.  This is the highest-rated probiotic on the market and the most concentrated.  
  • Hyperbiotics PRO-15 Probiotics—with 15 strains of probiotics and 15 billion CFU, contains 5 of the 8 researched strains for relieving acid reflux.  Contains 60  time-release pearls with Lactobacillus acidophilus, Bifidobacterium infantis, Bifidobacterium longum, Lactobacillus rhamnosus, Bifidobacterium lactis, Lactobacillus reuteri, Lactobacillus salivarius, Lactobacillus paracasei, Lactobacillus gasseri, Bifidobacterium bifidum, and Streptococcus thermophilus.
  • NOW Supplements, Clinical GI Probiotic for ages 50+, formula with 20 billion CFU’s per serving, Strain Verified, 60 vegetarian capsules, *the only probiotic with the specific Bifidobacterium lactis HN019  as the predominant strain, plus 8 other beneficial strains: Lactobacillus acidophilus, Bifidobacterium lactis, Lactobacillus rhamnosus, Lactobacillus salivarius, Lactobacillus casei, Streptococcus thermophilus, Bifidobacterium longum, Bifidobacterium bifidum, Bifidobacterium lactis. 
  • NewRhythm Probiotics 50 Billion CFUs and 20 Strains, with 60 vegetarian capsules per bottle, contains Lactobacillus acidophilus, L. rhamnosus, L. crispatus, L. reuteri, L. casei, L. salivarius, L. gasseri, B. lactis, Pediococcus pentasaceus, B. breve, B. adolescentis, B. infantis, B. longum, L. lactis, Pedicoccus acidilactici, S. thermophiles. Also contains a prebiotic fiber blend. 
  • DrFormulas Nexabiotic 23 Probiotics for Women and Men – Dr. formulated with 5 of the 8 studied strains for GERD including Lactobacillus gasseri, Lactobacillus rhamnosus, Lactobacillus Acidophilus, Bifidobacterium Infantis, Saccharomyces Boulardii, Bifidobacterium lactis, Bifidobacterium bifidum, for a total of 17.25 Billion CFUs per serving.

Histamine-free probiotic for reflux

Some people need a probiotic that doesn’t release histamine in their body such as people with histamine intolerance. One on the market meets that criteria:

Lifted Naturals Probiotics 30 Billion CFU per serving-contains Bifidobacterium breve, bifidobacterium, bifidum, bifidobacterium longum, and bifidobacterium infantis, This is a mood support supplement that also contains prebiotics to help support the gut microbiome. 


Also this brand is very useful for people with histamine sensitivity or histamine intolerance because these probiotic strains do not increase histamine production in the body. 

Best probiotic brands for acid reflux-single strain

NOW Supplements, Saccharomyces Boulardii, contains S. boulardii at 5 billion CFUs. This product is highly rated for improving many aspects of digestive health and very inexpensive for people on a budget.

Swanson’s Lactobacillus Gasseri, with 3 billion CFU’s per serving-I listed this brand because it is the only single-strain probiotic of the well-researched Lactobacillus Gasseri.  

This probiotic would be a good add-on for people who tend to eat probiotic foods or take another probiotic and are looking for a bit of extra benefit for acid reflux. Some people make their own yogurt out of it as well. 

Probiotic brand for acid reflux in babies and children

GERD-related symptoms in babies include colic and belly pain. New research shows that a probiotic strain called Lactobacillus reuteri DSM 17938 helps reduce both of these daunting symptoms. 

BioGaia Protectis Probiotics Drops for Baby, Infants, Newborn and Kids Colic, Spit-Up, Constipation, and Digestive Comfort, 5 ML, contains Lactobacillus reuteri DSM 17938. 

Cautions

Probiotics are considered safe for most people. However, if you have had an imbalanced microbiome, you may experience some temporary increase in digestive symptoms until your body adapts, generally after 2-3 weeks. In this case, use a smaller dose and increase as tolerated.

People with severely compromised immunity should consult with their doctor before starting probiotics.

Some people respond to different probiotic types better than others. This is because we are all unique. Using probiotics may take some trial and error, or trying different brands to get your best results.

As with anything, check with your doctor or healthcare provider before starting any new supplement or lifestyle routine.

Other natural treatments for heartburn

By eliminating food sensitivities and using safe add-ins like ginger, digestive enzymes, and many other food hacks, you may be on your way to better digestion and reduced heartburn and reflux.

Many people’s acid reflux simply goes away when they eliminate or minimize the big food sensitivities and limit sugar and overly processed foods.  

This can be a challenging journey, but well worth it.  

For many, adding calming drinks and these herbs can be beneficial to help reduce stress-induced acid reflux. 

The following herbal teas or supplements can be used to help with heartburn and reflux symptoms:

  • Chamomile
  • Licorice
  • Ginger
  • Marshmallow root
  • Slippery elm
  • Fennel seed

Please know that using licorice tea can be soothing for the gut, but should only be in moderate amounts because it can lower your blood potassium levels if taken in large amounts or for prolonged periods of time. 

Fermented foods for heartburn

Fermented foods are great sources of natural probiotics and natural digestive enzymes as well.  

The following fermented foods and beverages are potent sources of probiotics:

  • Sauerkraut
  • Puerh tea
  • Kimchi
  • Fermented vegetables and fermented pickles
  • Aged cheeses
  • Kefir
  • Yogurt
  • Apple cider vinegar with the mother

Some of these foods, while acidic, can be very soothing for GERD.  This is because at the root of some people’s reflux is low stomach acid. These foods can also have very healing effects on the digestive tract. 

Just make sure to start with a small amount and use common sense.  For example, dilute the vinegar before you use it, or serve it as a condiment rather than drinking it in its concentrated form. 

Probiotic supplements are often a great add-in for digestion if you aren’t eating these probiotic foods daily.   

Ginger for heartburn

Ginger reduces symptoms of indigestion, nausea, vomiting, improves the movement of food through the digestive tract, and increases saliva production.

It also reduces the chances that stomach acid will flow up into the esophagus.  For this reason, it is a natural remedy for acid reflux that many people turn to. 

You can try ginger tea, ginger candies, fresh ginger in recipes, or ginger capsules. 

However, some people find the sensation of ginger to be too warm on the esophagus, especially at first.  If this is the case for you, try adding it to recipes where it is diluted down. 

Read more about the benefits of ginger for digestion here.

Bonus: ginger enhances nutrient absorption in your small intestine. 

Digestive enzymes for acid reflux

One area that deserves attention for acid reflux is the use of digestive enzymes.

We need enzymes to digest foods well.  Simply put, enzymes help us break down our foods so we can digest them.

We have many places in our digestive tract that make enzymes: in our mouth, stomach, small intestines, and pancreas.  

Our small intestines actually produce more digestive enzymes than our pancreas does.  

What does this mean for us?  

Lack of digestive enzymes due to an imbalanced gut lining could be a silent problem that makes your stomach digestion way off. Adding digestive enzymes are safe and can be beneficial in relieving occasional acid reflux and indigestion.

What can make your digestive enzyme production low?  Inflammation, food intolerance, and anything that can throw off the gut bacteria (think PPI drugs, antibiotics, and more).

Enzymes are a safe and emerging treatment option for many digestive issues, including Celiac disease.  They can be combined with ox bile as well when needed. 

Overuse of stomach prescriptions

A common way to treat acid reflux is by using stomach acid blockers called proton pump inhibitors (PPI’s).  The function of these drugs is to block stomach acid.  

A recent analysis showed that over 80% of patients given the medicines in the category called proton pump inhibitors had no valid indication for use. The use of these drugs is now linked to an increased risk of serious infections, memory loss, and more.

PPI’s are sometimes needed and beneficial.  Keep in mind, they are indicated for short-term use.  

Yet people stay on them for years, even decades.

Many people recover and feel so much better if they choose to add in natural treatments for heartburn such as probiotics whenever possible.  They absorb their food better and have more energy as well.

What are PPI Drugs side effects?

Blue capsules and red and yellow capsules on a white background with writing acid reflux and a blue syringe by The Healthy RD

Using prescription medications for heartburn isn’t benign.  They have common and some serious long-term side effects. 

PPI drug side effects include:

  • Headache
  • Diarrhea
  • Constipation
  • Abdominal pain
  • Flatulence
  • Fever
  • Vomiting
  • Nausea
  • Rash

More serious side effects, although uncommon, include:

  • Serious allergic reactions
  • Stevens-Johnson syndrome
  • Toxic epidermal necrolysis
  • Reduced kidney function
  • Pancreatitis
  • Reduced liver function
  • Erythema multiforme

Types of PPI drugs

There are many types of PPI medications on the market today.  Generic names of most PPI drugs include:

  • Azeloprazole
  • Dexlansoprazole
  • Esomeprazole
  • Ilaprazole
  • Lansoprazole
  • Omeprazole
  • Pantoprazole
  • Rabeprazole
  • Revaprazan
  • Tenatoprazole
  • Timoprazole
  • Vonoprazan

Discuss short term and long term use of these medications with your doctor as they can bring with other long term health issues. 

I will describe some nutritional issues that can due to PPIs that occur below. 

Heartburn drugs reduce vitamin B12

What happens if you take a proton pump inhibitor or PPI? This medicine blocks acid production in the stomach.  Seems pretty benign, right?

Here’s the story you don’t hear.  By blocking acid, they also block the absorption of vitamin B12. Stomach acid is key to freeing or liberating B12 for absorption too.

There are many other nutrients that may suffer, too, like calcium, iron, and zinc.

Your healthy probiotics also get disrupted by the acid-blocking medications.

Consequences of B12 Deficiency

What’s the big deal about plummeting your B12  absorption due to PPIs? 

Vitamin B12 is necessary to make red healthy red blood cell cells and nerve cells.  Low B12 can cause PERMANENT nerve damage, memory loss, and mood disorders.

B12 deficiency is now extremely common, and no doubt that heartburn drugs are contributing to these issues.

Deficiency of B12 also interferes with energy production and liberation of energy from food.

Even the most skeptical nutrition critic probably doesn’t want low energy.  I’m pretty confident of this.

It would be all still manageable if it was just B12 deficiency.  However, there are some other consequences of blocking acid.

Other lesser known PPI side effects

PPIs interfere with the absorption of calcium, iron, zinc, and chromium to name a few. This means that you aren’t getting nutrients very well from the food you eat.

Stomach acid is  also required for proper protein digestion as well.  Think about it. You are trying to block acid, but the blocking of acid causes indigestion.  Yikes.

Some research suggests these drugs even create small intestinal bacterial overgrowth.

Long-term, this can wreak havoc on health! Research also shows that long-term PPI use increases the risk of cardiovascular disease and dementia.

PPI drugs rob the body of minerals needed for just about every function in the body.  These include calcium, iron, magnesium, and likely more.

Sound worse than heartburn to anyone?

You need to carefully consider the risks of this drug versus the benefits. Also consider that natural treatment for heartburn is within your grasp too.

Consider, perhaps, that you don’t have too MUCH acid.  You may have too LITTLE acid as well.  Here’s some really great information from my colleague Jeanette Kimszal RDN about low stomach acid symptoms.

Summary

When looking for the best probiotic supplement for acid reflux, make sure to look for the strains that have been researched for treating GERD or functional dyspepsia.  Also, consider making diet changes liking adding fermented foods and eliminating food sensitivities to help with your reflux.  Additionally, consider adding in some calming teas and herbs, and find ways to manage your stress. 

As with anything, make sure to check with your doctor or healthcare provider before making any changes to your healthcare routine.  This post is for informational purposes only and is not intended as medical advice. Make sure to seek the care of your medical doctor or healthcare provider if you are struggling with acid reflux. 

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