Integrative Way: Tummy upset? Melatonin may provide relief

Gastro-esophageal reflux disease, also known as GERD, is a huge problem in industrialized countries; studies suggest that 10 percent to 20 percent of people in the Western world experience symptoms of reflux at least once a week.

GERD occurs when acid from the stomach washes up and inflames the esophagus; symptoms may include heartburn, belching, indigestion, nausea, difficulty swallowing, hoarseness, cough, wheezing and chest pain. Dyspepsia is another type of common abdominal discomfort, but unlike GERD, dyspeptic pain is limited to the upper abdomen and is not associated with inflammation in the intestines.

Irritable bowel syndrome, or IBS, is also a common syndrome and is usually associated with lower-abdominal symptoms such as constipation, diarrhea, bloating and cramping.

Prescription medications used to treat GERD and dyspepsia, including medications like Prilosec and Zantac, are some of the world's biggest-selling drugs. They often provide great relief, but they also are associated with side effects, especially when used chronically.

This is because acid in the stomach is important for the absorption of various nutrients, such as calcium, iron, zinc, and vitamins C and B12. When we suppress acid production chronically, we put ourselves at risk for malabsorption of these nutrients. Acid in the stomach also suppresses the growth of harmful bacteria and protects us from pneumonia and some intestinal infections.

One potential alternative therapy for some of these disorders is melatonin, a hormone produced in the pineal gland in the brain and the intestines.

A study published in 2007 in the Journal of Clinical Gastroenterology looked at the effect of melatonin on 60 patients with dyspepsia. The patients were divided into two groups; half of them took 5 milligrams of melatonin every evening while the other half took a placebo. After three months, more than half the patients taking the melatonin had complete resolution of symptoms; another 30 percent had partial improvement. In contrast, less than 10 percent of the patients getting the placebo improved.

In another study of people with moderate to severe heartburn, 351 patients were either given 20 milligrams of Prilosec each evening or a "cocktail" of 6 milligrams of melatonin plus other supplements. Within seven days, all the patients getting the melatonin mixture reported some improvement; after 40 days, all the melatonin subjects reported almost complete resolution of symptoms. Only 66 percent of the patients getting Prilosec reported complete relief.

Side effects of melatonin may include headache, dizziness, nausea and fatigue. Because it may stimulate the immune system, it is not recommended for people with autoimmune disorders like rheumatoid arthritis. It should also be avoided in pregnant or nursing women. Long-term safety data is not available, so you have to use it at your own risk.

Before you head for the medicine counter, either prescription or supplement, we suggest that you look at your lifestyle. Certain habits can aggravate abdominal discomfort, including our tendency to indulge in large, high-fat meals, refined carbohydrates, caffeine, and alcohol.

About the writer:

• Drs. Kay Judge and Maxine Barish-Wreden are medical directors of Sutter Downtown Integrative Medicine program. Have a question related to alternative medicine? E-mail adrenaline@sacbee.com.