Can Alkaline Water Help with Acid Reflux?

When dealing with acid reflux, it’s only natural to want a simple or quick fix. 

In recent years, alkaline water has gotten a lot of attention for its supposed ability to reduce acid reflux. But what is alkaline water, and is it really worth the hype?

What is alkaline water? 

Let’s venture back to our high school chemistry days for a second. The pH scale is a scale of 0-14 that refers to how “acidic” or “alkaline” something is. A lower number is considered acidic, 7 is considered neutral, and a higher number is considered alkaline.

Normal drinking water is considered neutral at a pH of around 7, however, this can vary slightly depending on your tap water location and how it is processed. Alkaline water usually has a pH of 8 or 9. This is achieved through the addition of minerals before being bottled. Because the bottling process requires extra steps, alkaline water can be more expensive than regular drinking water. 

What are the claims?

One theory proposes that drinking alkaline water could help neutralize stomach acid, therefore decreasing acid reflux. However, it is important to note that our body tightly regulates its pH levels on its own to achieve homeostasis. So if alkaline water was introduced, your stomach would probably initiate processes that would get its pH back to where it likes to be.  

A 2012 study conducted by two doctors suggested that alkaline water could decrease the activity of the enzyme pepsin, an enzyme known to play a role in developing hydrochloric acid. This study was conducted in vitro, meaning in test tubes as opposed to in human studies. Before we can claim that alkaline water reduces pepsin and therefore acid reflux, we need quality studies in humans. 

Another study published in 2017 followed improvements in laryngopharyngeal reflux (LPR) in two cohorts of people. In one group, proton-pump inhibitors were used in combination with standard reflux precautions. The second group with reflux was treated with alkaline water, a plant-based Mediterranean diet, and standard reflux precautions. Each group of ~80-95 participants was followed for 2 years. No significant differences in outcomes between groups were identified. Even if the group who drank alkaline water saw significant improvements in reflux, those participants were also treated with a diet intervention. Therefore, we cannot conclude a direct link between alkaline water and reflux. 

So, what’s the bottom line? 

At this time, the evidence is not there to suggest that alkaline water can actually provide relief from reflux. However, staying hydrated is a vital part of good health! If you prefer alkaline water over regular drinking water, then by all means, drink away! 

But, if you don’t feel like spending the money on specialized water, at this time it doesn’t appear that you’re missing out on any reflux-minimizing benefits. Instead, manage your reflux with strategies known to have a bigger impact, such as avoiding specific food triggers, quitting tobacco products, and having a healthy waist circumference. 

1. _{Koufman, J.A. & Johnston, N. (2012). Potential benefits of pH 8.8 alkaline water as an adjunct in the treatment of reflux disease. Annals of Otology, Rhinology, & Larynology, 121 (7), 431-4.}
2. _{Zalvan, C.H., Hu, S., Greenberg, B. (2017). A comparison of alkaline water and Mediterranean diet vs proton pump inhibition for treatment of laryngopharyngeal reflux. JAMA Otolaryngology-Head and Neck Surgery, 143(10): 1023-1029.}