Rakel says the key is to set expectations. “I say, ‘Hey, this is one of those things where you’re going to get worse before you’ll feel better, but if you can hang in there for 1 1/2 to two weeks, that hyperacidity rebound effect should go away.’” Rakel says it’s important for patients to taper off PPIs slowly, first cutting the dose, if possible, and then taking it every other day. He usually recommends patients stay with one herbal remedy while weaning off PPIs. Kiefer, on the other hand, says patients can combine herbs. He suggests using anti-inflammatories such as chamomile or DGL plus melatonin during the medication tapering process. Once the PPI is gone, herbs that act to coat the GI tract (such as aloe vera or marshmallow root) can be added, he says. (These can interfere with the absorption of medication, so should be taken at least an hour before or after taking any pills.) Becky Fishman used a process like this to finally get off PPIs after a dozen years. She says her doctor hadn’t explained how, but her father — also a reflux sufferer — helped her work out a Nexium step-down plan. The 46-year-old North Carolina medical writer used DGL lozenges and aloe vera to help alleviate symptoms during her transition. Some mild reflux symptoms remained, though, which she then mostly eliminated by cutting back on carbs. Indeed, say Rakel and Kiefer, changing what you eat can also help avoid reflux symptoms, whether it’s avoiding trigger foods or eating less. Other non-herbal remedies they advise include acupuncture, stress management (mindfulness and meditation, for instance) and lifestyle changes, such as exercising and losing weight.