At-A-Glance
- Alkaline water helps eradicate pepsin, the enzyme that causes tissue damage in acid reflux.
- To be maximally effective, the water’s pH should be 9.5 or higher, but any water pH 8.8 or higher will help eradicate pepsin.
- The alkaline water movement began in 2012, after I published a study showing its therapeutic potential.
- Both bottled and filtered options (like pitchers) can be effective, as well as alkaline water drops, and are convenient for daily use.
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Alkaline water for reflux isn’t just a trend — it’s backed by research and may play a key role in reducing symptoms and promoting recovery.
What is Alkaline Water?
Let’s define the kind of water we are talking about:
- “Alkaline” is another word for “basic”, the opposite of “acidic.”
- On the pH scale, which measures how acidic or basic a substance is, pH 7 is neutral.
- Values below 7 are acidic (with lower numbers indicating greater acidity).
- Values above 7 are alkaline or basic.
- The pH scale is logarithmic, meaning even small changes are significant — for example, pH 2 is 10 times more acidic than pH 3.
Most tap water is around pH 7, while alkaline water typically has a pH between 8.0 and 10.5, making it significantly more basic/alkaline than drinking water.
Why Alkaline Water Helps with Acid Reflux
Stomach acid typically has a pH between 2 and 4 — about the same as most soft drinks. In fact, nearly every bottled or canned beverage in the U.S., except still water, is just as acidic as stomach acid. This stems from a 1973 FDA mandate to acidify bottled products to prevent foodborne illness.
In my first book, Dropping Acid: The Reflux Diet Cookbook & Cure, I emphasized that an acidic diet doesn’t just irritate — it can damage the delicate tissues of the throat and esophagus.
The same kind of damage can occur when acid comes from the stomach. Over time reflux can lead to swelling, chronic inflammation, and even the development of benign or malignant growths.
Whether acid is introduced through food or comes up from the stomach, it activates tissue-bound pepsin and creates an environment that enables deeper harm, but not from acid alone. A stomach enzyme called pepsin is the key contributor to tissue damage.
What Role Does Pepsin Play?
Pepsin is a digestive enzyme responsible for breaking down proteins in the stomach. During reflux, stomach contents — including pepsin — can cause backflow (reflux) into the esophagus, throat, nasal, and airway, where the enzyme adheres to mucosal surfaces.
Outside the stomach, pepsin remains inactive but stable. The danger comes when acid is reintroduced from another reflux episode or from acidic foods and drinks. This reactivation allows pepsin to resume its enzymatic activity in tissues … where it doesn’t belong.
When activated in the upper airway or esophagus, pepsin causes chronic inflammation, tissue damage, and increased vulnerability to benign and malignant growths.
The key to healing from this damage lies in alkalinity. At pH levels above 8, pepsin becomes permanently inactivated — the enzyme breaks down and loses its ability to cause harm.
This is why alkaline water can play such a meaningful role in healing from reflux.
The Science: Alkaline Water Inactivates Pepsin
In 2012, my colleagues and I published a study titled Potential Benefits of pH 8.8 Alkaline Drinking Water as an Adjunct in the Treatment of Reflux Disease. The study found that alkaline water at pH 8.8 instantly denatures pepsin, rendering it permanently inactive. It also demonstrated good acid-buffering capacity — making it a potentially therapeutic option for reflux sufferers.
This research helped spark the widespread interest in alkaline water as a natural, non-pharmaceutical strategy for managing acid reflux. You should know that in healthy people, alkaline water does not change the pH inside your body — your internal pH is virtually always pH 7.4. And, on the internet, there are many false claims about alkaline water’s benefits.
In short, for the refluxer, alkaline water may neutralize harmful pepsin and reduce overall acidity in the respiratory tract — two key factors in promoting healing. I recommend it to anyone managing acid reflux, especially those with respiratory reflux and/or Barrett’s esophagus.
With that in mind, the next question is: which alkaline waters are actually effective?
Best Alkaline Water for Acid Reflux
When choosing an alkaline water, it’s important to understand that not all products are created the same.
Some waters are naturally alkaline, meaning they come out of the ground with a higher pH due to their mineral content. Others are manufactured, using processes like calcium carbonate or added minerals to artificially raise the pH, often including phosphates to help stabilize it.
I recommend:
- Choosing naturally alkaline water when possible
- Avoiding alkaline waters with phosphates in them
- Preferably using BPA-free bottled water
- Using pH paper or a pH tester to confirm that the water’s pH is 8.0 or higher
If you prefer a home solution, the Cerra Water pitcher reliably produces pH 9.4 water from tap water and is a convenient alternative to hauling bottled water. You can also find a similar alkaline pitcher on Amazon. As an alternative, you can use alkaline water drops.
I personally use Cerra Water and recommend it as a reliable, convenient option for producing alkaline water at home.
What About Alkaline Water Brands?
In 2020, I tested 22 popular bottled water brands using pH paper to assess their actual alkalinity. While many claimed to be alkaline, more than half had a pH below 8.0 — meaning they were unlikely to offer therapeutic benefit for reflux.
Note: The complete test results have been moved to an archived page, which you can view here. Please keep in mind that formulations and pH levels can change over time, so testing your preferred water at home is best. In addition, there are more “higher” pH waters available today
When Should You Drink Alkaline Water?
Alkaline water can be a helpful part of a reflux management routine, especially when timed strategically. It is particularly useful —
- During active reflux flare-ups
- When you’re experiencing throat symptoms like hoarseness, sore throat, or chronic cough
- With meals, to help buffer acid from food and aid in pepsin deactivation
- After consuming acidic foods … which are a no-no for refluxers.
Despite its benefits, alkaline water is rarely mentioned in standard reflux treatment — a gap that reflects a broader issue: reflux, especially respiratory reflux, is often misdiagnosed or misunderstood, especially in its less obvious forms.
When Reflux Is Misdiagnosed
Patients have often asked me, “Why doesn’t my doctor know about this?”
The truth is, my research, particularly around LPR (laryngopharyngeal reflux), silent reflux, and respiratory reflux, has been available for decades. My book Dropping Acid has been a best-seller for many years, and I’ve appeared on national media.
Yet the medical field remains fragmented and overly specialized. Patients with reflux symptoms are often referred from GI doctors to ENTs to allergists to pulmonologists — with no real answers. The reality is that the digestive and respiratory tracts form one united system, the Aerodigestive System, which belongs to no medical specialty.
Most doctors are not trained to recognize respiratory reflux as the root cause of chronic cough, sinus issues, hoarseness, sleep apnea, shortness of breath or even asthma. And they often overlook the role of pepsin and dietary acid in driving inflammation.
Imagine building a house where every tradesperson works in isolation — the plumber installs sinks in every room, the electrician wires chandeliers on every ceiling. That’s how our healthcare system functions today.
As someone who coined the terms silent reflux, respiratory reflux, and LPR, I can confidently say that reflux — particularly silent reflux — is one of the most overlooked root causes of respiratory and digestive distress — and it probably affects 100 million Americans.
Conclusion: Final Thoughts on Alkaline Water and Reflux
Alkaline water is not a fad — it’s a science-backed tool to deactivate pepsin and support healing in reflux sufferers. When paired with targeted lifestyle changes, it can be part of an effective long-term strategy.
Please read, research, and advocate for yourself — your healing journey may not follow the traditional medical path, but relief is absolutely within reach.
For more information about diagnosis and treatment of acid reflux, see two companion books on Amazon: Dr. Koufman’s Acid Reflux Diet and Dropping Acid: The Reflux Diet Cookbook & Cure. If you would like to receive personalized guidance and strategies for lasting relief, consider scheduling an online consultation.
