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Aug 1

Gluten and GERD: What’s the Relationship? – Healthline

Long Term Weight Loss Comments Off on Gluten and GERD: What’s the Relationship? – Healthline

Gastroesophageal reflux disease (GERD) is a chronic disease in which stomach contents re-enter the esophagus and damage the lining of the esophagus.

This condition is common, affecting around 20% of people in the United States.

GERD can be a painful and uncomfortable condition, especially when left untreated. Fortunately, there are many medical and lifestyle interventions that can help you better manage your GERD symptoms.

In particular, the foods we eat have been linked to improving or worsening GERD symptoms. One ingredient that has been thought to worsen GERD symptoms is gluten, which is a protein found in wheat products.

This article discusses the relationship between GERD and gluten, including whether gluten actually worsens GERD symptoms, and provides helpful tips for managing your GERD.

The relationship between gluten and GERD isnt well understood, but some research shows a link between celiac disease an immune disorder affecting up to 1% of people that requires the complete avoidance of gluten and GERD.

However, celiac disease can be difficult to diagnose, so more people may have it than we think.

A recent clinical trial also suggests that there may also be a link between GERD and non-celiac gluten sensitivity (NCGS), which might affect up to 13% of people.

In an older 2008 study, researchers investigated whether a gluten-free diet (GFD) would improve GERD symptoms in people with celiac disease compared with a control group of people without celiac disease.

After 6 months on a GFD, only 20% of celiac participants and 30% in the control group had a recurrence of GERD symptoms. Note that the participants also took proton-pump inhibitor (PPI) medications, which are standard treatments for GERD.

At 1 year, no additional people in the celiac group experienced GERD symptoms, but a total of 60% of participants in the control group did.

At 2 years, the celiac group continued to have no additional recurring GERD symptoms, but 85% of the control group had GERD symptoms.

These findings suggest that if you have celiac disease and GERD, following a gluten-free diet while taking PPI medications may help to manage GERD symptoms. Going gluten-free is less likely to help with GERD if you dont have celiac.

Another older study supports that idea.

The study found a strong correlation between untreated celiac disease and GERD symptoms: 30% of people with celiac reported moderate to severe GERD symptoms, compared with only 4.7% of people without celiac.

After adopting a GFD for three months or longer, participants with celiac disease saw significant improvements in their GERD symptoms.

Some older studies have also found correlations between celiac disease, NCGS, and GERD. That said, other studies found no correlations between celiac disease and GERD, so more research is needed.

Some people with GERD who have either NCGS or no formal diagnoses may still benefit from a gluten-free diet.

Even though theres a lack of research on the link between NCGS and GERD, some people with NCGS experience symptoms like reflux after eating gluten.

A recent study analyzed the effects of a dietitian-monitored GFD in people who had symptoms consistent with celiac disease, including reflux and GERD, but for whom blood tests didnt show the markers necessary for a formal diagnosis.

Many of the participants showed improvement after following the GFD, leading researchers to suggest that they may have had whats called seronegative celiac disease meaning, celiac disease that isnt detected by a blood test.

Therefore, some people with GERD symptoms who dont have a diagnosis of celiac disease or non-celiac gluten sensitivity may still benefit from limiting or avoiding gluten.

If youre considering a GFD to help with your GERD symptoms, its a good idea to work with a registered dietitian to make sure youre not missing out on important nutrients.

The mechanism behind how celiac disease affects GERD symptoms isnt well-established.

Its thought that certain symptoms of celiac disease may contribute to the development of GERD, such as:

These symptoms may increase stomach acid entering the esophagus, causing GERD symptoms. This likely means that its not gluten itself causing GERD for people with celiac disease, but the symptoms of their celiac.

Beyond this, no studies have found that following a GFD provides any symptom relief for people with GERD but not celiac disease or NCGS. Thus, a GFD is unnecessary for most people with GERD.

In fact, while a GFD can be healthy and is medically necessary for some people, a poorly-planned GFD may increase the risk of:

Plus, a GFD can be expensive to follow long term, and since its somewhat restrictive, it can affect your social life and relationship with food.

There are many useful nutrition and lifestyle tips that may help reduce your GERD symptoms, such as:

While lifestyle modifications can help reduce symptoms of GERD, its important to work closely with a healthcare provider who can provide personalized recommendations.

If symptoms worsen, they may recommend more invasive interventions, such as surgery.

Here are some questions people often ask about gluten and GERD.

To date, there is no evidence that following a gluten-free diet will help with acid reflux.

However, if you have celiac disease, following a gluten-free diet is necessary to manage that condition, and it may also reduce your acid reflux or GERD symptoms.

There is currently no evidence that gluten negatively affects the esophagus in people who dont have celiac disease or non-celiac gluten sensitivity.

However, if you have celiac disease or NCGS, gluten may interfere with the small intestine and lead to digestive issues.

One small study also found changes in the mucosal lining of the esophagus in people with celiac disease, and a recent clinical trial found high rates of esophageal lining damage in people with NCGS.

Some research suggests that certain foods may irritate and weaken the lower esophageal sphincter, which normally prevents stomach acid from re-entering the stomach.

Common triggers include high fat foods, acidic foods (like tomatoes, oranges, and vinegars), chocolate, carbonated beverages, alcohol, caffeine, herbs and spices (like mint, chili pepper, black pepper, cayenne, and nutmeg), and spicy foods.

That said, not everyone will need to limit or reduce these foods. If you suspect a food is making your GERD worse, try eliminating it for 24 weeks. If symptoms dont improve, then you can reintroduce it back into your diet.

The relationship between GERD and gluten is not well-established.

There is some research that links celiac disease and non-celiac gluten sensitivity with increased risks of GERD and worsened symptoms, but this is likely a side effect of the condition rather than gluten being the main culprit.

Therefore, unless you have celiac disease or NCGS, there is no need to eliminate gluten from your diet to manage your GERD symptoms.

Instead, other lifestyle modifications such as quitting smoking, limiting alcohol, maintaining a moderate weight, and changing some eating practices may help.

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Gluten and GERD: What's the Relationship? - Healthline

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