This post will help you understand if gluten is behind your acid reflux or GERD symptoms, as well as the connection between celiac disease and acid reflux. Please see my disclosures.
If you’ve ever experienced a burning sensation in the lower chest area, then chances are you’ve experienced acid reflux.
Acid reflux is commonly referred to as heartburn and includes symptoms such as pain in the chest, difficulty swallowing, and regurgitation of bitter-tasting food, which is basically food mixed with your stomach acid. Some 20 percent of the US population has GERD.
Acid reflux is caused when your stomach acid bubbles up so much that it backflows into the esophagus, which connects the mouth to the stomach.
For most people, swallowing food is a one-way street directed by the sphincter at the bottom of the esophagus that opens to allow food to flow from the esophagus into the stomach. If the sphincter weakens over time, likely due to continued stomach acid exposure, the food and stomach acid you’re eating can backflow into the esophagus and even into your mouth.
Those who experience acid reflux on a regular basis are typically diagnosed with Gastroesophageal Reflux Disease or GERD.
If GERD is not addressed and mitigated, it can lead to a variety of complications including the narrowing of the esophagus pathway due to scar tissue build up, which in turn can lead to trouble swallowing. It can also lead to esophageal ulcers or sores as well an increased risk of esophageal cancer.
What Causes Acid Reflux?
To fully understand what causes acid reflux, it’s important to understand how basic digestion works.
Digestion begins in the mouth with both mechanical chewing and the chemical release of digestive enzymes through your saliva. The chewing and digestive enzymes help break down the food so it fits through the esophagus and then continues onto your stomach for further chemical processing.
Your stomach produces hydrochloric acid that further breaks down your food into small bits so it can more easily enter into and become absorbed by the small intestine, a powerhouse organ that sends nutrients from the food you eat to every organ and cell in your body.
However, when the stomach is having trouble breaking down large or hard-to-digest food particles, it can easily turn up the gas and begin to bubble up as it works harder to digest the foods you’re eating.
Increased stomach acid production isn’t a disorder; rather, it’s your body’s natural reaction to digesting certain foods, such as fried foods, fatty meats, sugar, caffeine, spicy foods, alcohol and other inflammatory foods.
Experts say GERD is not only aggravated by specific foods, but also it can become aggravated by overeating, eating too fast, not fully chewing your food, or eating before bedtime.
What is Gluten’s Role in Acid Reflux and GERD
Gluten, a sticky protein found in wheat, barley, rye and sometimes oats, undeniably plays a role in digestion, although there is some conflicting data, and some data produced by those with conflicts of interest. It can be hard to trust everything you read these days.
Those with celiac disease, a genetic autoimmune condition in which gluten causes the body’s immune system to mistakenly attack the healthy tissue surrounding the small intestine, have a known issue with gluten and avoid it like the plague.
Interestingly enough, 60 percent of untreated celiac disease patients (i.e. patients who do not know the have celiac disease and/or have not implemented a gluten-free diet) say they experience upper GI tract symptoms.
One study found that up to 19 percent of celiac adults experienced some sort of erosion in the lining of the esophagus while only 8 percent of non celiac adults experienced that same erosion.
Another study found that just over 30 percent of adult celiac patients experienced mild to severe symptoms of GERD.
Additionally, researchers found that the gluten-free diet can effectively relieve acid reflux symptoms, such as reduced severity of both heartburn and regurgitation, in all adults.
On top of that, evidence suggests a strong association between celiac disease and and eosinophilic esophagitis (EoE), a chronic inflammatory condition of the esophagus. EoE patients experience white blood cell build up in the esophagus due to food allergies or acid reflux.
While the evidence is clear that people with celiac disease and EoE must stay away from gluten for a slew of reasons, there is also growing evidence to suggest that those who suffer from other digestive disorders, autoimmune disease, or who have a known sensitivity to wheat/gluten, should strictly avoid gluten, too.
The inconvenient truth is that gluten causes inflammation in all humans according to the leading celiac disease researcher in the world. Most people don’t realize that gluten is an inflammatory food that scientists have found leads to an inflammatory response in all humans.
To support this, several studies highlight how the gluten-free diet can be an effective tool used in rapidly controlling esophageal symptoms (i.e. acid reflux, heartburn, and GERD) and preventing their recurrence. That said, there isn’t research that exists that supports the GERD-gluten link in those without celiac disease; albeit, lack of research doesn’t mean lack of connection.
Use Caution When Medicating GERD
Instead of telling you to change your diet, most doctors will prescribe a magic pill to help relieve the symptoms associated with acid reflux or GERD. It might start as over-the-counter antacids (Tums, Pepto Bismol or Alka-Seltzer) and may eventually lead to prescription proton pump inhibitors like Prilosec and Nexium.
Many people find relief with these prescription drugs because they work by neutralizing the stomach acid. But be forewarned, such medications only treat the symptoms, not the root cause, and they can make your digestion worse.
In fact, proton pump inhibitors block the production of stomach acid, which you need to help you digest the food you’re eating. Just because your stomach turns up the bubbles after you eat hard-to-digest foods doesn’t mean your body isn’t working right; instead it means your body is working overtime.
There are several consequences to blocking the production of stomach acid.
First, undigested food particles are now being sent directly into the small intestine, where they wreak havoc on your gut.
These large particles can’t be properly absorbed by the intestine, so they look for ways to escape the confines of your small intestine.
As a result, they tear through the intestinal wall, “leak” out of your gut, and enter your bloodstream, where they can cause inflammation and other diseases depending on the weak link in your genetic chain. This is known as intestinal permeability or leaky gut, and when this happen, a slew of new and unsavory symptoms and diseases emerge. (You can learn more about the mechanisms of autoimmune disease in The Autoimmune Fix by Dr. Tom O’Bryan.)
Second, food that isn’t being properly digested and absorbed can lead to nutritional deficiencies. In fact, stomach acid plays a leading role in the absorption of vitamins (particularly Vitamin B12), the digestion of proteins, and initiation of peristalsis, which causes the food to properly move through the digestive tract according to the American College of Gastroenterology.
In a WebMD article about hypochlorhydria, which is a condition marked by low levels of stomach acid, patients experience a slew of digestive and nutritional disorders including limiting the body’s ability to digest and absorb proteins (hello, gluten is a protein!). It is also known to damage the gut and lead to digestive health issues and infections.
As you age, the stomach decreases its production of hydrochloric acid; however, long-term use of antacids and PPIs also contribute to this phenomenon and explain why so many people suffer from this disorder.
In other words, if you’re using medication to decrease or suppress the production of stomach acid, you’re likely also suppressing your body from accessing essential nutrients from the food you eat.
There is also a high risk of fractures associated with long-term use of PPIs. While PPIs are meant to only be used for short-term treatment of acid reflux, the truth is many PPI users have been on the drug for years in a quest to relieve their chronic heartburn symptoms.
Unfortunately, the FDA says that the long-term use of PPIs is associated with an increased risk for fractures of the hip, wrist and spine.
In fact, if you Google “overuse of proton pump inhibitors” you’ll find pages upon pages of literature suggesting that PPIs are being overused and overprescribed.
In this article, the writers say by continually altering the concentration of acid in the stomach, PPIs alter the absorption of many medications and essential vitamins and are associated with an elevated risk of kidney disorders and disease, dementia, bone fractures, among other issues.
While ultimately you may relieve your heartburn symptoms through medication, you may be trading those symptoms for a slew of new symptoms that can be even more annoying and/or damaging.
This is why it’s wise to look to nutritional therapies – such as the gluten-free diet – to “treat” acid reflux and GERD, and only use medications, on occasion, as directed by your doctor and the FDA.
The Bottom Line
Yes, gluten consumption can lead to symptoms associated with acid reflux and GERD, and this is particularly well documented in cases of undiagnosed celiac disease.
Gluten is difficult protein for humans to digest, and leads to inflammation in all humans. If you’re looking to quell stomach acid production, consider changing your diet by eliminating not only gluten, but also highly inflammatory foods such as fried foods, fatty meats, sugar, caffeine, spicy foods, alcohol and more.
Also, be sure to eat smaller meals (no overeating), slow down and chew your food to pre-digest as much of your food as possible, and do not eat near bedtime when gravity is not your friend.