December 9, 2011

Acid Reflux Linked to Gluten Intolerance

 

A recent research study linked peptic disease (heartburn, GERD, stomach ulcer) to gluten exposure in patients with gluten sensitivity.

PD (peptic disease) is not uncommon in the presentation of CD (celiac disease). It is more likely to be found in the second decade of life. CD should be included in the differential diagnosis of patients with non-HP(H pylori) PD and we suggest routine CD serology and small bowel biopsy in patients with unexplained PD.

The authors of this study recommend that all patients with non infectious peptic disease be screened for celiac disease.

Source:

Scand J Gastroenterol. 2009;44(12):1424-8.

Gastric Reflux is A Common Symptom of Gluten Exposure

I commonly see patients with a conglomeration of gastric symptoms that are directly caused by gluten exposure. Reflux, heartburn, ulcer disease, Barrett’s esophagus, and even hernia are some of the more common diseases I have seen go into remission with the implementation of a TRUE gluten free diet.

Make Sure Your Doctor Orders the Right Tests

It is common for physicians to rule out infection (primarily H. pylori) in these patients, but gluten intolerance is very rarely investigated. The results of this study suggest that patients with gastric disease be screened for celiac disease. The problem with this recommendation is that celiac blood tests and biopsies are extremely inaccurate and have a high degree of false negatives. The other problem is that many people have non-celiac gluten sensitivity. Therefore, testing them for celiac disease is a complete waste of time and extremely misleading.

That it why I recommend genetic testing. The results cannot be skewed by diet and are not accompanied with the flaws of celiac blood and biopsy testing.

Drugs That Block Stomach Acid Have Dangerous Consequences

Remember that taking heavy doses of anti-acids and prescription reflux medications is not the answer. These drugs only serve to neutralize or reduce stomach acid. Reduction of stomach acid is a major problem as it increases the risk for:

  • Infection
  • Osteoporosis (ironically, gluten also causes bone loss)
  • Vitamin and Mineral deficiencies (calcium, B-12, folic acid, iron, zinc, and more – also common in those with gluten sensitivity issues)
  • Protein and fat malabsorption as well as indigestion.

The chronic use of these medications works against your natural physiology.  It does not treat the actual cause of disease, but merely reduces the symptoms (sometimes), thus creating a false sense of “healthy security”.  See the diagram below for nutritional deficiencies and consequences of taking acid blocking medications:

What are the Consequences of these Deficiencies?

  • Vitamin A – suppression of the immune system, skin inflammation, gastric inflammation, lung inflammation, acid reflux, and infertility
  • Protein Deficiency – immune suppression, anemia, inability to heal, blood sugar abnormalities, weight gain, cancer…
  • Calcium Deficiency – bone loss, hormone disruption, blood clotting problems, muscle cramping, high blood pressure, gum disease…
  • Iron Deficiency – anemia, increased risk for viral and bacterial infections, fatigue
  • Vitamin B12 – nerve damage, increased risk for cancer, heart disease, bone loss, anemia, depression…
  • Zinc Deficiency – reduced immune function, slow healing, easy bruising, lowered antioxidant status, acidic pH, diabetes, heart disease…
  • Folate (Folic Acid) – intestinal cancer and polyps, mood disorders (depression, anxiety), cancer, heart disease, bone loss…

?????Why would anyone want to trade the problems above just to reduce symptoms of heartburn?????  Does it not make better since to try and determine the cause of the heart burn?  We bathe our intestines with food 3 or more times a day.  Shouldn’t we start looking at the diet first?  When did common sense go out the window?  Below is a list of foods that commonly trigger acid reflux:

  • grain
  • wine and other alcoholic beverages
  • dairy
  • eggs
  • soy
  • coffee and tea

There are many more, and it should be stated that different people react differently to different foods.  The bottom line is this – if you have acid reflux, have your doctor test for food allergies as part of his investigation into the cause of your problem.  Don’t accept a drug based treatment without a solution.

Please do me a favor. If going gluten free eliminated or reduced your gastric problems, please share with us below in the Leave a Reply Box. Your story may help encourage someone else to go gluten free.
Wishing you excellent health,

Dr. Osborne – The Gluten Free Warrior

Dr. Peter Osborne
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33 Responses to “Acid Reflux Linked to Gluten Intolerance”

  • Lucinda says:

    I feel much better on a gluten-free diet. I don’t know why I have to keep testing myself on this theory though. My celiac panel came back negative and my doctor acted surprised when I told him I felt better sans gluten. So occasionally, I convince myself that this notion is “all in my head” and I eat a wheat product and end up feeling awful. Just happened recently at Thanksgiving…and took me over a week to get my digestive system calmed down again. I don’t know what’s wrong with me…but I do in fact, feel much much better without gluten.

  • It’s also interesting that people stuck in a cycle of antacid use would have decreased protein digestion (as the article mentions), leading to potentially more food reactions and sensitivities to food proteins like gluten. It can be a vicious cycle.

  • dots says:

    My reflux worsened when I went gf in 2006. I went gf at a time my brain didn’t work and well, it was all new to me. When I didn’t know what to eat, I turned to dairy (Yoplait – lots of sugar, too). My reflux worsened and I thought I was going to die from the pain (what a joke, I was practically falling out of bed it was on such an incline – didn’t touch my pain either). Dr gave me Nexium, I googled around and I thought, “How crazy is that!”, I’m trying to recover my ability to absorb nutrients and this stuff prevents it! I kept googling and found references to pH and low stomach acid. I likely had low stomach acid and wasn’t digesting my food well (duh). I ate TRULY gf, ie more veg and fruit than anything, and ate protein. Bam, problem solved. It came down to eating more alkaline foods (fruit and veg) vs acid foods (grains, dairy, legumes, meat). I eat a lot of eggs still, and plan to do an Enterolab stool test for antibody response. I don’t have reflux from them, but I wonder if I’m reacting to them and not know it, as celiacs have a harder time digesting proteins in general.

    I found this dr. on Youtube: http://bit.ly/uPtj6E and find it very interesting. I’d appreciate your opinion Dr. I don’t have the luxury of such a seasonal diet as I’m celiac, but increasing my digestive fire is probably a good thing.

    Donna Gates taught me a lot: http://bit.ly/l23caU . I also use apple cider vinegar in my salads; not sure I shouldn’t be drinking a diluted amount in a glass of water prior to meals, as I’ve read, but I figure it doesn’t hurt.

    I appreciate all you do to spread awareness Dr. Osborne. You’re my alter ego. ;)

  • Shari says:

    I suffered for years with acid reflux and when I asked my Gastro doctor to find the cause, he just said I just had acid reflux. When I asked him if it could be from a gluten sensitivity, he said no. A year later I developed a thyroid problem and read research that said there could be a connection to gluten so I gave it up completly. When I told my Gastro doctor what I was doing, he said it would not help my thyroid or my reflux. Well, my reflux is about 90% better and after 6 months my thyroid returned back to normal. Usually the only time I feel my acid reflux is when I have accidentally ingested gluten. I have learned that you can’t always listen to your doctors (which is very frustrating!)

  • CJ says:

    Sophia Smukalla, I have hiatal hernia as well, and the apple cider vinegar really helps. Not right away, but cumulatively. I used to sip it regularly, a teaspoon or so in my water especially with meals. Now I don’t have to use it very often, mainly if I eat gluten or another of my sensitive foods (corn,milk etc) although I have heard it is a good thing to do for maintenance. Also, I use enzymes and probiatics.
    Oh, and Shari, I heard that from doctors too, but my body told me otherwise!

  • Debbie T says:

    After years of taking anti-acids and staying away from dairy as I assumed I was lactose intolerant a friend (RN and nutritionist) recommended a gluten-free diet. I haven’t taken an anti-acid for years, and can enjoy some dairy. I was tested (only after I asked) for celiac and it came back negative. Seems strange that eating GF is the only way I don’t feel lousy !!

  • K. Rajeev says:

    I had been suffering from GERD and all the associated problems for more than 20 years until I was diagnosed with gluten intolerance in 2010 October. Within six months on gluten free diet, GERD had disappeared completely. When I occasionally ingest gluten, I get the delayed gastric emptying problem. So I am completely convinced about the origin of the GERD in my case.

    The doctors mindlessly tried to keep me on pantoprazole even when my digestion was getting affected by medication. GERD caused me years of sleep problems and cost me dearly.

    I am very glad that the relation between Reflux and Gluten is becoming more popular knowledge now. For many, this may be the predominant symptom.

  • Gail says:

    I had many chronic health problems for years, but the last 5 of Fibromyalgia type problems, the daily pain being the worst…and my stomach problems were so out of control that I was taking many pills. I finally found a chiropractor that would test me for everything and anything, he found Gluten allergy to be the problem and going off gluten and all grains has really helped my many symptoms. I would encourage anyone to get tested, see exactly what’s going on and stop using band-aids, the acid reflux pills eventually just make things worse!

  • Joanne says:

    Please look into the way you are combining foods. An excellent way to eat (forever) is described in Great Taste No Pain by Sherri Brescia. Check out the website. I am gluten and casein intolerant so aside from not eating these foods I also follow her advice.
    It’s a no brainer and has helped me and many people especially with GERD, IBS and all the digestive problems described.

  • Stacey K says:

    If you’re suffering from undetermined or MD medicated symptoms with no search for the cause, I cannot recommend highly enough eliminating gluten products from your life. It’s not that hard, and in my experience, it wasn’t that long before I felt tremendous relief and overall well-being!!
    I self diagnosed a couple of years ago by going on a strict elimination diet. I knew within days that I was gluten intolerant. Since September 2009 I have been completely gluten free. 17 years ago I had been diagnosed with IBS and told “that’s just how it is”… took medication that didn’t work and continued to feel terrible on many levels, physical and emotional. I had terrible acid reflux (and an ulcer when I was in my early 20′s – I am 42 now). Since going gluten free my whole world has changed. I now sleep soundly, actually waking up feeling rested. I have little to no bloating when I eat meaning no painful gas. My bowels function “normally” (I never knew what that was like my entire life), I had chronic pain in my neck and shoulders which is virtually gone since going gluten free. My periods, both physical and emotional symptoms, are so much easier. My hypoglycemia is almost non-existent. My thinking is clearer and memory improved. (I was inadvertently “glutened” last summer and I was a complete mess for a week!) Going gluten free is not as hard as you think!

  • T Lyons says:

    Dr. O – Yes, my acid reflux is GONE thanks to seeing you! I am also off blood pressure meds, carpal tunnle gone, numbness of toes gone, fatigue is gone, 32 lbs gone, skin is also greatly improving.
    THANKS – YOUR AWESOME!

  • Kristy K. says:

    Has anyone on here suffered from bile reflux? I am trying to go gf for a few weeks to see if gluten is the cause of my bile reflux. Just curious if anyone else has had this promblem resolved by going gf…

  • Deb Malloy says:

    Hi,
    I have been on the meds for over 20 years. I was recently tested and told to avoid wheat, gluten, soy and eggs. My stomach is a little better and I would like to try and go off the prevacid. I’m now taking enzymes and probiotics on a regular basis.

    Is there a method for going off the meds ? Whenever I try, I have a lot of stomach pain. I assume its the “rebound” effect.

    Thanks

  • Vince says:

    I was having the worst acid reflux I had ever experienced last October. So much that I could hardly swallow my food and was in constant discomfort and pain especially when lying down or bending over. I would have considered myself a healthy eater. I mostly avoided the SAD diet. I was slightly below average weight for my size at 158 pounds. As things got worse I developed hives and a constant rash. Allergy testing in December revealed that I was allergic to nearly every food I was eating at the time. In an effort to cut back on these foods and because eating anything was miserable I dropped to 125 pounds. At this weight I could barely function and my usual 2 mile run was nearly impossible. The doctors prescribed several acid blockers that I took for a short amount of time only to feel worse. I had a scope done and was diagnosed with mild GERD. I expected it would have been much worse due to my discomfort.

    In desperation my wife scoured the internet and found your site, so I decided to give the gluten free thing a serious take along with reducing the the foods I am allergic to. In mid December I started the new diet. The results have been very slow but pleasing. I like the new diet and now look forward to eating foods that I never guessed I would look forward to eating. My reflux is very manageable now and the hives and rash are currently gone. I avoid soy, dairy, oats, corn, and wheat completely. I do eat rice and tapioca. I consume a large amount of fruit, vegetables, and meat. I avoid eating 3 hrs before bedtime. I worry that the rice will someday give me issues but feel 100% better then I did 10 months ago, I can function normally and and grateful for some of the info I’ve learned from your site. I fine the hardest parts are the social events but people who saw me at 125lbs understand and have no comments to make but good ones. Interestingly my mouth sores are gone too, as I’ve read here that can be linked to gluten sensitivity. Thanks for the help and Acid reflux is certainly an nasty and difficult opponent to beat.

  • chris says:

    Hi,
    just thought I would let you know among many other illnesses I have suffered from for years. The minute I went off grain my acid reflux stopped. I have found that when I eat chocolate, or any gluten product back it comes. The gp wanted me on nexium all the time and I refused to take it because of all the reasons above that Dr Osborne explains. I have tried to explain to my doctor how it has helped and he thinks it is a coincidence. Oh dear. I know what has cured me and its not eating the food that causes the irritation in the first place. Yay. I just wish I knew how bad gluten is for you many years ago.

  • Raghda Bakir says:

    I had acid reflux and Barrett Oesophagus. My gastroenterologist prescribed Nexium and Prilosec, after reading about their side effect i stopped taking them and especially because i didn’t feel they were treating my problem. After being referred to Dr.Osborne who discovered that I had gluten allergy I now am cured from both after 2 years on a gluten free diet. When I reviewed the results of my endoscopy this year with my gastroenterologist, he couldn’t believe that I no longer have barrett oesophagus knowing that I wasn’t listening to him and not taking his prescribed drugs. When I told him about the gluten he didn’t want to believe it although he had no explanation as to how I got rid of my barrett oesophagus. He can think whatever he wants I am happy that I am cured. Thanks Dr. Osborne for opening my eyes.

  • Your Welcome Raghda and thank you for sharing your story with us!

  • Hi Deb,
    There is a method for titrating off of reflux medications. I would contact your doctor for the details. Rebound reflux is a common phenomenon when trying to do this.

  • Your welcome! Thanks for the update :)

  • Amanda says:

    After going gluten-free, I was able to slowly go off of medication for acid reflux. Previously, my acid reflux was so bad that I could barely swallow or eat – and I went from doctor to doctor to try to figure out what was wrong. Finally, someone recommended I try gluten-free. I feel so much better that I don’t even miss eating bread :)

  • Adam Stodart says:

    It’s really great to read through the messages above, it gives me a real insight into my acid reflux problem. I have come to understand that I am not as gluten tolorant as I used to be. I used to be able to eat 8 or 9 weet-bix and have no issues whatsoever. I don’t eat weet-bix in that quantity anymore but I do like porridge. In doing that though, if I eat 4 of those wee heat n eat porridge portions that you can get in a multi pack, within 2 days of each other I suffer acid reflux and need gavascon to sort it out.

    My affliction seems less severe than some of those I see here because I can scoff heaps of bread and have no problems.

    I wonder how much better I might feel if I dropped the gluten laden foods all together? Seems like madness, I love pies and that bread based goodness.

    Worth a crack though I suppose :)

  • Aunt Kay Kay says:

    CD runs in my family, but I test negative for it. However, I do have terrible acid reflux. I can eat all kinds of spicy, high acid foods without problem–to the horror of the “experts”–but if I ate anything with gluten in it during the day, I’d have to pop Tums all day long because of the severe pain in my back, chest and stomach. If I ate anything with gluten within 5-6 hours of going to bed I’d be up all night. Eliminating gluten brought me almost instant relief. I’m hoping it will also help with weight and joint pain over time.

  • Karen says:

    Eating gluten free stopped my GERD almost immmediately about five years ago, and it has not returned. However, I have further symptoms that are related to gluten-sensitivity and foods that contain or produce vaso-active amines in the gut.

    I was diagnosed with GERD and medicated for about a year when I began eating gluten free, which cured that problem. However, additional symptoms I had at the time included stinging of oral soft tissues and pins and needles in my extremeties, especially at night. These did not go away with the gluten free diet.

    One allergist treated me for food allergies, but a second allergist/immunologist diagnosed me with sensitivity to vaso-active amines instead. Dr. Osborne, I believe this phenomenon is likely the result of years of gluten damage to my gut microstructure resulting in loss of the ability to produce the enzyme diamine oxidase.

    This enzyme is produced by the microvilli of the intestine. It normally degrades histamine (a breakdown product of the amino acid histidine). Without diamine oxidase (also called histiminase), histamine from food crosses the intestinal wall and adds to the histamine load internally resulting in allergy-like symptoms. Although histamine is the most commonly discussed vaso-active amine, other amino acids that produce other bioactive breakdown products when partially degraded also contribute to this problem.

    In sharing with family members diagnosed with CD, they agree that vaso-active amine sensitivity causes symptoms that they could not recover from by eating gluten free alone, in spite of the fact that they have been diligent in removing grain from their diets, especially corn. Again, I think this may be due to years of gluten exposure before being diagnosed with CD and the inability of their guts to fully recover. In our cases, reducing symptoms has required limitation or avoidance of vaso-active amine-containing foods, which are well-documented. Use of histaminase in capsule form has helped us when exposed to low doses if used quickly.

    This sensitivity is well-known in the medical literature, and I have even seen an old article that suggested it could be related to “gut health”. Information about it can be found on the internet. Further digging may find that it has been linked in the past to gluten sensitivity but I haven’t seen that, yet. I believe it deserves further attention by gluten sensitive people.

    Karen, Ph.D. Microbiology/Biochemistry

  • Adrienne says:

    My 13 year old son was having chronic stomach pain, we got caught up in the conventional loop of endocopies and PPI’s. he was diagnosed with Eosinophilic Esophagitis and duodenal ulcers. He was tested for Celiac and the doctors told us it was absolutely NOT related to food. Test for CD came back as negative. We were on the standard American diet “SAD” at the time. We tried just about everything to make him feel better, he had terrible allergies and dry eye. Thanks to the likes of Dr. Osborne , we have gone gluten free. We eat pretty much paleo with no grains, dairy (except grass-fed butter or ghee), or legumes. Allergies are pretty much gone and he is doing so much better. We worked with Chris Kresser, and he ordered a mMetametrix

  • Adrienne says:

    (Cont) stool test and found H. Pylori. He was put on a herbal antibiotic and H. pylori reduced. We have tried to get him off of PPI’S but to no avail. He gets severe debilitating stomach pain. We assume this is rebund, and have got no good solutions on titrating off. I have searched the web and talked with numerous doctors and pharmacists. Dr. Osborne, if you have some suggestions on titrating off of 20 mg of Omeprazole daily for the last 5 years, it would be greatly appreciated.

  • Sherri says:

    I have had terrible reflux for nearly 30 years. I am now to the point of chocking on almost everything I eat. I used to take Prilosec, but even that didn’t completely help. Now my 15 year old daughter is showing much of the same symptoms and hasn’t been able to sleep well for nearly a year. My son’s wife has been diagnosed with Celiac, and so I have found myself going more and more gluten-free in consideration for her. So a month ago my daughter and I decided to go completely gluten free. I can’t believe how much better I and my daughter feel, and she is also sleeping very well now. Neither of us has been tested for GERD or Celiac, and now I have learned that being gluten-free for a month will probably cause a negative result on the celiac test. I can’t fathom the thought of going back on the gluten just to prove that I have gluten sensitivity, and I don’t have a lot of faith in my doctor’s ability to help me anyway. Am I crazy to “self diagnose” like this? I am still chocking, but not nearly as bad, and that’s only after a month.

  • Jeannie says:

    I wanted to lose weight and decided to eliminate wheat from my diet. I had been taking antacid (Rolaids) for heartburn several times a week but never thought to relate it to wheat.

    However, since I haven’t eaten wheat (4 weeks or so), I have not taken a single Rolaid for heartburn and burping and have not had a single digestive problem!

    I am still amazed at this simple “cure” for my digestive problems and it was only now that I have read up on Celiac disease and gluten sensitivity that may cause digestive problems. It certainly did for me!

    Jeannie

  • Nancy says:

    I read Wheat Belly in February and immediately cut out all obvious gluten (4 months). I had been having an occasional small episode of acid reflux. It stopped immediately, and my arthritis pain lessened also. A few days ago I was in a situation where I had pizza, one beer, then the next day burger with a bun and also barbeque with a bun, etc. I had acid reflux so bad that I was up almost all night. I was just wondering if by going gluten free I actually made my response to ingesting gluten even worse? I plan to stay off, but just wondered if anyone knows the answer. Thank you!

  • Allison Coates says:

    I took Omeprazole for several years and decided to go off of it. I ate just one food item 2 hours apart for a few weeks and discovered that out of all the foods listed not to eat, there was only one that seriously bothered me – wheat (although I don’t drink soda). That said, I have also discovered that certain processed “gluten free” items will bother me. I seem to be able to make things from scratch from gluten free flours and not get reflux.

  • Allison Coates says:

    Nancy, I just read your post. I have wondered the same thing. It does seem to be worse than before if I eat something with wheat (although I wonder too if it’s just because I am spoiled by not experiencing it very often now).

  • Kelly C. says:

    I’ve had a horrible cough for two years and was diagnosed with acid reflux two months ago (Sept. 2013). I was prescribed Omeprazole but took myself off it after four weeks because it made my symptoms worse and seemed to weaken my immune system.
    I switched to a gluten-free diet three weeks ago on the off chance it would help – and my cough has improved 90%; hooray! However, now I’m getting some mild heartburn almost every day, which is a totally new and annoying symptom for me! Could it be all the nuts I’m now eating? I don’t get it; I’ve eliminated pop and cut way back on coffee, caffeine, and sugar…

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  • Faye says:

    I have a challenge for you non-celiacs who get heartburn/GERD after eating wheat: Try eating a wheat product made with unbromated/unbleached flour and see if you still get heartburn/GERD. Over several years of trial and error I determined that I am only sensitive to bromated/bleached wheat. Since the European Union banned the use of bromated/bleached flour, I can eat cookies imported from Germany with no heartburn. I can also eat Zomick’s challah bread which is baked in New York with unbromated/unbleached flour. Please note that I have no problem with gluten – I can eat rye and barley – it was just wheat that gave me heartburn. I was on the Nexium journey when I figured out that my problem was wheat. I cut out wheat and I was fine. It’s been a years-long process to figure out that it was bromated/bleached wheat flour I react to. By the way, the FDA is aware that bromated flour causes cancer but its own regulations keep it from taking it off the market. It’s already off the market in many places including the European Union, Canada, the United Kingdom, Peru, China, and Nigeria. I hope there are more folks like me out there!

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