Heartburn and Chronic Acid Reflux: How to Manage with Proper Nutrition

Do you suffer from heartburn and chronic acid reflux? If so, you may want to consider taking a closer look at your diet and lifestyle choices which may be contributing towards worsening of your symptoms.

What is heartburn, acid reflux, and GERD?

Acid reflux is a term used when stomach acid splashes up from the stomach into the esophagus and may be used interchangeably with “heartburn”. Long term suffering from this condition could potentially lead to GERD (gastroesophageal reflux disease) if left untreated. According to Webmd.com, if you been experiencing symptoms of GERD and treating with over-the-counter medicines for more than 2 weeks and/or noticing a progression of your symptoms, your heartburn could be GERD related.

Many health care practitioners speculate that too much hydrochloric acid may cause GERD while others suspect the complete opposite, that insufficient hydrochloric acid production (hypochlorhydria) may be an underlying cause.

Smoking, drinking alcohol, caffeine, and carbonated beverages, eating fried, fatty, or spicy foods can all increase the tendency of the esophageal sphincter to relax. Eating too much food or too quickly (not chewing properly) and/or eating too late in the evening can also exacerbate symptoms.

The exact cause of GERD may vary from person to person and certain trigger foods may not affect everyone the same. For this reason, a nutrition protocol may vary depending on the case. Focusing on good-quality proteins, nutrient-dense foods that provide antioxidants (such as zinc) and beverages containing no caffeine may benefit a variety of sufferers. Additionally, identifying any food allergens would be the key to keeping GERD symptoms to a minimum, as well as eating smaller, more frequent meals.

What causes GERD?

GERD is caused by irritation of the esophageal mucosa by stomach acid, bile, pepsin, ingested liquids, and foods that reenter the esophagus (Life Extension). Normally, the lower esophageal sphincter (a valve that separates the esophagus and stomach) will open to allow food to pass into the stomach and close afterwards. In the case of GERD, this sphincter does not stay completely shut allowing stomach contents to back up into the esophagus creating unpleasant symptoms: heartburn, pain, belching, a sour taste in the mouth, inflammation, and tissue damage (Lipski). Untreated GERD could result in precancerous changes called Barrett’s esophagus and can eventually progress to esophageal cancer if left untreated.

The underlying cause of GERD is an incompetent lower esophageal sphincter, though there are certain lifestyle and dietary habits that can exacerbate symptoms. A hiatal hernia, hormonal imbalances, and/or stress may be contributing factors to the sphincter malfunctioning (Life Extension).

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Important Nutrients to Consider

Protein

It is necessary to obtain protein from the diet in order to grow, heal, remodel, and internally defend ourselves on a continual basis (Murray). For someone with GERD and testing low in hydrochloric acid (HCl) production, consuming good-quality protein in small quantities may be beneficial. Hydrochloric acid is produced by the stomach and is necessary to initially digest proteins and to absorb vitamin B12 and other minerals (Lipski). A normal response to consuming food would be for the stomach to begin producing HCl. Eating protein and healthy fats with a meal is one way to increase stomach acid production.

A study done by Professor Yancy and his team at Duke University examined patients with GERD.  Symptoms of GERD were eliminated completely in each case while the patients adhered to a low carbohydrate, high protein diet. The researchers were not able to come to a conclusion as to why this diet had yielded such positive results, but they speculated that the lower-carb intake influenced the activity of various hormones that open and close the esophageal sphincter. http://www.westonaprice.org/holistic-healthcare/gastro-esophageal-reflux-disease-gerd/

Another reason to consume good-quality protein is to ensure that any damage to the esophagus (from any regurgitation that has occurred) can be repaired. Important nutrients such as amino acids (lysine in particular), zinc, and vitamin C can aid in the repair process. Eating a variety of protein sources will guarantee that one is obtaining these critical amino acids which are vital to repairing the esophagus.

Some good-quality sources of protein (with gram per serving listed) are:

• Poultry (chicken, turkey) —  33.79, 32.56
• Salmon – 29.1
• Beef – 32.04
• Eggs (quantity, 3) — 16.62
• Quinoa — 5.57
• Sardines – 22.65

Zinc is a trace mineral which participates in many enzyme-mediated metabolic processes in the body, making it one of the most important needed minerals. Also because of its antioxidant properties, a diet rich in zinc containing foods should be considered for those with GERD. Those with GERD can increase their risk of developing esophageal cancer if the disease gets left untreated. GERD can cause esophageal scarring or Barrett’s syndrome, a chronic irritation from acid-bile reflux that causes the normal esophageal lining cells to be replaced by dysplastic (precancerous) cells (Life Extension).

Zinc has the ability to scavenge free-radicals, undoing some of the oxidative damage that has taken place to various cells in the body. With the case of GERD, constant acid reflux can create this oxidative damage to the cells of the esophagus. Also, zinc is required for protein synthesis and cell growth, and therefore helpful in wound healing (Murray).

Some good-quality sources of zinc (with mg. per serving) are:

• Oysters — 103
• Spinach – 1.4
• Pumpkin Seeds – 2.6
• Beef – 6.3
• Lamb – 4.6
• Chard – 0.6

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Other considerations

If you suspect you have GERD, first of all consult with your physician for professional guidance on how to move forward. Testing for HCl would be important to determine if levels are low or high which could determine a course of treatment.

In summary, from a nutritional standpoint, consider identifying any food triggers that may cause or exacerbate any GERD-related symptoms and eliminate them. Gluten, for example has been shown to contribute towards inflammation, possibly making matters worse for something with heartburn or GERD.

It’s also worth noting that eating cooked or slightly steamed food may be more easily tolerated, whereas raw and/or cold foods may make symptoms worse (depending on the individual). And eating smaller, more frequent meals rather than large meals may be helpful in your situation.

Lastly, lifestyle changes may have to be made such as quitting smoking and drinking alcohol, as well as caffeine — all of which have been shown to provoke symptoms.

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Please note:

I am a nutrition educator/consultant and not a physician.  As such, I do not diagnose or treat disease, rather I support lifestyle balance and health with my work. Please understand that any information provided on the relationship between nutrition and health is not meant to replace competent medical treatment for any health problem or condition.

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References

Life Extension Media. Disease Prevention and Treatment. 2003.

Lipski, Elizabeth. Digestive Wellness. McGraw-Hill: 2005.

Mateljan, George. www.whfoods.com

Murray, Michael. Encyclopedia of Nutritional Supplements.  Three Rivers Press:  New York, 1996.

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