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7 Things About Acid Reflux, Gluten and IBS You Never Knew

Updated June 5th, 2024 by Dr Richard Hagmeyer DC, CFMP to reflect the most accurate information. 

Call it acid reflux, heartburn, or GERD, but having stomach acid splash back up into your esophagus is painful, frustrating and at times overwhelming. In a recent editorial published in the Journal Gastroenterology, the author remarked: “Treating gastro esophageal reflux disease with profound acid inhibition will never be ideal because acid secretion is not the primary underlying defect.” What this means is that taking acid stopping pills does not fix the underlying cause or mechanism.

This is something I have been educating patient about for well over 25 years. For decades the medical establishment has been directing it’s attention at how to reduce stomach acid secretion in people suffering from IBS, heartburn and GERD, even though it’s well-known that these conditions are not caused by excess stomach acid. In today’s article I want to share 7 Things You May Not Know About IBS, GERD, Acid reflux and Gluten. 

#1 Studies Link Gluten With Acid Reflux

Many people suffer from acid reflux and don’t realize that what they eat can greatly influence their symptoms. One major dietary culprit that often flies under the radar is gluten—a protein found in wheat, barley, and rye. While gluten intolerance and celiac disease are well-known, the connection between gluten and acid reflux is less talked about, but it can be significant for many individuals. 

Gluten is a group of proteins found primarily in wheat, barley, and rye, which gives dough its elasticity and helps it rise. While it is a staple in many diets, gluten can cause adverse effects in some people. For individuals with celiac disease, consuming gluten triggers an autoimmune response that damages the lining of the small intestine. Meanwhile, those with non-celiac gluten sensitivity also experience discomfort and various symptoms due to gluten consumption, albeit without the autoimmune response.

Acid reflux occurs when stomach acid flows back into the esophagus, causing a burning sensation known as heartburn. The lower esophageal sphincter (LES) is a ring of muscle that acts as a valve between the esophagus and the stomach—when it doesn’t close properly, it allows acid to escape, leading to acid reflux. 

Research shows acid reflux symptoms more commonly affect those with celiac disease, an autoimmune disease triggered by gluten. One study found 30 percent of celiac disease patients had GERD compared to less than 5 percent of those not diagnosed with the disease. Another study found almost 40 percent of children with celiac disease suffer from esophagitis, inflammation of the esophagus and heartburn.

#2 Gluten-Free Diet Found To Relieve Heartburn

Fortunately, researchers also found that a “true” gluten-free diet relieved symptoms of GERD rapidly and persistently. When I say “true” gluten free” I mean elimination of all grains and their cross reactive family members. You can learn more about about that here.

If you experience frequent heartburn and suspect that gluten might be a trigger, monitoring your symptoms is crucial. Consider keeping a food diary to document your meals and any subsequent heartburn episodes. Note patterns and consult your functional medicine doctor to discuss your symptoms. Be sure to read food labels carefully. Processed foods often contain hidden gluten. Make it a habit to read food labels and look for gluten-free certifications to avoid accidental exposure.

Some people have found they also need to give up grains, processed foods, or other foods to which they are intolerant (such as dairy) to completely relieve acid reflux. You can learn more about the proper testing for Gluten Sensitivity right here

#3 GERD Could be Autoimmune

Gastroesophageal reflux disease (GERD) is a chronic digestive disorder where stomach acid or bile irritates the food pipe lining. While GERD is most commonly associated with lifestyle factors, it can also be linked to certain autoimmune conditions. Autoimmune diseases are conditions in which the immune system attacks the body’s own tissues.

Scleroderma is a connective tissue disease characterized by changes in the texture and appearance of the skin due to increased collagen production. It often affects the gastrointestinal tract, including the esophagus. In cases where scleroderma affects the esophagus, it can lead to decreased motility and weakened sphincters, exacerbating GERD symptoms.

This autoimmune disorder primarily affects the glands that produce saliva and tears but can also impact other organs and tissues. The resulting dryness in the mouth and esophagus can impair the natural mechanisms that protect against GERD. Additionally, the motility of the esophagus may be affected.

Celiac disease is an autoimmune disorder where ingestion of gluten leads to damage in the small intestine. Inflammation caused by this condition can affect digestive function and exacerbate GERD symptoms.

What does gluten have to do with this? Gluten is very pro-inflammatory in many people and has been linked with 55 autoimmune diseases. It’s possible acid reflux could be yet another inflammatory disorder triggered by gluten.

#4 Antacids Increase Health Risks

Most people relieve acid reflux by taking an antacid to neutralize stomach acid, with sales of the drug topping $10 billion annually. Not only does this fail to stop stomach acid from washing back up into the esophagus (one study showed protein-pump inhibitors induce acid reflux). Antacids also impair nutrient absorption leading to Vitamin and mineral deficiencies.

Vitamin and Mineral Deficiencies Caused By Antacids

  1. Zinc Deficiency – leads to reduced immune function, easy bruising, lowered antioxidant status, diabetes, heart diseases, and impaired or slow healing.
  2. Vitamin B12 – nerve damage, Fatigue, Anxiety, Depression, Inflammation, Elevated Homocysteine levels, increased risk for cancer, heart disease.
  3. Vitamin A – suppression of the immune system, loss of mucosal tolerance in the gut, Skin allergies, skin inflammation, gastric inflammation, lung inflammation, acid reflux, and infertility
  4. Protein Deficiency – fatigue, Hair loss, immune suppression, weight gain, poor muscle tone, blood sugar abnormalities,
  5. Iron Deficiency – Iron anemia, Fatigue, Brittle hair and nails, Poor wound healing, bruising, breathing difficulties, increased risk for viral and bacterial infections, fatigue
  6. Folate (Folic Acid) – Depression, Anxiety, fatigue, Neural-tube defects, infertility, intestinal cancer and polyps, Brain fog, cancer, heart disease, bone loss.
  7. Calcium Deficiency – bone loss, hormone disruption, blood clotting problems, muscle cramping, high blood pressure, gum disease…

#5 Antacids Increase Your Risk of Food Poisoning

Antacids, particularly those that neutralize or reduce stomach acid, can indirectly increase the risk of food poisoning. Stomach acid is not only vital to the absorption of minerals and vitamins, but also protects the stomach from bad bacteria, yeast, and infection-causing bacteria. Chronic use of antacids has been linked to increased risk for bacterial infections, candida (yeast) overgrowth, and food poisoning. Here are a few ways antacids and proton pump inhibitors can increase the risk of food poisoning. Stomach acid serves as a natural barrier to ingested pathogens by creating a highly acidic environment that kills bacteria, viruses, and other microbes. When antacids reduce stomach acidity, this protective effect is diminished. With reduced acid levels, harmful microorganisms in contaminated food are more likely to survive and pass into the intestines, where they can cause infections and related symptoms.

Some types of antacid medications, particularly proton pump inhibitors (PPIs) and H2 receptor antagonists, can slow down the process of gastric emptying. This means that food stays in the stomach for a longer period, potentially creating a conducive environment for bacterial overgrowth and survival.

Stomach acid plays a role in signaling the immune system to mount a defense against pathogens. Reduced acidity can impair this signaling process, weakening the overall immune response to ingested microbes.

Salmonella, E. coli, and Shigella are pathogens that can more easily survive the reduced acidity and proceed to the intestines, where they can cause infections. Other common bacteria seen as the result of prolonged suppression of stomach acid with antacids and proton pump inhibitors include Clostridioides difficile and Helicobacter pylori.(*)

People taking acid-suppressing medications have a higher risk of C. difficile infections, known for causing severe diarrhea and colitis, especially in hospital settings. Lower stomach acidity can favor the colonization of H. pylori, a bacterium associated with gastritis, stomach ulcers, and increased risk of gastric cancer. (*),(*),(*)

#6 Antacids Increase Fracture and Osteoporosis Risk

Evidence suggests that long-term use of certain antacids, specifically proton pump inhibitors (PPIs) and  H2 receptor antagonists, are associated with an increased risk of osteoporosis and related fractures. 

1. Calcium Absorption-Proton Pump Inhibitors (PPIs)**: PPIs reduce stomach acid, which can impair the absorption of calcium. Adequate levels of stomach acid are necessary to dissolve calcium salts and make them absorbable in the intestines. Reduced calcium absorption can lead to decreased bone density over time. H2 Receptor Antagonists also reduce stomach acid, although to a lesser extent than PPIs, affecting calcium absorption similarly.

2. Magnesium Levels-Low magnesium levels, which can occur with long-term use of PPIs, are another concern. Magnesium is essential for proper calcium metabolism and bone health, and its deficiency can indirectly affect bone density.

3. **Parathyroid Hormone (PTH) Regulation:Prolonged reduction in stomach acid can stimulate an increase in PTH, which helps regulate calcium levels in the blood by increasing calcium release from bones, potentially leading to bone loss over time.

Vitamin B12 Absorption-Long-term use of antacids can lead to vitamin B12 deficiency by reducing stomach acid, which is necessary for B12 absorption. Vitamin B12 is crucial for bone health and deficiency can contribute to increased fracture risk.

Clinical Evidence-Several studies have pointed out the relationship between long-term PPI use and an increased risk of hip, spine, and wrist fractures.  

Heres what you should remember. Chronic antacid use also impairs the absorption of minerals, including calcium, which can increase the risk of osteoporosis and fractures.

#7 Proper Testing for Gluten intolerance, Leaky Gut, and Nutritional Deficiencies is Vital.

With one in five people now believed to be suffering from gluten sensitivity, it’s important to know whether you are too and whether undiagnosed gluten intolerance is contributing to your heartburn. Don’t think for a minute that taking your antacids is fixing the problem. Left uncorrected you will have more serious health problems to contend with.

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 noninfectious peptic disease be screened for celiac disease.

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

Have Questions about acid reflux or Heartburn? Wondering how this might be affecting your Health? Looking for a natural approach to treating Heartburn, GERD, and acid reflux? Every week I set aside a handful of free 15-minute phone consults for Prospective patients. After filling out a short health questionnaire with your symptoms, concerns, and goals you can pick a time to discuss these concerns with during a telephone consult.

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