Many people experience recurring heartburn, reflux, or digestive discomfort after meals. It’s estimated that 1 in 3 people worldwide suffer from these symptoms. Often this leads to a diagnosis of reflux or Gastroesophageal Reflux Disease (GERD) and a prescription for medication (e.g. antacids, NSAIDs or PPIs like omeprazole) designed to suppress stomach acid.
While medication can help manage symptoms, there are growing concerns in the scientific literature around long term use of medications to manage the symptoms. Instead, patients and providers are becoming increasingly interested in the role of diet in disease management.
As a nutritionist specialising in gut health, I frequently work with clients who want to understand the root causes of their reflux symptoms and explore nutrition and lifestyle can help relieve the symptoms.
Symptoms: Persistent Reflux & Digestive Discomfort
Often symptoms include:
- Burning chest discomfort after meals (heartburn)
- Acid taste in the mouth during the night
- Frequent burping while eating
- Hoarse voice after eating
- A chronic dry cough
- Digestive discomfort - bloating, nausea or vomiting
The Mechanics Behind Acid Reflux
Reflux occurs when stomach contents move back up into the oesophagus, where they can irritate the lining and create the familiar burning sensation.
This process is controlled by a muscular valve called the Lower Esophageal Sphincter (LES). Tone of the LES is dependent on neural, hormonal, and paracrine factors which maintain intrinsic contraction.
A contributing factor to reflux or GERD can be when the LES doesn’t close effectively, so the stomach contents can travel upward, leading to reflux symptoms.
Looking Beyond “Too Much Acid”
One of the most common misconceptions about reflux is that it is always caused by excessive stomach acid. Interestingly, stomach acid declines as we age - yet older people still get reflux.
In reality, the situation is often more nuanced.
Acid in the stomach plays a vital role in digestion, helping to break down proteins, release nutrients from food and support the early stages of digestion. When acid production is suppressed long term, digestion can become less efficient and nutrient absorption may be affected. Over time this can lead to depletion of essential nutrients for your body.
Often your stomach acid can be impacted by your diet and drinks intake as well.
From a nutrition perspective, the aim is therefore not simply to reduce acid; but to support healthy digestive function overall through your diet.
Investigating The Root Causes
When I work with clients, I explore several factors that can influence reflux symptoms to bring together a holistic protocol that can be implemented over time. These include:
- Diet make up
- Eating patterns and meal timing
- Portion sizes and evening meals
- Potential trigger foods (e.g. spicy food)
- Stress and nervous system regulation
- Overall digestive function
- Gut microbial balance
- Weight management
In some cases, testing may also identify factors such as infection with Helicobacter pylori, which can influence stomach function and digestive symptoms.
This is why working with a nutrition professional can help uncover the individual drivers behind your symptoms.
General Dietary Advice
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Elimination of Trigger Foods: Avoiding certain foods and beverages may help reduce reflux symptoms. Acidic foods, carbonated beverages, coffee, alcohol, chocolate, mint, and spicy foods can reduce the lower oesophageal sphincter tone and motility, cause mucosal irritation, or increase gastric juice secretion.
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Fibre: Regular and adequate intake of fibre is associated with decreased heartburn symptoms. This plan is rich in vegetables, fruits, and whole grains to provide a daily fibre goal of up to 40 grams. Soluble fibre found in foods like oats, bananas, dates, and sweet potatoes is found to decrease symptoms and oesophageal pressure.
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No Added Sugars: Simple sugars raise blood sugar levels and produce an osmotic effect in the gastrointestinal tract. To prevent this effect and minimise reflux symptoms, this plan is sugar-free, focuses on whole foods, and avoids artificial sweeteners as these can negatively alter gut microbiota.
- Healthy Fats: High-fat diets, especially those which include increased amounts of saturated fat from fried or greasy foods, can worsen reflux symptoms. This program uses lean protein options and healthy unsaturated fat from seeds, avocado, and olive oil.
When To See A Nutritionist For Acid Reflux
If you experience symptoms (see below) it may be worth exploring whether diet and lifestyle factors are contributing:
- frequent heartburn
- acid reflux after meals
- bloating and burping
- persistent throat irritation
- digestive discomfort at night
Working with a nutritionist allows you to take a root-cause approach to reflux, rather than focusing solely on symptom suppression.
Work With A Gut Health Nutritionist
At The Nutritious Way, I work with clients experiencing digestive symptoms such as reflux, bloating and IBS.
Through a personalised nutrition approach, we explore the root causes of symptoms and develop strategies to support long-term digestive health.
If you’d like to explore whether nutrition support could help your symptoms, drop me an email at hello@thenutritiousway.com.
Sources:
El-Serag HB, Satia JA, Rabeneck LDietary intake and the risk of gastro-oesophageal reflux disease: a cross sectional study in volunteersGut 2005;54:11-17.
Jarosz M, Taraszewska A. Risk factors for gastroesophageal reflux disease: the role of diet. Prz Gastroenterol. 2014;9(5):297-301. doi: 10.5114/pg.2014.46166. Epub 2014 Oct 19. PMID: 25396005; PMCID: PMC4223119.
Morozov S, Isakov V, Konovalova M. Fiber-enriched diet helps to control symptoms and improves esophageal motility in patients with non-erosive gastroesophageal reflux disease. World J Gastroenterol. 2018 Jun 7;24(21):2291-2299. doi: 10.3748/wjg.v24.i21.2291. PMID: 29881238; PMCID: PMC5989243.
Newberry C, Lynch K. The role of diet in the development and management of gastroesophageal reflux disease: why we feel the burn. J Thorac Dis. 2019 Aug;11(Suppl 12):S1594-S1601. doi: 10.21037/jtd.2019.06.42. PMID: 31489226; PMCID: PMC6702398.
Suez, J., Korem, T., Zeevi, D. et al. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature 514, 181–186 (2014). https://doi.org/10.1038/nature13793