Are You Amongst the Many Suffering from GERD?

Do you have acid reflux, heartburn, or GERD (gastroesophageal reflux disease)? If so, you are in very good company.

Up to 20% of U.S. adults suffer from GERD and children also join the ranks with up to 8% of adolescent children suffering. If you suffer from celiac disease, those numbers increase – 30% of celiac suffer from GERD and almost 40% of children with celiac disease suffer from esophagitis, an inflammation of the esophagus with heartburn.

Despite these conditions being more frequent in celiac sufferers, the symptoms haven’t been highly associated with gluten as a root cause. And not a great deal of research has occurred in the area.

Gluten IS a Cause

Here at the clinical nutrition department at Root Cause Medical Clinic, we see a high correlation between the two. Patients with these symptoms frequently improve dramatically and often to full resolution when they introduce a gluten-free diet, whether they have celiac disease or gluten sensitivity.

I recently found a few studies, one a very nice one that not only did find a strong correlation with these symptoms and gluten, but they discovered an interesting association that I think you’ll find quite fascinating.

Presented in the Journal of Gastroenterology and Hepatology, the paper was entitled “Effect of Gluten-free Diet on Preventing Recurrence of Gastroesophageal Reflux Disease-related Symptoms in Adult Celiac Patients With Nonerosive Reflux Disease”. As per most research papers, the title is a mouthful. [Note: gastro means stomach]. Basically, the authors set out to discover if gluten had a role in causing GERD, acid reflux, and heartburn.

The study involved 105 patients with GERD and celiac disease plus a control group of 30 non-celiac patients with GERD. Both groups were treated for 8 weeks with a proton pump inhibitor – a classic drug to treat the symptoms of GERD. After the withdrawal of the drug at the 8-week mark, patients were assessed as to their symptoms at 6, 12, 18, and 24 months following the elimination of the drug.

It is very important to know that for those with celiac disease, only those patients who were strictly gluten-free were allowed to remain in the study.

Symptoms Improve Permanently on a Gluten-Free Diet

The results were as follows:

At the end of the 8-week mark, GERD symptoms were resolved in 86% of the celiac patients and 67% of the control group.

At the 6 month mark, recurrence of symptoms occurred in 20% of the celiac patients (and they were then excluded from future follow-up), but in the longer follow-up interval of 12, 18, and 24 months, there was no recurrence of symptoms found in any of the celiac patients. The control group, however, revealed a 30% recurrence at the 6-month mark, escalating to 60% at the 12-month mark, showing a further increase to 75% at 18 months and ending with a total of 85% at the 24-month mark.

Fascinating –80% of the celiac group who maintained a gluten-free diet remained symptom-free after 2 years, while the non-celiac group who did not follow a gluten-free diet continued to worsen the longer they were off the drug with only 15% being symptom-free. What did the researchers think about this?

Their conclusion was:

• a gluten-free diet could be helpful in reducing the symptoms of GERD,

• the elimination of gluten from the diet could act as a protection against GERD since gluten seems to precipitate symptoms in some people.

Based on the small rate of relapse – 20% vs 75% of the celiac patients vs the control group, it makes good sense to conclude that following a gluten-free diet can help protect against GERD.

The researchers also cited another population-based study by Dr. Nocon and the team who noted that consumption of sweets or white bread at least once per day acted as a risk factor for reflux symptoms. Sweets, in the typical U.S. dessert, equates to gluten, and of course, so does white bread.

GERD, Acid Reflux or Heartburn? Get Tested for Gluten!

In summary, these research findings support what we see here at the clinic: patients with acid reflux, GERD, or heartburn should be evaluated for gluten sensitivity.

As a personal note, I would like to add that these studies only looked at those suffering from celiac disease and failed to test people with GERD symptoms for gluten sensitivity. In my experience, I think they would find an additional correlation with that population; we do here at the clinic. Having these symptoms is not just annoying, frustrating and a cause of poor sleep, but they also signal poor digestive health, something that must be addressed when present in order to maintain good health.

I hope this was informative. If you or someone you know suffers from such symptoms, please alert them to this information.