Have You Been Diagnosed With Gastroesophageal Reflux Disease (GERD), Heartburn, Or Indigestion? You Could Be Having Immune Mediated Reactions To Foods!

January 17, 2011 · Filed Under Indigestion 

Gastroesophageal reflux disease (GERD), heartburn, and indigestion can be a symptom of gluten intolerance and other food allergies. Many doctors are not aware of this connection, unless they are specialists in the field of gluten intolerance and allergies. The lack of awareness around this issue is the reason why most patients are put on medication for their symptoms and they are never informed that their symptoms could be related to immune reactions to food.

Why are many doctors (and nurses) unaware of this association? The answer is a sad reality, many doctors are unaware of the wide variety of symptoms associated with gluten intolerance and food allergies. In fact, many people with a gluten intolerance, including celiac disease (CD), dermatitis herpetiformis (DH) and non-celiac gluten intolerance remain undiagnosed. For example, with CD, over 90% of individuals remain undiagnosed. Likely, it is even higher in non-celiac gluten intolerance since it is more under-recognized by doctors than celiac disease. Unfortunately, many doctors are not very aware of the many elusive symptoms associated with gluten intolerance and as a result, only the symptoms (ie. possibly GERD, heartburn, indigestion) are diagnosed, not the underlying problem. Typically, it isn’t on the doctor’s radar so it often isn’t investigated as a cause.

Within the medical profession, gastric reflux is generally called gastroesophageal reflux disease (GERD), but many people just call it heartburn or indigestion. Gastric reflux (reflux of stomach contents) usually presents with burning pain that can radiate from the upper abdomen to the neck (sometimes it can be sharp and feel like pressure), nausea can be a problem and sometimes regurgitation of foods and vomiting can occur. If a gluten intolerance and allergies are the underlying cause and left undiagnosed, many complications can occur, such as inflammation in the esophagus (esophagitis), ulceration of the esophagus, blood loss, adenoiditis, build up of fluid in the sinus and middle ears of children (from irritated adenoids), aspiration pneumonia and pulmonary fibrosis (from aspiration of gastric contents). As well, sore throat, hoarseness, coughing, asthma like symptoms (irritated esophageal nerves can affect lung nerves), scarring and strictures of the esophagus, and cancer in the inflamed areas can occur (ie. Barrett’s esophagus). As you can see, for some, chronic heartburn can lead to many problems, some of which can be life threatening. 

I had indigestion and heartburn for many years prior to my diagnosis. For me, the symptoms would flare up for a month or two and then disappear for a few months or more. During the flare ups, I would live fully stocked with an antacid. Once I was diagnosed with celiac disease and eating gluten-free, the gastric reflux went away and has never returned. I experienced permanent relief with a natural treatment which was wonderful since gastric reflux is usually treated with medication. A medication-free approach was very appealing!

I have met many patients who had heartburn while they were undiagnosed with a gluten intolerance and/or food allergies. Studies have also identified an association as well. Others had the same symptoms that were due to a food allergy (IgA, IgG, or IgE mediated) and experienced symptom relief once the offending foods were removed from their diet. Some patients may also have an infection (ie. H. Pylori) that requires treatment as well. With this in mind, I believe it is worthwhile to rule out a gluten intolerance by testing for celiac disease, dermatitis herpetiformis and non-celiac gluten intolerance. Other types of tests can investigate possible infections. Further testing for food allergies (IgE, IgA, and IgG mediated) can help to identify other food reactions. An allergist often only tests for IgE mediated allergies and offers an elimination diet. Naturopathic doctors will generally do blood tests for the other types of allergic reactions. Your physician, allergist or naturopathic doctor may recommend a food log along with an elimination diet if needed.

Some people on a paleolithic diet also experience relief from gastric reflux once they are eating a lectin-free. These people may have an underlying lectin intolerance, gluten intolerance or be allergic to a food that is naturally removed from the diet with eating paleolithic. Others, like myself, eat a paleolithic diet, but have additional allergies as well. My entire story with gluten-free and paleolithic living can be found in my book, “Gluten Toxicity”.

For a future study, I would like to see a large group of patients with gastric reflux, heartburn and indigestion tested for infections, gluten intolerance (celiac disease, dermatitis herpetiformis, and non-celiac gluten intolerance), a lectin intolerance, food allergies (IgA, IgG, and IgE antibody mediated) and investigated for other diseases. The results may help to shed some light onto the true underlying cause of gastric reflux.

References

1. Karpova EP, Tulupov DA, V. ina EE, Zakharova IN, Soldatski? IuL. Chronic adenoiditis prevention in children with acid-depended stomach pathology. Vestn Otorinolaringol. 2009;(5):55-8.

2. Bernztein R, Grenoville M. Chronic cough in pediatrics. Medicina (B Aires). 1995;55(4):324-8.

3. Al-Saab F, Manoukian JJ, Al-Sabah B, Almot S, Nguyen LH, Tewfik TL, Daniel SJ, Schloss MD, Hamid QA. Linking laryngopharyngeal reflux to otitis media with effusion: pepsinogen study of adenoid tissue and middle ear fluid. J Otolaryngol Head Neck Surg. 2008 Aug;37(4):565-71.

4. Williams JL. Gastroesophageal reflux disease: clinical manifestations. Gastroenterol Nurs. 2003 Sep-Oct;26(5):195-200.

5. Nachman F, Vázquez H, González A, Andrenacci P, Compagni L, Reyes H, Sugai E, Moreno ML, Smecuol E, Hwang HJ, Sánchez IP, Mauriño E, Bai JC. Gastroesophageal Reflux Symptoms in Patients With Celiac Disease and the Effects of a Gluten-Free Diet. Clin Gastroenterol Hepatol. 2010 Jun 30.

6. Usai P, Manca R, Cuomo R, Lai MA, Russo L, Boi MF. Effect of gluten-free diet on preventing recurrence of gastroesophageal reflux disease-related symptoms in adult celiac patients with nonerosive reflux disease. J Gastroenterol Hepatol. 2008 Sep;23(9):1368-72.

7. Odman M, Bart PA. Rev Med Suisse. Eosinophilic esophagitis. 2010 Oct 6;6(265):1854-6, 1858.

Comments

9 Responses to “Have You Been Diagnosed With Gastroesophageal Reflux Disease (GERD), Heartburn, Or Indigestion? You Could Be Having Immune Mediated Reactions To Foods!”

  1. Gastroesophageal reflux disease (GERD), heartburn, and indigestion can be a symptom of gluten intolerance and other food allergies « CeliacFacts on January 21st, 2011 4:50 pm

    […] Read More… […]

  2. katie on January 21st, 2011 5:54 pm

    Interesting. I was diagnosed with Celiac in May and never had reflux problems before that. I have been gluten free since, but I just had a nasty occurrence of reflux so severe I went to the ER for chest tightness and shortness of breath. My doctor wasn’t sure what caused it, but I’m wondering if I accidentally ingested gluten and this was the result.

  3. Shelly on January 21st, 2011 11:11 pm

    Katie,

    Sorry to hear about your experience.

    It is possible, your experience may have been related to gluten. Accidental ingestion of gluten can happen very easily and often reactions to problematic foods can be more pronounced once you are off the food. Protective mechanisms (within the immune system) are active when your body is reacting to foods. This can dampen the immune response. Once the offending food is removed, the protective mechanisms are no longer active and the immune response can be stronger.

    As well, additional food allergies can cause heartburn and infections can too (ie. H. Pylori infection of the stomach). Just something to think about and discuss with your doctor:)

    Shelly

  4. Meghan on January 22nd, 2011 12:38 pm

    I am new to the Gluten Free scene, but NOT new to it’s symptoms! (which I must say are reduced by at least 80% on GF diet). I have been medicated for GERD for two years – the irritated-esophagus-3-AM-vomiting type. I have a whole host of other symp. too,includes Fibromyalgia, but they don’t pertain to the post. I have a maternal grandfather who died of esophageal cancer after two years of diagnosed Chrons disease, including the colostomy bag. My brother is battling Chron’s disease and my father has had a third of his stomach removed due to ulcers. I sit here and wonder why on earth my doctor wouldn’t test me for Celiac disease. In any case, I mainly write this to sound off that my MAIN symptom seems to be intense heart burn the day after a gluten incident, and intense joint/muscle pain on the second day. I hadn’t heard the GERD issue talked about much until I stumbled into your website. Thank you so much for your work in this field.

  5. Shelly on January 22nd, 2011 2:23 pm

    Meghan,

    Thank you for your comments and your story. Your story helps to illustrate how GERD can be associated with gluten intolerance and helps to show others that this association is possible:)

    You may be interested in this post about Crohn’s disease as well http://celiacnurse.com/could-immune-reactions-to-foods-cause-crohns-disease/

  6. jennifer on August 12th, 2012 5:45 pm

    Hi, I’m currently in a clinical trial with dr. Premsyl Bercik in hamilton ontario – he is investigating the effect of removing gluten from the diet of gluten-intolerant patients, on stomach motility (reflux indirectly).

  7. Carol Amber on January 16th, 2013 4:10 pm

    After years of suffering from heartburn and acid reflux, a recent set of circumstances, waking up choking, a burning sour throat and agonising acid coming up the oespophagus made me turn to the internet.

    It finally dawned on me that it was either wheat or gluten, I know not which that was the culprit and though my doc tested me for celiac a few years ago, it was negative, I have resolved to go gluten free. when I have a slip up, like today I know about it. Very uncomfortable. I am however relieved to know the problem and be able to at least help myself.

  8. Lizzie King on September 9th, 2013 6:44 am

    I self diagnosed a wheat allergy 5 years ago and cut it from my diet but still ate other gluten. Over the last year I have been getting rather ill and having been to the doctors they suspect I am a celiac and are going to take a biopsy which apparently should confirm it (the blood test indicated positive). Due to the lack of gluten in my diet they have requested I eat wheat and thus wheat gluten for 6 weeks prior to the test to be able to get an accurate result. To cut a long story short since eating wheat again I am having the most awful heartburn… not something I have ever experienced in my life! I am looking forward to being able to cut gluten out of my diet again following the biopsy as I am 100% convinced the pain will disappear as you have experience!

  9. Stacy Willis on March 21st, 2016 8:47 am

    I appreciate that you talk about testing for food allergies. After researching celiac disease, I requested that I be tested. The physicians assistant did not see a need to test me even though it ran in my family. After being diagnosed with celiac disease and maintaing a gluten-free diet, I did not improve. I did further research and asked 2 gastroenterologists about it. One tested me for H. pylori. The test was positive. He was surprised. However, after treatment I felt worse. After seeing my gastroenterologist several more times, a nurse at an urgent care clinic in Eugene, OR recommended I get tested for food allergies. So I went back to my doctor and requested this. I was positive for egg white allergy. He was surprised at that too. Not long after my nephew began getting sick. He also came up positive for egg white allergy. I recommend that everyone with celiac disease get tested for food allergies. It could save their lives.

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