Keto Diet: Heartburn Friend Or Foe?

The keto diet is a popular eating plan that involves reducing carbohydrate intake and increasing protein and fat consumption. While it has gained traction as a quick weight-loss solution, it may not be suitable for everyone, especially those with acid reflux or heartburn issues. The high-fat content of the keto diet can trigger acid reflux symptoms, as fatty foods relax the lower esophageal sphincter, allowing stomach acid to back up into the oesophagus. Additionally, fat takes longer to leave the stomach, which can further contribute to acid reflux. However, some people have reported improvements in their acid reflux symptoms after adopting the keto diet. This discrepancy highlights the need for further research into the complex relationship between diet and acid reflux.

Fatty foods and acid reflux

Fatty foods can cause acid reflux, or heartburn, for several reasons. Firstly, they can cause the lower esophageal sphincter (LES) to relax, allowing more stomach acid to back up into the oesophagus. The LES is a muscular tube that usually stops food from coming back up after it has passed into the stomach. Secondly, fat takes longer to leave the stomach, which can also increase acid reflux symptoms.

Fatty foods that can cause acid reflux include fatty meats, such as bacon and sausage, and heavily fried foods like French fries and pizza. Obese people are more likely to suffer from acid reflux, and a keto diet may be beneficial for them in reducing heartburn. However, the keto diet is high in fat, which may trigger acid reflux.

If you are suffering from acid reflux, it is recommended that you avoid large meals, as they digest slowly, putting pressure on the LES. Instead, eat smaller meals, and don't eat too late or right before bedtime. It is also recommended that you avoid certain trigger foods, such as spicy foods, citrus fruits, garlic, onions, peppermint, chocolate, carbonated beverages, and alcohol.

To alleviate acid reflux, you can try eating more alkaline foods, such as bananas, melons, and cauliflower, as well as fibrous foods like whole grains, root vegetables, and green vegetables. Non-fat milk and low-fat yogurt can also help, as they act as a temporary buffer between the stomach lining and stomach acid, and provide probiotics, which aid digestion.

Acid reflux symptoms

Acid reflux is when acid from your stomach flows up into your oesophagus and throat. This causes a burning pain or discomfort in your chest, which may move from your stomach to your belly, chest or throat. This is known as heartburn.

Other symptoms of acid reflux include:

• Regurgitation, or a sour or bitter taste in the mouth
• A dry cough or repeated throat clearing
• A sore throat, hoarseness or laryngitis
• Wearing away of tooth enamel
• Difficulty swallowing or a feeling of a lump in the throat
• Wheezing
• Chest pain
• Bloody or black stools or bloody vomiting
• Dysphagia, or the sensation of food being stuck in your throat
• Hiccups that don't let up
• Weight loss for no known reason
• Bad breath and/or a bad taste in the mouth

If you experience acid reflux more than twice a week, you may have acid reflux disease, or gastroesophageal reflux disease (GERD).

Obesity and acid reflux

Obesity is a risk factor for the development of gastroesophageal reflux disease (GERD). The association between obesity and GERD has been observed not only in the US but also in Europe and Eastern Asia. Central obesity, characterised by a larger abdominal circumference, is more closely associated with GERD than other measures of overall obesity, such as body mass index (BMI).

Several mechanisms have been proposed to explain the link between obesity and GERD. Firstly, obesity may increase intra-abdominal pressure, which can promote acid reflux. This increased pressure can also lead to the development of a hiatal hernia, a risk factor for GERD. Obesity can also impair gastric emptying, causing a delay in the stomach's ability to clear acid, thereby increasing the risk of reflux.

Additionally, obesity can decrease lower oesophageal sphincter (LES) pressure and increase transient LES relaxation, allowing acid to flow back into the oesophagus more easily. Obesity-related hormonal changes, such as increased estrogen exposure, may also contribute to the development of GERD.

The most effective lifestyle interventions to reduce GERD symptoms include weight loss and, if symptoms occur during sleep, elevation of the head of the bed. A study published in the journal *Obesity* in 2012 found that individuals who enrolled in a structured weight-loss program experienced an improvement in their GERD symptoms. The improvement was dependent on the amount of weight lost, with greater weight loss leading to more significant symptom relief.

Acid reflux treatment

Acid reflux, or heartburn, is the forcing of stomach acids back up into the oesophagus, creating a burning pain in the lower chest. It can be very uncomfortable, especially at night.

The keto diet is characterised by a reduction in carbohydrates and a relative increase in protein and fat consumption. While it has been demonstrated to help with certain disorders, such as epilepsy, it may not be for everyone.

Causes of Acid Reflux

There are many causes of acid reflux, including:

• Bacterial overgrowth in the gut
• Obesity, which can cause increased pressure in the abdomen
• Underlying issues such as stomach ulcers, hernias, and diseases of the oesophagus
• Aspirin and ibuprofen
• Carbonated beverages, especially sugary ones
• Acidic foods and juices such as oranges, pineapple, and tomatoes
• Fatty foods

Treatment Options

If you are on the keto diet and are experiencing acid reflux, there are several treatment options you can try:

• Avoiding certain foods: Stay away from acidic foods like tomatoes, as well as carbonated beverages and acidic juices.
• Probiotics: Try adding probiotics to your diet to balance out bacterial issues in the gut.
• Antacids: Over-the-counter antacids like Tums or Mylanta can help alleviate acid reflux symptoms.
• Fermented foods: Include fermented foods like kombucha, kefir, and sauerkraut in your diet.
• Supplements: Magnesium and zinc supplements may help reduce acid reflux.
• Cutting out dairy: Dairy may be a trigger for acid reflux, so try eliminating it from your diet for a few days to see if there is any improvement.
• Chia seed pudding: Try making chia seed pudding with coconut milk, which is high in healthy fats and may help soothe acid reflux.
• Salt: Adding more salt to your diet can help with acid reflux symptoms.
• Baking soda: Mix a teaspoon of baking soda with a small amount of water and drink it quickly to neutralize stomach acids.
• Nissen fundoplication: This surgical procedure increases gastric emptying and restores a dysfunctional Magenstrasse emptying pathway, providing a reliable and durable cure for advanced acid reflux disease.

It is important to note that if you are experiencing persistent or severe acid reflux, it is best to consult with a healthcare professional for personalized advice and treatment options.

Acid reflux and gut health

Acid reflux and gastroesophageal reflux disease (GERD) are terms used to describe the backflow of food or stomach acid from the stomach up into the oesophagus. This can cause a burning pain in the lower chest, a sore throat, hoarseness, and a bad taste in the mouth.

The Link Between Acid Reflux and Gut Health

The link between acid reflux and gut health is complex and not yet fully understood. However, there are a few theories that suggest a connection between the two.

Gut Dysbiosis

Gut dysbiosis is a condition that occurs when there is an imbalance between good and bad bacteria in the gastrointestinal tract. There are two ways in which gut dysbiosis and acid reflux are linked. Firstly, acid reflux could be a symptom of an unbalanced gut microbiome. Secondly, over-the-counter acid reflux medications such as antacids and proton pump inhibitors (PPIs) can cause gut microflora imbalance and reduce the number of healthy bacteria in the system. PPIs have been shown to alter the diversity of gut bacteria, leading to a less healthy gut microbiome.

Small Intestine Bacterial Overgrowth (SIBO)

SIBO is a health condition characterised by an overabundance of bacteria in the upper part of the small intestine. Norman Robillard, Ph.D., suggests that the gas produced by these bacteria can put enough pressure on the small intestine and stomach to push acid from the stomach into the oesophagus, resulting in acid reflux. He recommends a diet low in "difficult-to-digest" carbohydrates to treat GERD and reduce bacterial overgrowth.

The Keto Diet and Acid Reflux

The keto diet is a popular diet characterised by a reduction in carbohydrates and a relative increase in protein and fat intake. While it has been demonstrated to help with certain disorders, it may not be suitable for everyone, especially those with acid reflux. High-fat foods can cause the lower oesophageal sphincter to relax, allowing more stomach acid to back up into the oesophagus. Additionally, fat takes longer to leave the stomach, which could further increase acid reflux symptoms.

However, some people have reported improvements in their acid reflux symptoms after adopting a keto diet. This may be particularly effective for overweight and insulin-resistant individuals. Obesity plays a key role in increased acid reflux symptoms, and a keto diet may aid in weight loss.

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