Gluten Intolerance and Acid Reflux

Acid reflux affects nearly 20 percent of people in the United States (1). The premise of acid reflux is when stomach acid repeatedly flows back into your esophagus, causing a burning pain in your chest and throat. While tomatoes, spicy foods, and caffeine are commonly known to worsen acid reflux, gluten may also play a role in this condition for certain people. 

In this article, we’ll discuss the relationship between gluten intolerance and acid reflux. 

Gluten is the name for a group of proteins found in grains like wheat, barley, and rye. Gluten provides texture, retains moisture, and promotes elasticity to bread and other baked goods.

Because of its unique properties, gluten is sometimes used as an additive in processed foods like gravy, condiments (like soy sauce), and soup.

Celiac disease is a serious autoimmune condition in which a person’s immune system mistakenly attacks the lining of their small intestine after eating gluten-containing foods. This condition is fairly uncommon and affects just one percent of the population. However, experts suspect that many people remain undiagnosed. The primary treatment for celiac disease is a strict and lifelong gluten-free diet. 

Many people suffer from acid reflux before receiving a celiac disease diagnosis. Unfortunately, we also see individuals with celiac disease who report acid reflux even after removing gluten from their diet. This is likely due to an unhealed digestive tract. While removing gluten will stop further damage from occurring, it’s crucial to prioritize a gut healing protocol to reverse prior damage and reduce inflammation. 

Gluten intolerance (also known as non-celiac gluten sensitivity) is a condition in which a person experiences a variety of symptoms after eating gluten-containing foods, but does not have celiac disease or a wheat allergy. Symptoms of gluten intolerance vary and may include bloating, constipation/diarrhea, acid reflux, headaches, or skin disturbances. Gluten sensitivity is thought to affect up to 13 percent of the general population and may be more prevalent in women than men (2). 

New research suggests that gluten may cause acid reflux in certain individuals with a gluten intolerance. For example, one study found a high prevalence of gluten sensitivity in people with severe acid reflux (3). An approximate 35 percent of test subjects reported an improvement in digestive symptoms while following a gluten-free diet. Interestingly, subjects with gluten sensitivity also reported an improvement in other non-digestive symptoms while on a gluten-free diet, like fatigue, joint pain, and headaches. 

The best way to determine if gluten is contributing to your acid reflux is to follow a short-term elimination diet. However, if you, or your health care team are suspicious for celiac disease, it may be recommended to test for celiac disease before eliminating gluten. Otherwise, the blood test used to screen for celiac can result in a false negative. We offer celiac blood testing at Root.

Remove all sources of gluten-containing foods for three to four weeks. You can tell if a packaged food item has gluten by reading the label and looking for wheat, barley, or rye in the ingredient list. A gluten-free label also confirms there are no gluten-containing ingredients in the product as the FDA strictly regulates these labels. After a few weeks, slowly reintroduce gluten-containing foods to your diet and monitor your symptoms. For example, on day one, you could test your response to one piece of regular toast.

Many gluten-free food items have poor nutritional value, are high in added sugar, and can worsen your acid reflux. If you decide to try a gluten-free diet, focus on eating whole and unprocessed foods that are naturally free of gluten like fruits, vegetables, nuts, seeds, lean protein, and gluten-free whole grains (like brown rice, quinoa, and oats).

While gluten can trigger reflux in certain individuals, there is oftentimes a deeper root cause of this symptom. For example, an H.pylori infection is largely responsible for acid reflux. We can look for this bacteria with a functional stool test. Contrary to common belief, we also see low stomach acid causing acid reflux in certain individuals as well. Unfortunately, taking medications that further reduce stomach acid, like proton pump inhibitors (PPIs), ultimately worsen the underlying cause of these cases of reflux. We test for and treat these conditions in our functional medicine membership program. 

Furthermore, one of our favorite supplements to recommend for heartburn relief is our Gut Health Rebalance powder. This supplement contains calming ingredients, like deglycyrrhizinated licorice (DGL), proven to lower inflammation and repair the digestive tract. 

Gluten may contribute to acid reflux, especially if you have celiac disease or gluten intolerance. A temporary elimination diet is the best way to determine if gluten is worsening your heartburn. However, healing the gut and identifying any other root causes of reflux (like low stomach acid) is also a crucial step to find long term symptom relief.