Over the past few years, there has been a growing trend of individuals experimenting with various fasting regimens. These approaches have been scientifically recognized for their potential to bring several health advantages, notably weight loss.
Research indicates that fasting diets can serve as preventive measures against severe health conditions such as type-2 diabetes, coronary heart disease, stroke, and even cancer1.
However, as you delve into intermittent fasting, you might ponder a different question: does intermittent fasting cause acid reflux?
This article aims to shift its focus away from the core discussion of fasting itself and instead shed light on a common side effect associated with fasting, commonly referred to as acid reflux.
What Is Acid Reflux?
Acid reflux is a medical condition that occurs when the acid in the stomach flows backward into the esophagus. It can cause heartburn, which is a burning sensation in the chest, often behind the breastbone.
While people often use these terms interchangeably, it’s essential to note that heartburn is a symptom of acid reflux, also known as gastroesophageal reflux (GER)2. Despite the misleading name, heartburn doesn’t relate to the heart.
When acid reflux becomes a persistent issue, occurring more than twice a week for several weeks, doctors diagnose it as gastroesophageal reflux disease (GERD), signifying a more significant concern3.
Acid Reflux: Causes And Prevalence
Hydrochloric acid, a potent acid found in the digestive system, aids in the breakdown of food and serves as a defense against pathogens like bacteria4. While the esophagus is unprotected, the stomach’s lining has been carefully modified to shield it from the stomach’s powerful acid.
The gastroesophageal sphincter, a muscular ring, typically functions as a valve that allows food into the stomach but prevents it from returning to the esophagus5. However, when this valve malfunctions, stomach contents regurgitate into the esophagus, causing what is commonly known as acid reflux.
During this process, many people experience a burning sensation in their esophagus due to the ascending acid, called heartburn.
Weekly reflux symptoms are reported by approximately 10-48% of individuals in developed countries6. GERD is especially prevalent in Western nations, impacting roughly 20% of the population in these areas7.
In the United States alone, about 20% of Americans suffer from GERD, making it the most frequently diagnosed gastrointestinal condition in outpatient settings8.
Acid Reflux Symptoms
The most common symptom of acid reflux is heartburn, characterized by a distressing, burning feeling in the esophagus.
Typically felt behind the breastbone, this discomfort intensifies when lying down or bending over and can persist for hours, especially after meals. Sometimes, the pain might ascend towards the neck and throat.
In certain instances, stomach fluids can reach the back of the throat, leading to a bitter or sour taste in the mouth.
It can also manifest in often distressing symptoms. One of which is chest pain, which at times can be so severe that it mimics the symptoms of a heart attack, creating anxiety and uncertainty. Additionally, individuals with GERD may experience difficulty swallowing, which can be attributed to irritation and inflammation of the esophagus.
A persistent cough is another indication of the condition, as the acid irritates the throat, leading to a chronic cough that can be both irritating and disruptive. Lastly, sore throat is a frequent complaint among those with acid reflux, as the continuous exposure to stomach acid can result in throat irritation and discomfort, further underscoring the diverse and uncomfortable nature of this condition.
Does Intermittent Fasting Cause Acid Reflux?
For some individuals, intermittent fasting helps relieve acid reflux symptoms. However, there are essential factors to consider.
Regardless of the intermittent fasting method chosen, there will be periods of abstaining from eating, ranging from several hours to days during longer fasts.
Even during fasting, your stomach still produces stomach acid. Prolonged periods without food can result in an accumulation of excess acid in the stomach, which may move into the esophagus, causing discomfort and pain.
Additionally, intermittent fasting may increase contractions of the stomach and intestines, potentially pushing more acid into the esophagus. Surprisingly, a study revealed that even the mere smell or thought of food can trigger heightened acid production in the stomach9.
These aspects underscore the need for careful consideration and awareness of how intermittent fasting might affect individuals, particularly those prone to acid reflux.
The gastroesophageal reflux disease symptoms may be worsened during fasting by:
- drinking caffeine
- eating large quantities of fried foods
- eating spicy and acidic foods during the eating window
- high levels of stress
- eating large meals
Different Ways To Alleviate Heartburn And Acid Reflux While Fasting
Staying adequately hydrated throughout the fasting period is crucial, given that most intermittent fasting plans permit zero-calorie beverages. Regular sips of water can mitigate reflux symptoms by aiding in removing acid from the esophagus. If cold water doesn’t seem compelling, opting for warm water can help dilute stomach acids.
In addition to water, herbal options like licorice, ginger, marshmallow root, or chamomile tea can be beneficial10,11.
Research has demonstrated that an herbal concoction featuring deglycyrrhizinated licorice (DGL) can prevent acid reflux during intermittent fasting or alleviate GERD symptoms. Additionally, ginger tea, known for its anti-inflammatory properties, has been found to reduce nausea, according to another study12.
2. Avoid drinking coffee on an empty stomach.
Coffee stands as one of the limited beverage options allowed during fasting periods. However, if you’re grappling with acid reflux symptoms such as heartburn, it’s advisable to restrict your daily coffee intake to just one cup. If the symptoms persist, eliminate coffee from your routine temporarily.
3. Increase your fiber intake during the eating window.
Including fiber-rich foods in your diet aids the digestion process and can alleviate reflux issues.
Unlike other nutrients that break down during digestion, fiber moves through the body essentially unchanged, facilitating smooth emptying of the digestive tract13. This process lessens pressure on the stomach, reducing the likelihood of acid reflux and acid flow into the esophagus.
You can incorporate high-fiber foods like whole grains, legumes, non-acidic fruits, vegetables, as well as nuts and seeds into your meals to promote better digestive health.
4. Consume smaller meals.
Feeling ravenous after fasting is natural, but it’s essential not to overdo it with rich, oily, or sugary foods when you break your fast. Choose a more stomach-friendly approach by beginning your meal with something light, like soup or a salad. Then, incorporate proteins and conclude your meal with carbohydrates.
Avoiding heavy meals is crucial as they can strain the stomach and heighten the risk of acid reflux. Excessive food can expand the stomach, preventing the sphincter from closing fully and enabling digestive juices to flow back into the esophagus.
To avoid acid reflux, opt for a balanced and gradual approach to breaking your fast.
5. Avoid foods that can trigger acid reflux.
Some specific foods have the potential to induce acid reflux or heartburn, especially in individuals prone to these conditions. If you’ve been experiencing discomfort after meals recently, it’s crucial to be mindful of your dietary choices. Paying attention to what you eat can assist in managing uncomfortable symptoms and steering clear of triggers.
Oranges, lemons, and tangerines are examples of citrus fruits with a high acid content. Consuming these fruits during your eating window might lead to acid reflux episodes, especially while fasting.
Therefore, it’s advisable to avoid or limit the intake of these food items during fasting periods. Being mindful of your food choices can significantly contribute to minimizing the risk of acid reflux episodes.
6. Skip the fried and fatty foods.
In both regular individuals and those practicing fasting diets, fatty and fried foods tend to be the primary culprits for triggering acid reflux. The challenge lies in the fact that fatty foods can be hard to digest14, often resulting in episodes of acid reflux and heartburn.
For individuals adhering to fasting, it becomes especially important to steer clear of fried and spicy foods in the immediate lead-up to and aftermath of fasting periods.
7. Do not lie down immediately after eating.
Lying down shortly after a meal can push food back into the esophagus, potentially causing discomfort. It’s essential to remain upright after eating, avoiding immediate napping.
Brisk walking after meals can help the food settle in the stomach more effectively, promoting better digestion and reducing the risk of acid reflux.
1 Arnason TG, Bowen MW, Mansell KD. Effects of intermittent fasting on health markers in those with type 2 diabetes: A pilot study. World J Diabetes. 2017 Apr 15;8(4):154-164. doi: 10.4239/wjd.v8.i4.154. PMID: 28465792; PMCID: PMC5394735.
2 Acid Reflux (GER & GERD) in Adults – NIDDK. (n.d.). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults
6 Delavari A, Moradi G, Birjandi F, Elahi E, Saberifiroozi M. The Prevalence of Gastroesophageal Reflux Disease (GERD) in the Islamic Republic of Iran: A Systematic Review. Middle East J Dig Dis. 2012 Jan;4(1):5-15. PMID: 24829629; PMCID: PMC4017699.
8 Richter JE, Rubenstein JH. Presentation and Epidemiology of Gastroesophageal Reflux Disease. Gastroenterology. 2018 Jan;154(2):267-276. doi: 10.1053/j.gastro.2017.07.045. Epub 2017 Aug 3. PMID: 28780072; PMCID: PMC5797499.
9 Feldman M, Richardson CT. Role of thought, sight, smell, and taste of food in the cephalic phase of gastric acid secretion in humans. Gastroenterology. 1986 Feb;90(2):428-33. doi: 10.1016/0016-5085(86)90943-1. PMID: 3940915.
12 Schulz RM, Ahuja NK, Slavin JL. Effectiveness of Nutritional Ingredients on Upper Gastrointestinal Conditions and Symptoms: A Narrative Review. Nutrients. 2022 Feb 5;14(3):672. doi: 10.3390/nu14030672. PMID: 35277031; PMCID: PMC8839470.