While many types of food have been associated with an increase of acid reflux, there is very little evidence on dietary components that are associated with a reduction of acid reflux.
Fermentation has become a popular, fun, trendy, and creative approach to gut health. It is known that fermented foods can be naturally high in probiotics, but what is fermentation? Fermentation is the transformation of food through microbial activity. Fermented foods essentially have their own living microbiome, so when we consume them, not only are we taking on a portion of food, but also a new living microbiota. Fermentation of food can actually change its nutritional value; for example, when cabbage – a food that contains little to no vitamin C – is fermented, it becomes a good source of vitamin C.
Fermentation of vegetables is another way to explore plant foods with new textures and tastes and introduce these into your diet. Sauerkraut and kimchi are both fermented vegetables, mostly consisting of cabbage. Kimchi also contains fermented radish and often other seasonal vegetables and is prepared with a wide variety of spices. The process of fermentation involves controlled microbial growth and the use of enzymes to produce food and beverages. Historically, fermentation was used as a method of preserving food.
Fermented foods contain potentially probiotic microorganisms. Not all microorganisms will survive the journey to the GI tract and so whether or not a fermented food is probiotic will vary across products. Of all the recognized health benefits of fermented foods, there is no sound evidence to suggest that consuming fermented vegetables will cure acid reflux.
That said, consuming fruits and vegetables (not necessarily fermented) has been shown to be a protective factor against developing Barrett’s esophagus.
When buying fermented vegetables like sauerkraut and kimchi, it must be purchased from the chilled section of the supermarket. Otherwise, the bacteria may be sterilized, and it will not have an effective probiotic nature.
If you are consuming large amounts of processed fats and sugars, these foods are generally low in fiber, therefore low in prebiotics, which is beneficial for the gut. These foods are fine to consume in moderation, as treats, and as part of a well-balanced diet. The risk of consuming too many of these foods is that they will displace more nutritious foods in your diet.
A study was conducted comparing the diets of African Americans and rural South Africans to demonstrate the effects that a diet low in fiber and higher in animal fat and protein can have on gut health. The diet of the African Americans represented what is described as a western diet, and was 2-3 times higher in animal protein and fat intake, and lower in forms of resistant starch than the South Africans. The western diet had a decrease in microbial diversity and higher inflammation of the gut lining. The high fiber diet had reduced inflammation and increased the production of butyrate and other short-chain fatty acids. Butyrate is a short-chain fatty acid with particular benefits for reducing inflammation. It is an antioxidant which means it protects the body against damage and helps to maintain a healthy gastrointestinal lining.
People that are concerned about their diet often end up restricting a variety of unnecessary foods, which can lead to nutritional compromises and consequent health problems. For example, many people may cut out gluten from their diet in an attempt to reduce symptoms that may not be linked to consuming gluten. This can cause potential harm including:
-diet deficient in fiber and nutrients like zinc, magnesium, and b-vitamins
- diet consequently high in fat content which may contribute to heart disease
- Social limitations while eating out
- Increased financial spending on gluten-free alternatives
Some particular foods have been identified to relax the lower esophageal sphincter, therefore, allowing stomach contents to pass back into the esophagus. Although the list of foods that may trigger reflux seems long, different foods can be problematic for different people. One way of working out which foods trigger reflux for you is by using a food journal for a week or so to record which foods you have eaten, and then any symptoms you experienced after eating that food.
See the section at the end of this guide on “How to Track Your Reflux Triggers” so you can print a food journal of your own.
Citrus Fruits and Juices
In a survey of about 400 people with symptoms of heartburn, almost three quarters of people reported that orange or grapefruit juice increased their heartburn. It is thought that this effect may not only be related to the acidity of these beverages but also to some other unidentified part of citrus fruits. This can be evidenced by lemon water actually being able to help some peoples symptoms.
There is some pretty good evidence to suggest that avoiding carbonated drinks may be beneficial in the reduction of acid reflux. Carbonated beverages are thought to increase the relaxation of the lower esophageal sphincter, potentially due to the changes in the volume of gas rather than changes in pH or caffeine. However, some carbonated beverages can have a low pH which may contribute to the feeling of heartburn after consumption.
Acid reflux has been shown to be significantly reduced by people drinking decaffeinated coffee in comparison to regular coffee, although the evidence isn’t exactly straight forward. One large study found that drinking more than one cup of coffee a day was linked with symptoms of acid reflux. In an extensive survey of people with heartburn, coffee, and to a lesser extent, tea was associated with a significant increase in reported heartburn symptoms compared to water.
A third study made the link a little more complex, it found that coffee has the opposite effect on reflux; the risk of reflux was reportedly reduced in those who drank copious amounts of coffee. Overall it seems some coffee lovers may have improved reflux if they reduce their caffeine intake but others may not.
Like with coffee, the facts around alcohol and its relationship to reflux aren’t entirely clear. Red wine, white wine, and beer have all been shown to be associated with heartburn when compared with water. However, an extensive health survey found that alcohol did not impact the risk of reflux in their study population.
Alcohol has been suggested to increase the amount of a hormone called gastrin, which stimulates acid secretion into the stomach. An increase in gastrin, therefore, increases the amount of stomach acid. Alcohol also reduces the amount of pressure on the lower esophageal sphincter, increases the number of lower esophageal sphincter relaxations, and in high doses, impairs the movement of food through the esophagus and out of the stomach.
While numerous studies have shown an associated increase in the symptoms of reflux in alcohol users, we don’t know for sure that reducing or removing alcohol from the diet will reduce these symptoms. Reducing alcohol consumption has been shown to improve the mobility of food through the esophagus, but not improve the pH of the stomach or symptoms of acid reflux.
People who experience reflux often report that spicy foods worsen their symptoms of reflux. One survey of around 1000 people questioned the incidence of heartburn and studied the foods commonly reported as contributing to symptoms. Spicy food was declared as the most common food to cause heartburn.
It has been acknowledged that the term “spicy” is very vague. Spicy food has been noted to commonly have a tomato base and so the effects of tomato on the esophagus have been investigated. It has been found that the pressure of the lower esophageal sphincter was significantly reduced after consuming tomatoes; however, the effect did not last long. It was suggested that the impact of “spicy” food on reflux might be caused by irritation of the esophagus.
Raw onions have also been identified as a common component of spicy meals and so have been investigated separately for their effect on acid reflux. Authors of a small study gave people with and without acid reflux a burger without onions, and a burger with onions on separate days. In the people without known reflux, onions did not increase any signs of reflux. In the participants with known reflux, the burger with a slice of onion significantly increased reflux.
Beer is the most commonly consumed fermented beverage in the world. Beer contains a relatively wide range of micronutrients compared to many other beverage choices, which is a perk to all the beer-drinkers out there.
Notably, beer contains significant amounts of folate and choline as well as polyphenols which come from the malt (grain) and hops. What does this mean for gut health?
Polyphenols are micronutrients with an antioxidant effect, reducing inflammation and oxidative stress. The gut microbiota (microorganisms that live in the digestive tract) and polyphenols have a good relationship, whereby the microbiota helps to break down polyphenols into its by-products. The products produced during polyphenol break-down are then used to help block out harmful bacteria. Polyphenols in beer therefore act as a prebiotic and enhance the beneficial bacteria, particularly Bacteroidetes.
On the whole it seems that moderate beer consumption could potentially be beneficial for gut bacteria due to the relationship between polyphenols and the microbiota. More research is needed, however, to completely understand this relationship with the gut.
Probiotics have become a significant contributor to the buzz around gut health. Probiotics are defined as “living microorganisms in foodstuffs which, when taken at certain levels in nutrition, provide equilibration of the intestinal flora, and hence have a positive effect on the health of the consumer “. In simple terms, they are either bacteria or yeasts that provide the consumer with health benefits. Probiotics come in different forms ranging from yogurt, supplements, cultured milk foods, fermented vegetables, and drinks like kombucha. The question is, do they work?
The stomach plays a vital role in protecting our body from harmful pathogens (creatures that cause disease) that may be present in food and drink. The stomach mixes food with acid and other fluids, breaking the food down. Hydrochloric acid is the primary stomach acid, and around 1-2L is released from little cells that line its walls each day. Stomach acid has a significant role as a layer of protection, or shield, to create an environment in which harmful bacteria cannot thrive or grow. This acidity level is detrimental to pathogens, so many end up dying. This can present a problem when we want good bacteria, such as those found in probiotics, to get through the stomach to the intestines where they can have their beneficial effect.
For a microorganism to be described as a probiotic, specific criteria set by the Food and Agriculture Organization of the United Nations (FAO and the World Health Organization (WHO) need to be met. These criteria state that a probiotic must be able to survive passage through the stomach where acid is secreted. It also must withstand the effect of bile, a fluid produced by the liver to support the digestion of fat and fat-soluble vitamins. Some bacteria have developed ways to adapt, allowing them to survive an acidic environment and still exert their effect, be that harmful or beneficial. Some beneficial species such as Lactobacillus, Bifidobacterium, and Streptococcus species can survive the stomach acid and make it through to the intestines. These species are found in some foods including yogurt, sauerkraut, kimchi, kefir, sourdough, tempeh and miso. Bacterial strains can also be scientifically developed in the lab for more targeted results and sold as dietary supplements. Clinically studied single-strain probiotics such as Bacillus coagulans are not only stable at room temperature, but can also survive and thrive in the harsh stomach environment. Other species of probiotics cannot always survive; in this case, they need a layer of protection, like an enteric coating, to prevent harm from the stomach acid.
An important consideration is that not all probiotics are created equally. Unfortunately, some so-called probiotics on the market today don’t meet the FAO/WHO guidelines for probiotics.
Also be weary of the “shotgun” approach that many supplement companies use these days such as multiple strains and the highest CFUs (colony forming units) as possible per serving. Fortunately these trends are now giving way to more targeted approaches to gut health.
Acid reflux occurs when the acidic contents of the stomach flow back up into the esophagus, but when does acid reflux become recognized as Gastroesophageal Reflux Disease (GERD)?
The World Gastroenterology Organization defines GERD as “troublesome symptoms sufficient to impair an individual’s quality of life, or injury or complications that result from the retrograde flow of gastric contents into the esophagus, oropharynx, and/or respiratory tract”. GERD is basically the result when symptoms of acid reflux become an ongoing problem.
Symptoms of reflux include heartburn, regurgitation, nausea, belching, bloating, vomiting, burning in the throat, chest pain, early satiety, and others. Some of these symptoms overlap with other gastrointestinal symptoms, which must first be ruled out.
Probiotics can benefit gut health, particularly in the lower part of the digestive system, but there is little known about the effects of probiotics on symptoms of GERD.
One recent review aimed to evaluate ‘the efficacy of probiotics in alleviating the symptoms, incidence, and severity of GERD’ in adults not receiving any medical treatment. From the ten studies that reported on reflux symptoms:
- three reported significantly reduced acid regurgitation
- two reported significant improvement in heartburn or reflux symptoms
- five reported no improvement
Overall, the results were too varied to draw a conclusion, and the quality of the studies investigated was not strong.
While there is potential for beneficial effects of probiotics on GERD symptoms, higher-quality, long-term studies are needed. Probiotics may help decrease ailments like constipation or other conditions that can contribute to symptoms of GERD, but there is limited evidence to support this.
While there may not be a direct link between probiotics and treating acid reflux itself, there may be a place for probiotics to treat some of the side effects caused by medications that treat reflux.
PPIs have received recent attention for the effect they may have on the microbiota of the gut, with an increase in the amount of small intestine bacterial overgrowth (SIBO). During SIBO, bacteria move from the large intestine to the small intestine where they do not belong and start to break down carbohydrates. The small intestine cannot handle the products produced during the break-down process and therefore symptoms such as diarrhea, constipation, and stomach pain can
Taking probiotics at the same time as PPIs to treat reflux can decrease SIBO and its related effects on the gut. So, the probiotics aren’t treating the incidence of acid reflux directly, but they may have a role in reducing the drug-associated side effects.
When we talk about the flora of the gut, we are talking about all the microorganisms that live in the human gastrointestinal (GI) tract. Along with bacteria, the microbiota consists of viruses, fungi, and yeasts. The microbiota all work together to keep our GI tract healthy, and our digestive system working effectively so we can optimize the absorption of nutrients from food and drink. Different bacteria in the microbiota have different jobs, which all keep the body in balance. Some bacteria help to reduce inflammation, some help make enzymes and messenger signals like hormones and neurotransmitters, and others are involved in digestion.
Unlike your genes, which you were born with and can’t control, the gut microbiota, can be partially influenced by how it’s treated. While your core microbiota remains relatively stable over time, certain bacteria of the microbiota will fluctuate. The make-up of the core microbiota is thought to be determined by factors, such as genetics, how you were birthed, if you were breast- or formula-fed, and the use of antibiotics and/or other drugs around birth.
Several other factors can alter your gut microbiota in the short-term, such as diet considerations, including probiotic and prebiotic use, maternal diet and weight, and timing of feedings, as well as drugs/medications, the environment, and different disease states. Some of these factors are discussed in more detail below. Keep in mind, several gaps in the research about how our lifestyle can impact the gut microbiota still exist.
What you eat can greatly impact the types of bacteria present in your gut microbiota. The food you consume is the main energy source for your gut microbiota. It has been suggested that the foods we consume can cause rapid changes to the microbiota structure.
As far as we know, changes in what humans eat do not result in a permanent change to the microbiota. Although maybe it’s just too early to tell, changes in what mice eat have suggested that diet could account for up to 57% of the total variation in gut microbiota. In this case, perhaps more research is needed.
There are also many myths today, suggesting that eliminating gluten, dairy, lectin, and even some vegetables will support gut health. The more restrictive a diet becomes, the fewer foods you can feed your gut flora, thereby limiting the diversity of the microbiota. The more diverse the microbiota is, the better for health.
Diet affects the gut microbiome in two key ways:
It provides a source of microorganisms that survive and travel through the stomach and small intestine to land in the large intestine, then grow and become metabolically active. These microorganisms are the probiotics.
It provides a source of indigestible foods, known as prebiotics, which also reach the large intestine where they can feed the probiotics mentioned above.
Let’s take a look at how prebiotics and probiotics can optimize your gut microbiota.
One way in which you can optimize gut health is by consuming prebiotics. Many dietary carbohydrates contain non digestible dietary fibers, which classify as prebiotics. The gut microbiota relies on dietary fiber and other prebiotics to get energy. A prebiotic is “a nondigestible food ingredient that beneficially affects the host by selectively stimulating the growth and/or activity of one or a limited number of bacteria in the colon, and thus improves host health”.’ Some of the more commonly available prebiotics include fructooligosaccharides, inulin, lactulose, and galactooligosaccharides. These carbohydrates are not digested in the stomach, or small intestine. and so Thus, they make their way to the large intestine where they get fermented by the gut microflora.
Food sources of these key prebiotics include:
Inulin – leeks, asparagus, onion, garlic, bananas, and wheat
Fructooligosaccharides – chicory, tomatoes, asparagus, some grains, and onions
Lactulose – milk-based products (ice-cream, yogurt, cheese)
Inulin and fructooligosaccharides when consumed at levels between 5 and 8g/day, have been shown to increase the amount of Bifidobacterium, a beneficial bacteria for the gut. Lactobacilli are often increased by the consumption of prebiotics but not always to the same extent as Bifidobacterium is.
A review by the Department of Food Science and Nutrition at the University of Minnesota reported the following suggested health benefits of prebiotics:
Reduce the prevalence and duration of infectious and antibiotic-associated diarrhea;
Reduce the inflammation and symptoms associated with inflammatory bowel disease;
Exert protective effects to prevent colon cancer;
Enhance the bioavailability and uptake of minerals, including calcium, magnesium, and possibly iron;
Lower some risk factors for cardiovascular disease; and
Promote satiety and weight loss and prevent obesity.
In large amounts (>20g/d), prebiotics run the risk of causing gas and bloating, but prebiotics found naturally in foods result in a lower risk, including:
Choosing foods that contain dietary fiber like whole grains, vegetables, fruits, beans, peas, chickpeas, lentils, brown rice, nuts, and seeds will provide your gut bacteria with a varied source of food, helping to create diversity and function. Unfortunately, the benefits of consuming dietary fiber won’t be the same for everyone. A; as such, variation between individuals can be expected.
Bacteria called Bifidobacterium and Lactobacillus are tThe most common natural bacteria used as probiotics are groups of bacteria named Bifidobacterium and Lactobacillus. The discovery of probiotics happened aroundcame around as early as 1907, when yogurt was discovered to be beneficial to health by increasing the number of good bacteria in the GI tract.
It is important to keep in mind that not all strains of probiotics are equal; some that have been tested don’t contain the organisms they claim to. Studies of probiotics have mostly focused on specific populations, such as those who suffer from gastrointestinal conditions like IBS and IBD. The benefits of probiotics on the general health of the microbiota are not as well described. While probiotics have been shown to increase the number of specific bacteria in some cases, the changes to the overall composition of the gut microbiota with probiotic use are generally small and last only as long as the probiotics are taken.
Protein is a crucial part of a well-balanced diet and plays an important role in the growth of the microbes in the gut. When proteins are digested, they provide a source of nitrogen,n which is a type of gas, fueling the microbes to grow and break down carbohydrates. This also creates, and so beneficial by-products like butyrate, a short-chain fatty acid., can be made.
Limit Added Sugar
Once again, the evidence around the consumption of sugars on microbiota is lacking. One study carried out in mice has shown that the ingestion of a diet consisting of 60% energy from fructose was associated with an increased presence of Enterococcus faecalis. Although this type of bacteria is a common species in the gut, the study also found that mice with increased Enterococcus faecalis developed inflammation in the large intestine.
A Mediterranean diet is high in plant-based foods like fresh fruit, and vegetables, legumes, and grains. It contains moderate amounts of fish and is rich in olive oil, nuts, seeds, and eggs, with limited amounts of added sugars. The Mediterranean diet is an example of an eating pattern that is beneficial to gut health because it has limited potential to cause inflammation, promotes the breakdown of undigested carbohydrates by gut bacteria, and has been associated with high levels of short-chain fatty acids. The Mediterranean diet demonstrates one of the most important elements of good gut health – eating a diverse range of plant-foods.
Exposure to stress can cause changes to the gut microbiota, and vice versachanges to the microbiota can cause stress.
Stress impacts the large intestine’s ability to mix and move about the contents, which can lead to constipation. Stress does this has its effect through the gut-brain axis and has been shown to alter the gut microbiota, including reducing the beneficial Lactobacillus bacteria. Stress is also thought to make the body more susceptible to harmful pathogens, which may result in an increased risk of disease or illness. In contrast, changes to the gut microbiota may create stress on the body as it tries to adapt to new demands.
Ultimately, pProbiotics may may play a role in reducing the effects of stress on microbiota by competing against pathogens and helping to strengthen the protective layer of the gut lining. This can protect the gut from stress, as well as potentially prevent drastic changes from occurring to the gut in the first place which may lead to overall body stress.
There has been little research done on the relationship between exercise and microbiota. One study conducted among rugby players of an elite team showed a wider range of gut bacteria when compared with men who were less active. However, the men who played elite rugby also consumed more food, which may have contributed to these changes. While there are suggestions that exercise may have positive effects on the microbiota, it is certainly too soon to tell, and more research in this field is required.
Chlorination of public drinking water prevent the contamination of the water by potentially harmful bacteria. Consequently, this, prevents the spread of waterborne diseases. How then does chlorine affect the gut bacteria of the human body?
It is unclear whether chlorine will survive the passage through the stomach acid and make it to the intestines where gut bacteria would be potentially harmed. Yet, there is reason to believe that as the stomach acid is naturally chlorinated, containing potassium chloride, chlorine may not affect the microorganisms of the intestine.
Supplements can help heal your leaky gut, but it’s very important to understand that to see the best results from supplementation, you must first heal your gut through making the appropriate changes to your diet and lifestyle.
Fulvic & Humic acids
Fulvic and humic acids are the new kids on the block when it comes to gut health, but they are probably one of the oldest remedies recorded for GI imbalances. These organic acids are found in an ancient Ayurvedic remedy called shilajit, which has been used for centuries for its gut healing and anti-inflammatory properties. These naturally occurring organic acids help your body to produce an ideal environment for probiotics to thrive in your digestive tract. Look for supplements such as the Canadian sourced AEON, a purified version of Shilajit, which have been extensively studied for their beneficial effects on the gut membrane and their ability to nourish and balance your natural bacterial flora. The fulvic and humic acids found in AEON also help to strengthen your tight junctions, which keeps the good stuff in and the bad stuff out.
Probiotics are naturally found in fermented foods, such as kimchi, sauerkraut, kombucha, and kefir. Research has shown that probiotics supplements may be able to improve gut health if you don’t get sufficient probiotics from your diet.
Probiotics can also be taken as a supplement. Single-strain probiotic supplements that are stable at room temperature, survive the stomach acids, and have a balanced CFU number (colonizing forming units) are generally recommended over multi-strain products with high CFUs and that need to be refrigerated. This may sound counterintuitive to some, but the reasons are actually simple. Probiotic supplements that need to be refrigerated are typically more sensitive and fragile and the high CFUs are to compensate for this loss during digestion. Look for strains like Bacillus coagulans , Lactobacillus casei, Lactobacillus reuteri and Lactobacillus rhamnosus for the best results.
Many people rush to buy probiotics to heal their gut, and while some research supports the logic behind this, supplementing with probiotics alone, without addressing your leaky gut through nutritional and lifestyle changes, might be a waste of time. In some cases, it can even increase inflammation and lead to the overproduction of histamines. This can result in various other health issues, which you don’t want.
When the barrier of the healthy gut gets weakened, it can become less effective at guarding off harmful pathogens. The following offers a brief overview of potential causes leading to a leaky gut.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs, such as ibuprofen and aspirin, are used to treat pain and inflammation. However, some people have claimed these NSAIDs irritate the gastrointestinal tract, resulting in bleeding and ulcers. To minimize the risk of damage, it’s recommended that NSAIDs be taken with milk or food, or that enteric-coated versions be taken.
Alcohol has similar effects to NSAIDs and has been reported to disrupt the cells of the intestine, as well as the junctions between the cells, resulting in increased leakage.
It has also been highlighted that people consuming excessive amounts of alcohol have altered, often unfavorable, dietary intake. Studies are evolving to suggest that the consumption of certain food groups may reduce the harmful effects of alcohol on the gut.
Overall, to minimize health risk, keep alcohol intake within the recommendations of):
No more than two standard drinks per day for women (no more than 10 per week, with at least two alcohol-free days per week).
No more than three standard drinks per day for men (and no more than 15 per week and at least two alcohol-free days per week).
There are many potential factors to consider wWhen it comes to bloating, there are various factors that can be considered. This often makesing the exactparticular cause of bloat difficult to pinpoint. On top of this, the cause of bloating likely differs frombetween individual to individuals. Each person’s body is unique and there are several variants between each person.
Under normal circumstances, bacteria live in the human body without causing harm. In fact, we need gut bacteria to be able to break down food, control digestion, and support the immune system and many other areas of health. When abnormal changes occur to the gut, bacteria can potentially become potentially harmful. An imbalance of these bacteria can cause bloating, stomach pain, and diarrhea.
Bacteria both consume and produce a lot of gas in the gut. Different types of bacteria will be either gas-producing or gas-consuming, and the balance of these bacteria will vary between people. The balance of these bacteria is thought to be mostly determined early in life, though it is believed that certain lifestyle habits can impact thise balance as well. In the large intestine of the gut, there are hydrogen-producing bacteria., and their The job of these hydrogen-producing bacteria is to help break down, or ferment, carbohydrates that haven’t already been digested. When large amounts of unabsorbed carbohydrates present in the large intestine are fermented, this can result in bloating. In this case, bloating is not caused by ‘bad bacteria’ as much as it is by an increase of undigested carbohydrates.
Bloating can also be a result of substances like food and fluid sitting in the intestine, even without gas production. The gas produced from fermentation by bacteria does not always cause bloating, particularly in otherwise healthy individuals.
Bloating can also be caused by the overgrowth of bacteria in the small intestine, though the evidence is controversial, and there is still a lot to learn. Small intestinal bacterial overgrowth is ‘excessive bacteria in the small intestine’.’ When bacteria are introduced to the small intestine, by-products, such as short-chain fatty acids and, gas, and other products are produced. The small intestine is not adapted as well as the large intestine to deal with these by-products, so pain and discomfort often result.
Lastly, Bloating is also associated with several other gastrointestinal conditions like IBS and lactose malabsorption.