GERD (gastroesophageal reflux) is a condition that can affect both adults and children and is caused by overproduction of stomach acid or by the backflow of acid from the stomach into the esophagus. It is also commonly called heartburn, reflux, gastritis, and acid reflux. GERD presents as a burning sensation in the upper abdomen, typically at the level of the heart. It can feel like food is stuck behind the breastbone or create an acidic burp-like feeling. Often GERD is associated with coughing, wheezing, hiccups, sore throat, and bringing up food. There is also a direct relationship between GERD and vitamin B12 deficiency.
The good news is that acid reflux and B12 deficiency can often be controlled by making better food choices or supplementing. While there isn’t an official GERD diet, some foods are definitely more likely to trigger acid reflux. This article explains which foods might cause heartburn and which ones can help keep your stomach feeling good, and which supplements can help GERD and prevent nutritional deficiencies.
GERD and vitamin B12 deficiency
People with gastro-esophageal reflux disease, chronic heartburn, or peptic ulcers have a higher risk of developing vitamin B12 deficiency, also known as pernicious anemia.
To absorb vitamin B12 from food, the body relies on digestive enzymes and an factor called intrinsic factor made in the stomach. Without these acids, vitamin B12 cannot be absorbed in the lower part of the intestine and would simply pass through the digestive system unused.
This is true for patients who use certain antacid medications to treat chronic acid reflux, stomach ulcers, heartburn, or esophageal strictures. These medications block the production of stomach acids, which also blocks the digestion of vitamin B12. This can lead to vitamin B12 malabsorption.
Which antacid medications cause B12 deficiency?
Before this list, its important to remember that this does not mean that taking these medications should stop. Instead, individuals using the following antacid medications for a long time should have their vitamin B12 levels checked regularly:
- Omeprazole (Prilosec)
- Esomeprazole (Nexium)
- Lansoprazole (Prevacid)
- Cimetidine (Tagamet)
- Famotidine (Pepcid)
- Ranitidine (Zantac)
If left untreated, a vitamin B12 deficiency can cause serious nerve damage, memory problems, and a higher risk of heart attacks and strokes. Pernicious anemia, which was once a deadly disease, became treatable after scientists discovered the benefits of vitamin B12.
How do I know if I have vitamin B12 deficiency?
The first signs of vitamin B12 deficiency indicate that levels have already fallen to a dangerously low point. It is essential to begin treatment right away.
A blood test can help detect a vitamin B12 deficiency, but it is better to start taking supplements early rather than waiting for a diagnosis. Vitamin B12 is safe to take in any amount, so there is no risk of taking too much. However, delaying treatment could lead to negative health effects if vitamin B12 levels remain low for too long.
What can trigger acid reflux?
Figuring out which foods cause acid reflux can be helpful. A food diary kept for at least a week can show what was injested, and any symptoms that followed. While some foods are known to trigger acid reflux, this doesn’t happen to everyone. In some situations, acid reflux might not be linked to specific foods at all but to other causes. Sometimes, it may even be a mix of certain foods and other triggers.
Several eating habits can make these symptoms worse:
- Eating late at night, especially within two hours of going to bed
- Eating right before physical activity
- Having very large meals
- Eating too quickly
- Being overweight, as even a small amount of weight loss can help improve symptoms.
- Drinking a lot of liquids during meals
- Cigarette smoking can also contribute to overproduction of stomach acid
After eating, staying upright is better than lying down because gravity helps keep the stomach valve closed, preventing food from coming back up. Sitting, standing, or walking after meals can reduce the chances of acid reflux.
Foods to avoid with acid reflux
Some foods are known to make acid reflux worse for certain people. An acid reflux diet doesn’t mean cutting out all these foods, as triggers can vary from person to person. However, the following foods are often linked to reflux symptoms and might be worth avoiding if they cause issues:
- Chocolate
- Mint
- Tomatoes
- Onions
- Garlic
- Citrus fruits like oranges and lemons
- Caffeinated and carbonated drinks
- Coffee
- Alcohol can also make things worse by relaxing the valve that keeps stomach acid in check and increasing acid production.
People with GERD should also avoid fatty foods. Fatty foods are harder to digest and stay in the stomach longer. This can cause the stomach acid to build up and weaken the valve to the esophagus, leading to heartburn.
Types of food that commonly trigger GERD symptoms
Acidic foods
The pH scale, often taught in science class, measures how acidic or basic something is. A lower pH means higher acidity. Eating or drinking acidic foods and beverages can irritate the esophagus and affect the stomach valve, which may lead to GERD symptoms. Acidic foods can cause the stomach to produce more acid, which might make GERD symptoms worse.
Spicy foods
Capsaicin, the compound that makes spicy foods hot, slows digestion and puts extra pressure on the stomach valve. Spicy foods can also irritate the esophagus, making heartburn symptoms worse. Also, many spicy dishes have acidic ingredients, such as tomatoes and onions, which can add to the problem.
Foods to eat with acid reflux
There aren’t any specific foods that can cure heartburn, but eating a healthy diet can help lower the chances of it occurring.
Eating foods high in good bacteria called probiotics, ot taking a high quality probiotic supplement like the Gut Pack may also help with GERD symptoms, but results can differ from person to person. A review of 13 studies found that probiotics improved issues like heartburn, regurgitation, nausea, stomach pain, and gas. Another study focused on children with GERD and found that those who took both a proton pump inhibitor (PPI), like Prilosec, and a probiotic had fewer digestive problems compared to those who didn’t.
Leaner meat options like chicken, fish, and low-fat cuts of beef or pork are less likely to cause acid reflux. Cooking methods such as grilling, broiling, or baking are better than frying to keep fat levels low.
Vegetables are another good choice because their fiber can reduce stomach acid and improve digestion. Better digestion can help prevent heartburn from happening in the first place.
Non-citrus fruits, like berries, and melons, are also helpful. These fruits are less acidic, which can calm stomach acid and reduce the chances of acid reflux. Plus, they are usually high in fiber.
Whole grains are great for gut health because they’re full of fiber. Examples include oatmeal, brown rice, and whole-wheat bread. Beans and lentils are also high in fiber and less acidic, which can help with stomach acid. Dairy can even help soothe the stomach by coating it and reducing irritation from acid. Foods with good bacteria, such as yogurt, can also be beneficial.
How to get rid of acid reflux naturally
An acid reflux diet means removing certain foods from a person’s meals for one or two weeks to see if their symptoms improve. If the symptoms go away, they can slowly add these foods back, one at a time, to figure out which ones might be causing the reflux. If the symptoms return, possibly due to other triggers, they may need to remove the problem foods again until the symptoms calm down.
What medications are prescribed for GERD?
There are many types of prescription medications that target GERD including Nexium, Prilosec, Prevacid, Zantac and Antacids. What you may not have known is that long term use of these medications affects the absorption of vitamin B12 and over time causes the body to be deficient in B12.
How common is B12 deficiency with GERD?
According to research, there is a 65% increase in the risk of vitamin B12 deficiency if you are taking proton pump inhibitors like Nexium and Prilosec. Stomach acid is essential in the absorption of B12, and this is the reason that GERD sufferers are deficient in this important vitamin, but don’t fret, it is easy to replenish this vital molecule.
Vitamin B12 is available over the counter in most pharmacies and health food stores. It is available as a sublingual tablet that dissolves under the tongue and also as an injection. A good quality multivitamin containing B12 can also help replenish levels, such as the His Essentials Pack and the Her Essentials Pack.
FAQs
What blocks B12 absorption?
Intrinsic factor is a protein made in the stomach that helps the body absorb vitamin B12. When you eat foods with B12, the vitamin attaches to intrinsic factor, and this combination gets absorbed in the small intestine. Without intrinsic factor, the body can’t absorb enough B12, which may cause a deficiency. Digestive problems like celiac disease, Crohn’s disease, or gastritis can affect how well your body absorbs nutrients, including B12. Surgeries involving the stomach or intestines can also reduce the amount of intrinsic factor the body makes.
What vitamins does omeprazole deplete?
Omeprazole (contained in Nexium and Prilosec) is widely used to help people experiencing heartburn and gastric refulx. Its use can lead to the depletion of several essential nutrients, including vitamin B12, calcium, iron, magnesium, and zinc.
Are there any facial signs of B12 deficiency?
A deficiency in vitamin B12 can cause noticeable changes in skin color, such as pale skin and yellowing, known as jaundice. This happens because the body cannot produce enough red blood cells (RBCs) without sufficient vitamin B12. As a result, the skin may appear pale due to the lack of RBCs. Additionally, megaloblastic anemia, linked to a B12 deficiency, can weaken RBCs, causing them to break down faster than normal. When the liver breaks down these weakened RBCs, it releases a substance called bilirubin. This brownish pigment is what gives the skin a yellowish tone, leading to the development of jaundice.
Can I live normally with GERD?
Living with GERD is manageable, but many people find that acid reflux symptoms can disrupt their daily lives. Seeking help from a healthcare professional when experiencing GERD and vitamin b12 deficiency is crucial to help manage symptoms so they do not interfere with day-to-day tasks.
Can you get rid of GERD permanently?
Yes, GERD can be treated and possibly cured for good, but it takes sticking to the treatment plan and making long-term lifestyle changes. Even if the symptoms go away, GERD can come back if you return to old habits.
Does water help acid reflux?
Drinking water can help relieve heartburn, but only if done the right way. Sipping small amounts of water during meals can help break down food and move it through the body more easily. However, drinking large gulps of water during meals can actually make heartburn worse. Too much water at once can fill up the stomach, causing discomfort and putting extra pressure on the muscle that keeps acid from coming up into the throat.
What is commonly mistaken for GERD?
Esophagitis is a condition where the esophagus becomes inflamed due to factors like infections, allergies, or irritation from medications. Symptoms often resemble those of GERD and may include pain while swallowing, heartburn, and nausea. Another related condition is peptic ulcers, which are painful sores that form in the lining of the stomach or the upper part of the small intestine (duodenum). These ulcers can cause burning stomach pain, bloating, and indigestion, and their symptoms are sometimes mistaken for heartburn caused by GERD. Gallbladder issues, anxiety, and cardiac issues can also sometimes be misdiagnosed as GERD.
What is hiatal hernia pain like?
A hiatal hernia occurs when the upper part of your stomach pushes through an opening in the diaphragm. While many individuals with a hiatal hernia don’t experience any symptoms, those who do often deal with issues related to acid reflux. Common symptoms include heartburn, a burning sensation in the chest after eating, and chest pain that may feel like angina but isn’t related to the heart. Other symptoms include indigestion, feeling full quickly, burping, regurgitation of food or acid, difficulty swallowing, and a feeling of a lump in the throat. Acid irritation can also lead to a sore throat and hoarseness.
