Many individuals experience both acid reflux (GERD) and Irritable Bowel Syndrome (IBS) concurrently. While these gastrointestinal (GI) disorders were once considered separate medical issues, emerging research suggests they might be facets of the same underlying disease process. Managing symptoms can be particularly challenging for those with both conditions. This article will explore the basics of GERD and IBS, and discuss management strategies, including overlapping techniques that can help alleviate both conditions.
Understanding GERD and IBS
GERD (Gastroesophageal Reflux Disease)
GERD is a prevalent, chronic condition characterized by upper abdominal discomfort, acid reflux, heartburn, sour stomach, difficulty swallowing, and/or a sensation of a lump in the throat. It arises when the lower esophageal sphincter (LES), located at the top of the stomach, relaxes inappropriately or excessively. Acid, a natural component of stomach contents essential for food digestion, irritates the esophagus, leading to pain and burning.
IBS (Irritable Bowel Syndrome)
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that affects approximately 10-15% of American adults. There is no universal treatment option to help alleviate IBS symptoms such as stomach pain and cramps, excessive gas and bloating. Symptoms can be drastically impacted by diet, potentially triggering IBS flare-ups.
Overlap Between GERD and IBS
Approximately 40% of the world’s population suffers from a functional GI condition, making the co-existence of IBS and GERD well-recognized. The pathophysiology involved in causing GERD is thought to be similar to what triggers IBS.
Lifestyle Modifications for Managing GERD and IBS
Several lifestyle adjustments can positively impact both GERD and IBS symptoms.
Read also: The ultimate guide to acid reflux cooking
Stress Management
Stress is a known trigger for various medical problems, exacerbating GERD and IBS symptoms.
Adequate Sleep
Prioritizing sufficient sleep is crucial for maintaining overall health, bolstering the immune system, and potentially reducing the severity of GERD and IBS symptoms.
Regular Exercise
Exercise activates intestinal function, promotes a healthy lifestyle, and reduces stress, all of which can benefit individuals with GERD and IBS.
Smoking Cessation
Quitting or reducing smoking can significantly alleviate GERD symptoms.
Weight Management
Maintaining a healthy weight or losing weight if overweight can reduce GI discomfort associated with both conditions.
Read also: Learn about soothing symptoms with food
Mindful Eating
Eating slowly and thoroughly chewing food aids digestion. The more food is broken down by enzymes in the mouth, the less work the stomach acid has to do. Taking sips between bites and chewing more thoroughly can curb excessive acid production.
Portion Control
The amount of food consumed at each meal is also important.
Avoid Tight Clothing
Wearing loose-fitting clothing can minimize GI discomfort.
Modifying Sleep Habits
Adjusting sleeping positions and habits can help reduce acid reflux during sleep.
Dietary Strategies for GERD and IBS
Diet plays a crucial role in managing both GERD and IBS. While individual triggers vary, some general guidelines can be helpful.
Read also: The Hoxsey Diet
Identifying Trigger Foods
Many reported 'trigger foods' can exacerbate GERD symptoms. Keeping a food diary to record reactions to specific foods can help identify personal triggers. Common triggers for IBS may overlap with those for GERD, such as gas and bloating, which can trigger GERD symptoms due to intestinal distention.
Low-FODMAP Diet for IBS
The low-FODMAP diet has shown potential in helping people with IBS. FODMAP stands for "Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols. Researchers discovered that the small intestine does not absorb FODMAPs very well. They increase the amount of fluid in the bowel. They also create more gas. That's because bacteria in the colon they are easily fermented by colonic bacteria. The increased fluid and gas in the bowel leads to bloating and changes in the speed with which food is digested. This results in gas, pain and diarrhea. The low FODMAP diet involves limiting foods high in these carbohydrates, as they can be poorly absorbed in the small intestine, leading to increased fluid and gas production in the colon, potentially triggering IBS symptoms. Work with a registered dietitian to ensure the diet is safe and healthy.
Fiber Intake
Fiber may improve constipation in IBS because it makes stool soft and easier to pass. To help your body get used to more fiber, add foods with fiber to your diet a little at a time. Too much fiber at once can cause gas, which can trigger IBS symptoms. Soluble fibers that are snack-worthy include cantaloupe, honeydew, nut butters, and baby carrots.
Gluten Avoidance
Avoiding foods that contain gluten may improve IBS symptoms. Foods that contain gluten include most cereal, grains, and pasta, and many processed foods.
Managing Acid Reflux Through Diet
Foods that are low in acidity are often helpful for acid reflux. The best sweet snacks for GERD are often fruits that are naturally low in acidity.
Foods to Limit or Avoid for GERD
- High-fat foods: Fatty red meat and other high-fat foods overstimulate the digestive system and can be more difficult to digest.
- Acidic foods: Highly acidic foods can worsen acid reflux symptoms.
- Spicy foods: Spicy foods can trigger heartburn.
- Carbonated beverages: These can increase stomach pressure.
General Dietary Recommendations
- Cooked vegetables: Cooked vegetables are easier to digest than raw vegetables.
- Limit dairy: Lactose and casein found in dairy can be a trigger for patients with IBS.
- Hydration: Staying adequately hydrated is important for overall digestive health.
The Role of Snacking
Snacking can be a vital part of your diet, and when utilized appropriately, snacks can help to reduce or prevent GI symptoms. Snacks provide smaller portions of food throughout the day than meals, they are easier for the GI system to break down.
Mindful Snacking
Snacking gets a bad rap, especially for people living with GI issues. But when done mindfully, snacking can actually support digestion and help meet your nutritional needs. It can also prevent you from getting overly hungry (which can lead to overeating and symptom flare-ups), and can even promote gut motility throughout the day.
Best Snack Choices
Snacking on foods that are easy to digest, such as complex carbs and lean proteins, can help keep reflux symptoms in check. Any snack that is naturally low in acidity and soothing for the stomach is a great option.
When to Snack
Avoid eating too close to meals, as this can overload your digestive system. In an ideal world, snacks should be enjoyed a few hours before or after a meal.
Medical Consultation and Treatments
Professional Guidance
Working with a dietitian is of great benefit when dealing with any complex disorder of digestion. Their expertise may prove invaluable.
Over-the-Counter (OTC) Treatments
Medical consultation with a professional may lead to suggestion of over-the-counter treatments, such as probiotics, and/or supplements.
Prescription Medications
Consultation could also result in prescription of a new medication. It is important to avoid self-diagnosis or excessive use of OTC treatments.
Personalized GERD Management
Clinicians should emphasize safety of proton pump inhibitors (PPIs) for the treatment of GERD. Clinicians should provide patients presenting with troublesome heartburn, regurgitation, and/or non-cardiac chest pain without alarm symptoms a 4- to 8-week trial of single-dose PPI therapy. With inadequate response, dosing can be increased to twice a day or switched to a more effective acid suppressive agent once a day.