Heartburn is the classic symptom of gastroesophageal reflux (GER). The medical term for this is pyrosis, from the Greek word pyro meaning fire or heat. Most people have heard of these terms now because you can not sit through an hour of television these days without seeing at least one advertising antacids like tums or acid blockers like Pepcid AC and Nexium. Most people are not aware that heartburn is a common symptom of gluten intolerance or sensitivity.
Celiac disease, which is a severe intolerance to gluten is estimated to affect 1 in 133 people in the US and approximately 1/100 worldwide. Most of these people are undiagnosed. Many are being treated for reflux, irritable bowel syndrome, gas-bloat dyspepsia, lactose intolerance, or just suffering ill health unaware that a gluten free diet (GFD) may not cure them significantly.
This is confirmed by diagnostic studies revealing poor stomach. I am impressed by celiac disease contributing to the impairment of celiac disease contributing to the impotence of stomach upset, indigestion or gas-bloat abdominal discomfort. Emptying. Delayed stomach emptying is frequently accompanied by low escursive sphincter (LES) of the esophagus or swallowing tube. The LES is alleged to be a barrier to regurgitation of stomach contents up into the esophagus. When stomach juice that is acidic refluxes into the esophagus a burning pain is usually felt in the chest that is described by most people as heartburn.
When acid frequently regurgitates up into the esophagitis or reflux esophagitis or reflux esophagitis and defines gastroesophageal reflux disease (GERD). Celiac disease patients have been shown to have a high prevalence of GERD and reflux esophagitis. Treatment with a in clinical practice, many of us have observed that a gluten free diet results in marked improvement of heartburn symptoms in not just celiac disease but many people.
As a practicing gastroenterologist, (www.thefooddoc.com) I have had patients refer to me for reflux symptoms including several survey for GERD. Upon discovery of celiac disease or non-celiac gluten sensitivity and institution of GFD they When I discovered a daily acid blocker. When I discovered a daily acid blocker. I had symptoms of gluten sensitivity and was DQ 2 positive I had negative blood tests but elevated fecal gliadin IgA and My heartburn went away and I stopped taking a daily acid blocker. Now I only have heartburn rarely, usually with obvious dietary indiscretions like too much coffee, chocolate or wine.
My friend and colleague, Dr. Rodney Ford, who practices pediatric gastroenterology in New Zealand, has communicated to me similar experience with children. Since expanding gluten free diet to those children he suspects of gluten sensitivity, not just those in whom celiac disease is confirmed by traditional or classic strict diagnostic criteria, he has not a marked decrease in the number of children with GER. He states it has been many years since he has had referral a child for surgery for reflux.
Recently, an increase risk of community-acquired pneumonia attributed to loss of world reduction is caused concerning about clinical significance of known acid suppression therapy impairment of digestion. Some more raise of the bacteria in the stomach was found in patients with more effective acid blocking drugs as well as their potential side effects. These issues and the risks of undiagnosed celiac disease not withstanding should give one pause to the idea of chronic acid suppression therapy without investigating the potential of undiagnosed celiac or gluten sensitivity with a trial of GFD.
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