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Heartburn: The Food Allergy Connection?

Heartburn: The Food Allergy Connection?

Prior to first losing weight and second going to a paleo lifestyle (in that order – lost more weight once paleo, but it all started just as a diet) I had to carry Tums around with me everywhere. I ALWAYS had heart burn! This is an excellent article on how paleo can impact this condition…
Heartburn: The Food Allergy Connection?

Acid-base balance When most people think of heartburn, they think about acid reflux and gastroesophageal reflux disease (GERD). The typical explanation for heartburn is that acid escaping the stomach and traveling up into the esophagus causes the pain, and the typical treatment is to somehow reduce stomach acid levels, either by over-the-counter antacids or by stronger drugs like proton pump inhibitors (PPIs).

Paleo approaches to acid reflux have been pretty critical of lowering stomach acid as a therapy, mostly because the human stomach is supposed to be acidic. Stomach acid is important for proper digestion; it’s supposed to be there, and if it stays in the stomach, it doesn’t cause heartburn at all. The problem is not the existence of acid; it’s acid getting up into the esophagus, where it’s not supposed to be.

There are a lot of factors that affect acid reflux, including physical pressure from obesity or pregnancy, tobacco smoking, meal timing, and posture. Various different lifestyle interventions like weight loss can help. Chris Kresser has also written a lot about a theory that GERD is actually caused by low stomach acid and weak digestion that puts pressure on the esophageal sphincter; you can read about it here .

But heartburn as a symptom doesn’t necessarily prove that acid reflux or GERD is the problem . Esophagitis, or inflammation of the esophagus, doesn’t only come from acid reflux – it can also be an inflammatory immune reaction related to an allergic response.

GERD, Eosinophilic Esophagitis, and Food Allergies

GERD is one cause of esophagitis, but there’s another that can overlap with GERD: eosinophilic esophagitis (call it EE for short, because that’s really a mouthful). EE is a form of esophagitis with an immune/allergic component. It can have symptoms that look like GERD, but it’s not the same disease. This study goes over some of the differences: EE is typically more common in men than in women, and it tends to affect younger people.

Difficulty swallowing is more common in EE (63% of patients) than in GERD (28% of patients); heartburn is more common in GERD (53% of patients) than in EE (20% of patients).

Asthma is more common EE than in GERD.

Patients with EE have various physical abnormalities of the esophagus that aren’t present in patients with GERD.

The difference is important, because EE is an allergic disease and many patients with EE don’t respond to proton pump…  Click here to view original article Heartburn: The Food Allergy Connection?

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