The occurrence of acid reflux and its subsequent treatment is not something people generally associate with food allergies. But research has shown that there is in fact a connection.
Acid reflux occurs when food that has been eaten travels back from the stomach and into the throat and mouth. With normal eating, during swallowing, a flap in the upper part of the esophagus (a tube that connects the mouth and throat to the stomach) opens to let food down, then closes to prevent food from coming back up. There is another flap at the bottom of the esophagus that allows food to enter the stomach and prevents it from coming back out. When either flap is not working correctly, food and digestive enzymes can travel back up from the stomach and into the throat and mouth causing irritation and other issues. Severe acid reflux is called Gastroesophageal Reflux Disease, or GERD, and is a digestive disorder that occurs two or more times a week over an extended period of time. Medical professionals are not sure what causes it, but about 25 percent of American children suffer from GERD. It can be a serious problem, and though treatment is readily available, certain treatments may cause allergic reaction to foods.
GERD Symptoms, Complications and Treatments
The main symptoms of GERD include heartburn, difficulty breathing, wheezing, frequent belching, nausea, stomach acid taste in the throat, a feeling of food in the throat, cough and/or hoarseness. Symptoms are typically worse when lying down.
Complications from GERD can include an inability to gain weight, inflammation in the throat or esophagus, trouble breathing and other respiratory problems.
GERD is often treated without medication. In those cases, children are advised to eat smaller, more frequent meals, and eliminate spicy, high fat, acidic foods and carbonated drinks. Other treatments that avoid medications include sleeping with an elevated head, reducing stress and not eating large meals before vigorous activities and sports.
Generally, three primary types of medications are used to treat GERD when non-medicinal treatment doesn’t work:
- Antacids, which neutralize stomach acid (Mylanta and Milk of Magnesia)
- Histamine–2 blockers, which prevent the production of stomach acids (Pepcid and Zantac)
- Proton Pump Inhibitors, which reduce stomach acid (Nexium, Prilosec and Prevacid)
The Link Between Stomach Acid and Food Allergies
Although preventing or reducing the production of stomach acid may be helpful at treating GERD, research has shown that reducing stomach acid too low is linked to an increase in Immunoglobulin E (IgE) production. With food allergies, IgE antibodies are produced by the immune system to attack the allergen and ultimately cause allergic reaction.
The immune system’s job is to protect us from illness, infection and disease. IgE plays an important role in immune system function by entering cells and binding to proteins. When the immune system overreacts, a large amount of histamine is released in an attempt to protect our body from attack. Histamine is a key defender against “foreign bodies” that could cause us harm. It fights infection and disease but also causes inflammation, which creates many symptoms of allergy including shortness of breath, itchiness, swelling and hives. Almost 70 percent of the body’s immune cells are located in the intestinal tract. Studies have shown that certain changes in the intestinal tract affect immune function, histamine and IgE production and, thus, allergic reaction.
In fact, a 2013 study published in the Journal of Pediatric Allergy and Immunology observed a link between changes in stomach acid levels and allergic reaction. In the study, a group of 4,275 children took acid reducing medications for one year. Another group of 4,275 did not take acid reducing medications during the same timeframe. The study revealed that the children taking acid reducing medications were 367 percent more likely to develop food allergies than the children who were not, regardless whether they suffered from GERD. Researchers observed that pH levels increased when stomach acids were reduced. Higher pH levels meant less acid in the stomach. Less acid in the stomach led to an increase in proteins binding to IgE antibodies and, thus, an increase in food allergic reaction. Researchers also noticed that slight changes in pH levels created substantial increases in IgE production. The implication is that the level of stomach acid present is linked to food allergy, not complications from GERD. Numerous additional studies have shown an increase in IgE levels after taking acid reducing medications for three months. The risk of developing food allergy also increased.
Although research shows there is a link between acid reducing medications and developing a food allergy, scientists do not know how much of a food protein must remain undigested to induce a food allergy. If you or your child suffer from GERD, you may want to talk with your doctor about treatments and whether they may induce or aggravate food allergies.
Please share your experiences with GERD, GAS medications and allergies in the comments below.