5.02.2013

Fasting Away Heartburn

Day 27, Fast Day #13

Ever since I turned 22, it seems like I have been at war with my GI tract. I am not sure if this was due to some gene switching on or off, or if years of stomach abuse caught up with me in college. Perhaps it might be a long-term effect of eating the 15% butterfat University of Maryland ice cream. (For me, the Fear the Turtle flavor is a spiritual experience, so if you ever are in Maryland, make the trip to eat at the dairy's ice cream.) Either way, it has not been a fun war and I lose to my gut most of the time.
Where my freshman 15 (lbs) came from, but probably not where all of my tummy troubles come from. Genetics is more likely, especially in the case of my lactose-intolerance.

One of continuous digestive wars that is being waged in my body is an acid attack. I have regularly experienced heartburn and acid reflux (gastroesophageal reflux disease or GERD) in some combination for almost a year. I blame the stress of wedding planning. 

Don't get me wrong, I am well aware that a lot of the foods I love to eat are commonly labeled as "heartburn triggers." All the yummy spicy, garlicky, oniony, citrusy, minty, fatty, and chocolatey ones I love are labeled "triggers." Plus I drink caffeine and alcohol, also supposedly heartburn triggers. However, what I have learned from researching heartburn for this blog post is that the first-line recommendations for acid reflux might be the result of medical practice being trigger happy.

Contrary to what one would think after reading through lists of foods and drinks to avoid if you have heartburn (like this one), there isn't an large or overwhelming body of evidence showing that quitting these foods or drinks will help with GERD even if they influence stomach pH (according to this meta-analysis of common heartburn first-line recommendations). Basically everything I was told or have read about heartburn is based on little or no evidence.

This doesn't really surprise me, since I have tried removing all those yummy foods and drinks by going on a BRAT diet to try to solve my heartburn. Removing "trigger foods" did NOT help me at all. I am sure there are many people that benefit from not eating heartburn trigger foods for one reason or another. I also know there are foods I know make my heartburn worse. The thing is, I don't have causal heartburn. My heartburn is already there whether I ate or not.

So, I still had acid indigestion without any trigger foods while on a BRAT diet and would still wake up early in the morning because of horrible stomach pain. I tried the usual antacids, OTC medications, and herbal remedies (peppermint and papaya) to deal with my sour stomach. Using omeprazole daily for a bit was my only relief from the stabby, debilitating heartburn pain at my worst point early last December. If I skipped a day, I was in trouble. No I did not have an ulcer---this was really bad heartburn.

The good news is my heartburn has improved since I started alternate day fasting and I have not needed to take any daily heartburn medication since. I still chew some Tums as a source of calcium with a meal, if I am lacking it that day, but no omeprazole and only ranitidine on occasion. The heartburn hasn't gone away completely, but it is so much better than it was. I have heard from other intermittent fasters that their heartburn worsened from fasting though, so fasting doesn't seem like a universal miracle treatment for heartburn or acid reflux.

I haven't found any specific research published on alternate day fasting (or just fasting) and its effect on acid indigestion, however, I have two theories on why ADF is helping with my stomach acid issues:

Research shows that at least in an overweight population (which can describe me right now), weight loss is an independent factor in reducing acid indigestion. My Body Mass Index (I am not claiming BMI is the most accurate method of determining healthy weight, I am using it as a unit of measurement) has dropped about 2.2 points in the last 27 days, including the additional pound I lost yesterday for 13 total pounds lost. Perhaps even just losing this amount of weight from ADF has pleased my stomach acid gremlins.

My second theory is that I am producing less stomach acid because I am eating smaller meals and eating less often ("shrinking my stomach" or at least its capacity). In the same meta-analysis where Kaltenbach looks at the body of research around first-line heartburn remedies, she emphasizes that acid exposure increased with volume of food, whether it is has high or low fat content. Controlling my food portions and being conscious of servings sizes due to starting ADF may also be helping with my heartburn problems.

Even though I am not entirely sure why my heartburn has lessened or if it related to intermittent fasting, I am happy about it. On that note I hope everyone has a great weekend and if you celebrate Cinco de Mayo, like I will be, have fun!

1 comment:

  1. I am sure there are many people that benefit from not eating heartburn trigger foods for one reason or another. I also know there are foods I know make my heartburn worse. www.incusis.com

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