We have long known that a diet which severely reduces high carb processed foods and emphasizes vegetables, nuts and seeds, grass fed meats, seafood, eggs, organic dairy and some fruit was a reliable cure for acid reflux disease. This is our first line treatment and usually is all that’s needed. The confusion about “fatty foods” causing reflux probably arose because foods like pizza, donuts, chips, fries etc…. often cause reflux. What’s common to all of these foods? They are basically processed carbs soaked in fat and like so much of the dietary confusion in our culture, the fat was vilified and the carbs were ignored. So while all of the guidelines about GERD recommend “lifestyle changes” as first line treatment, they do not give the correct dietary advice and almost everyone ends up on the purple pill. While not having large randomized controlled trials to confirm the benefit of this diet plan in reducing reflux, I’m comfortable with many years of personally observed benefit for several reasons:
1. The recommended diet is made up of “whole” foods with nutrient content not significantly changed from their natural state. It’s easy for me to accept that our bodies are designed to function very well on foods provided by our Creator.
2. Folks become healthier in every aspect (not just reflux reduction) when they eat these nutrient dense foods.
3. Helping folks find relief through natural means is consistent with basic medical ethics: “First do no harm“. That cannot be said for the knee jerk overuse of meds which carry the risks I’ve previously described.
What about the patient who will not readily embrace the diet, who embraced it yet still has symptoms or who is on a PPI and can’t get off it due to rebound symptoms? That’s where, as previously mentioned, I use apple cider vinegar and probiotics as a supplement to diet advice. It’s a folk remedy and arguably “alternative” but does that make it nutty? Will discuss on Wednesday.