Low carb can cure reflux disease

Heartburn – caused by reflux disease – is super common, millions of people suffer from it. Many people take medication for it every single day to reduce the symptoms. What if many of these people could cure the disease with a dietary change?

An earlier small study tested a LCHF diet on a few people with this problem, and they got significantly better. Even the pH in their esophagus improved, so it was not just placebo.

Now another, slightly larger, study has tested this idea again. Not only does it find that carbohydrates, sugar and the glycemic load of the diet was associated with reflux disease. They also test what happens when the participants go on a lower carb diet. The result?

chartBig improvements

Incredibly enough, it seems like all the women in the study were able to get off their reflux (GERD) medications… See the chart to the right.

Has a low-carb diet improved your reflux symptoms? Please let me know in the comments below.

More

A low-carb diet for beginners

The study

AP&T: Dietary carbohydrate intake, insulin resistance and gastro-oesophageal reflux disease: a pilot study in European- and African-American obese women

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240 comments

  1. lisa
    After being on omeprazole for 8 years and suffered laryngitis twice through GERD. The keto diet got me off medication , no more unpleasant reflux or waking up in the middle of the night choking on acid! The only cure I’ve found to work . Thank you
  2. Amy
    I've had reflux everyday for 6 months and nothing seemed to help and the medication my doctor put me on stopped working after a month. I've been on keto 3 weeks and I've not had reflux once, just the occasional heartburn after eating out. I have never felt better!
    Reply: #203
  3. Kerry Merritt Team Diet Doctor

    I've had reflux everyday for 6 months and nothing seemed to help and the medication my doctor put me on stopped working after a month. I've been on keto 3 weeks and I've not had reflux once, just the occasional heartburn after eating out. I have never felt better!

    That's great news, Amy! Thanks for sharing!

  4. Vicki B
    This was absolutely the case with me. I’m intolerant to dairy so avoid that but a low carb (not Keto) diet saw me come off Gerd medication within 2 weeks. I have to adhere to it. Any deviation and it returns.
    Reply: #227
  5. Ellen
    I have had GERD for almost 20 years. I have a hiatal hernia and Barrett’s esophagus. I eliminated sugar, refined carbs, caffeine, tomato, chocolate, mint, alcohol, and recently even decaf tea. I eat a very low carb diet, and I still have to take omeprazole because my reflux still occurs frequently, though it does not burn. I cannot imagine what food I can eliminate. I eat only meat, eggs, cheese, water, fish and seafood, with one or two servings of vegetables (or avocado) per day. I now have osteoporosis, so I am extremely concerned. I don’t know what to do. I would rather not be taking omeprazole, and I don’t want to have surgery on my esophagus.
    Replies: #206, #210, #242
  6. Kerry Merritt Team Diet Doctor

    I have had GERD for almost 20 years. I have a hiatal hernia and Barrett’s esophagus. I eliminated sugar, refined carbs, caffeine, tomato, chocolate, mint, alcohol, and recently even decaf tea. I eat a very low carb diet, and I still have to take omeprazole because my reflux still occurs frequently, though it does not burn. I cannot imagine what food I can eliminate. I eat only meat, eggs, cheese, water, fish and seafood, with one or two servings of vegetables (or avocado) per day. I now have osteoporosis, so I am extremely concerned. I don’t know what to do. I would rather not be taking omeprazole, and I don’t want to have surgery on my esophagus.

    So sorry, Ellen! Sometimes dairy can also be a trigger. You may want to try eliminating one thing at a time to see if there is any improvement. And we certainly encourage you to work with your doctor regarding your medications.

  7. Michael Tucciarello
    Kerry Merritt, The reason why you still have it is because your still eating red meat, eat only greens if you are eating veggies, and it depends on what kind of seafood you are eating. If you can fix all that, then I think you are on the road to recovery, It takes work to get real results but its worth it.
    Reply: #233
  8. Helen Baxter
    Kerry Merritt. I'd be very wary of cutting out dairy, as the advice above suggests, until you've spoken with your consultant re the current status of your osteoporosis. Cutting out this source of calcium is a massive deal and you need medical advice on this to ensure your osteo doesn't worsen as a result. Perhaps switch down to low fat dairy in the meantime, if you haven't tried that already, though if you're this far along I suspect you probably have tried it. Not easy managing reflux when you have more than one medical condition to consider, I have a close relative in the same position. Wishing you the very best.
    Reply: #209
  9. Helen Baxter
    Sorry this should have been addressed to Ellen, read the wrong name in post.

    Kerry Merritt [amend - Ellen]. I'd be very wary of cutting out dairy, as the advice above suggests, until you've spoken with your consultant re the current status of your osteoporosis. Cutting out this source of calcium is a massive deal and you need medical advice on this to ensure your osteo doesn't worsen as a result. Perhaps switch down to low fat dairy in the meantime, if you haven't tried that already, though if you're this far along I suspect you probably have tried it. Not easy managing reflux when you have more than one medical condition to consider, I have a close relative in the same position. Wishing you the very best.

    Reply: #220
  10. Liz
    Hi Ellen, I’m sorry you’ve been struggling so much, I can empathise as I have had reflux & gastritis for over 15 years. I’ve been navigating my ways through so many different ways of eating for years. I know what works for one person may not work for another but I wanted to share in case it helps:

    I am not ‘cured’ and am still a work in progress but I realised I have Histamine Intolerance. On top of the daily/ nightly heartburn & reflux, some foods in particular would either sit in my stomach and make me nauseous & awful reflux or, at worst, cause me to vomit shortly after (mushrooms, squid, very ripe bananas, red wine, beer, tinned fish). So I follow the SIGHI Histamine Food List but, though they list them as low histamine foods, I have minimal (if any) of the higher carb foods like corn, rice, potatoes (I will test those foods in small portions at a later date to see how I get on). No aged/fermented foods, only very young, uncultured creams/cheeses. You have to make sure meat (in particular fish) is as fresh as possible and either freeze leftovers or only cook fresh (as histamine rises in leftover foods, particularly meat/fish). So far it’s made a big difference to me. I realised that every diet that suddenly backfired contained high histamine foods (even avocado, tomatoes & strawberries are histamine producing along with aged beef, salami, mature cheeses - things I ate a lot of on low carb the first time around) so I was inadvertently loading my system up with histamine until it ‘spilled over’ & worsened my symptoms.
    Also being careful to not have too big portion sizes as it takes longer to digest so therefore increases the histamine load in your body (smaller portions are easier as far as reflux anyway). Google SIGHI histamine diet, their website has a lot of info and is totally compatible with a low carb diet if you want to stay eating this way.
    I hope this helps, I know after so many years it can become so disheartening when you try so many things to help and no one seems to have any answers, particularly doctors, & your diet becomes so restricted. It was after my last awful reaction to mushrooms that I googled and found out about Histamine Intolerance and it all started to click into place and also why sometimes some foods were ok and other times they weren’t as histamine levels fluctuate. I don’t know yet if this has fixed all of my issues long-term but so far it has made such a huge difference and makes so much sense. I hope you find what works for you x

    Reply: #219
  11. Diana
    I have acid reflux which is affecting my daily life and extremely unpleasant. Started the low-carb eating lifestyle 10 days ago and it is just not getting better. With the introduction of fats in my diet seems to have made it worse. I don’t want to come off the low-carb diet but would like to know how to deal with this. Thank you
    Replies: #212, #232
  12. Kerry Merritt Team Diet Doctor

    I have acid reflux which is affecting my daily life and extremely unpleasant. Started the low-carb eating lifestyle 10 days ago and it is just not getting better. With the introduction of fats in my diet seems to have made it worse. I don’t want to come off the low-carb diet but would like to know how to deal with this. Thank you

    Hi, Diana! Sometimes it can take a little time for healing to take place. I also suffered from acid reflux before I started keto, and it was at least 6 months or so before I was able to stop taking my medication. You may want to keep a food log to see if there are any particular foods or drinks that are triggering the reflux.

  13. Diana
    Thank you Kerry will give the food log a go.
  14. Justin
    I have been on meds for years. Eventually whatever I'm on wears off and I have to be put on a new one. I decided to try the low carb thing to try to get off my meds. I heard of rebound reflux going off meds, so when I started the low carb diet I just cut my med in half. After a week or so my reflux got kind of bad for 2 or 3 days. I was hoping it was just rebound, so I stayed on that amount and just added Tums or baking soda during that time. I decided today to go to every day and a half or every other day with my med. So far I'm doing ok. I'm very hopeful I can completely stop the meds for it. And I've lost 15 pounds! First time in years I've gotten under the 200 pound mark!
    Reply: #215
  15. Crystal Pullen Team Diet Doctor

    I have been on meds for years. Eventually whatever I'm on wears off and I have to be put on a new one. I decided to try the low carb thing to try to get off my meds. I heard of rebound reflux going off meds, so when I started the low carb diet I just cut my med in half. After a week or so my reflux got kind of bad for 2 or 3 days. I was hoping it was just rebound, so I stayed on that amount and just added Tums or baking soda during that time. I decided today to go to every day and a half or every other day with my med. So far I'm doing ok. I'm very hopeful I can completely stop the meds for it. And I've lost 15 pounds! First time in years I've gotten under the 200 pound mark!

    Check with your pharmacist for recommendations of what to do as you come off your reflux medication. They may be able to advise you on how to alleviate the symptoms.

  16. Leslee N.
    Low-carb lifestyle has completely resolved my GERD. Took Prilosec for 10+ years and ran out about the same time I started keto. Noticed right away that I had no heartburn or reflux (no rebound reflux or anything) and never renewed the Prilosec Rx.
  17. Linda
    I have suffered from GERD and acid reflux for the past one year which is also due to piling additional weight. I am also asthmatic and have nasal polyps. For the past 7 days I have eaten a low-carb diet mainly consisting of cauliflower, French beans, sugar snap peas, fresh ginger, eggs, chicken, sausages, peanuts, decaf tea, lentils, beetroot, butternut pumpkin, watermelon, sweet mangoes, carrots. I eliminated sugar, wheat, dairy. I am also not using too much spices. The nasal polyps that were visible when I raised my head have now disappeared (can't even feel them with my little finger). I am no longer blowing my nose too hard. I am not using my asthma pump (relieving inhaler) as I used to. I only use it in the morning and even routinely- before diet change I had to use the inhaler up to 5 times a day due to congestion. I still use my GERD medication but i have no symptoms of acid reflux. I sleep so well and wake up refreshed. When I am hungry in between meals I eat some little peanuts and water or decaf tea without sugar.

    I am just hoping that this is the beginning of spectacular change in my symptoms.

    Reply: #218
  18. Crystal Pullen Team Diet Doctor

    I have suffered from GERD and acid reflux for the past one year which is also due to piling additional weight. I am also asthmatic and have nasal polyps. For the past 7 days I have eaten a low-carb diet mainly consisting of cauliflower, French beans, sugar snap peas, fresh ginger, eggs, chicken, sausages, peanuts, decaf tea, lentils, beetroot, butternut pumpkin, watermelon, sweet mangoes, carrots. I eliminated sugar, wheat, dairy. I am also not using too much spices. The nasal polyps that were visible when I raised my head have now disappeared (can't even feel them with my little finger). I am no longer blowing my nose too hard. I am not using my asthma pump (relieving inhaler) as I used to. I only use it in the morning and even routinely- before diet change I had to use the inhaler up to 5 times a day due to congestion. I still use my GERD medication but i have no symptoms of acid reflux. I sleep so well and wake up refreshed. When I am hungry in between meals I eat some little peanuts and water or decaf tea without sugar.
    I am just hoping that this is the beginning of spectacular change in my symptoms.

    Linda, I am so glad to hear you are seeing such dramatic improvements in such a short time!

  19. Susie
    Oh Liz! You have just given me a lightbulb moment. Whenever I’ve had an overripe banana, or red wine I would wheeze as though I had asthma. I pointed it out to my mum and my boyfriend on a couple of occasions but we all thought it was just a weird “thing “ I had occasionally. Now I haven’t eaten a banana for years but I still have the occasional red wine and sometimes I get wheezy. Now I know from your post what it is! A histamine response! I cannot thank you enough. I never even thought of telling my doctor. I wonder what else triggers me, as I suffer from LPR? Off to google for further research.
    Reply: #241
  20. Susie
    Helen, dairy is by no means the only source of calcium in a diet.
  21. Ian
    Then I don't understand why it's worse for me on keto
    Reply: #222
  22. Crystal Pullen Team Diet Doctor

    Then I don't understand why it's worse for me on keto

    Ian, have you introduced any new foods or dramatically increased your consumption of things like sugar alcohols, dairy, etc?

  23. somme.de.toutes
    I learned this year that I have a small hiatal hernia. LC/keto resolved my GERD until I got "hooked" on heavy cream on my berries or in coffee. Also using full fat sour cream. I had noticed my GERD was back & I had a bad episode this week (vasovagal response, too low BP, elevated heartrate, fainted, etc.) because of having too much cream that day. After reading everyones' comments I think I will have lower fat sour cream and drop the heavy cream completely! Life is a process...!
  24. Ildi Varga
    For the people who react negatively to dairy, have you tried taking lactase enzyme? That helps digest the dairy, so you may better be able to tolerate it. I have had to do that as I age. And am about to start a low carb diet to try to get off my reflux medications. I too have gotten osteoporosis, and have had GERD for about 10 years. I really really hope this diet works!
  25. Charlotte
    30 years largely on some sort of GERD medication (ranitidine, omeprazole, lansoprazole, gaviscon) and now after reading The Obesity Code and taking note of ‘diet doctors’ advice I now only medicate maybe once a week (and that’s usually because of too much red wine late at night so totally self-inflicted!) This way of eating has transformed my health - using a combination of IF (24-40hrs twice a week) and LCHF eating, I am losing weight, feeling happier and more healthy AND I can have cream in my coffee! Win win!
  26. Deb M
    Your story is just like mine. After making several changes, all of my symptoms are gone. Just in case this helps, here is what worked for me:
    1) sleep with head of bed elevated.
    2) phase out medication very gradually over several weeks; there can be a significant rebound effect from these acid-reducing meds
    3) low carb diet, eliminating all types of bread, pasta, rice, etc. Whole Keto foods work well for me.
    4) eliminate dairy -- My allergist recommended a blood test that identified a significant allergy to dairy, so this was the final change that pulled it all together. I get calcium from sources such as almonds, broccoli, beans, and supplements.
  27. Timmy Van
    Same here. It's obvious to me what causes acid reflux for me now: bread, pasta, rice and too much sugar. Yes it comes back if I revert to my old nutritional habits.

    This was absolutely the case with me. I’m intolerant to dairy so avoid that but a low carb (not Keto) diet saw me come off Gerd medication within 2 weeks. I have to adhere to it. Any deviation and it returns.

  28. John Patrick
    I had palpitations also while intermittent fasting. I was following 18/6 method daily for 10 months. I stopped I.F. , resumed eating 3 meals and the palpitations went away. Now I only fast once or twice weekly at the most. Usually for 16-18hrs.
  29. John Patrick
    I ate LCHF from 2013 to 2018. I don’t recall ever needing to use antacid medicine during that time period. However, after doing some research and reading a couple of books by plant based Drs, I decided to go HCLF Whole Foods plant based. I removed meat and added back in wheat and rice on a daily basis to get full during meals. Without meat on the plate, it seemed grains and root vegetables were the next logical thing to add to be satisfied. The root vegetables don’t bother me but the grains sure have. From 2018 to now 2021, my heartburn worsened and is now full on GERD. I’ve been having chest pains and coughing/choking episodes during sleep from acid coming up my esophagus. So I recently eliminated grains/added sugar and went back to LCHF for 10 days. Best I’ve felt and slept in a few years. Then two days ago, I ate whole grain cereal at breakfast and rice and beans at dinner. I had chest pains and bad GERD symptoms for all that day and most of the next. So, it’s back to LCHF for me. No more wheat. No more added sugar.
    Reply: #230
  30. Crystal Pullen Team Diet Doctor

    I ate LCHF from 2013 to 2018. I don’t recall ever needing to use antacid medicine during that time period. However, after doing some research and reading a couple of books by plant based Drs, I decided to go HCLF Whole Foods plant based. I removed meat and added back in wheat and rice on a daily basis to get full during meals. Without meat on the plate, it seemed grains and root vegetables were the next logical thing to add to be satisfied. The root vegetables don’t bother me but the grains sure have. From 2018 to now 2021, my heartburn worsened and is now full on GERD. I’ve been having chest pains and coughing/choking episodes during sleep from acid coming up my esophagus. So I recently eliminated grains/added sugar and went back to LCHF for 10 days. Best I’ve felt and slept in a few years. Then two days ago, I ate whole grain cereal at breakfast and rice and beans at dinner. I had chest pains and bad GERD symptoms for all that day and most of the next. So, it’s back to LCHF for me. No more wheat. No more added sugar.

    Thank you for sharing your experience, John. I hope you continue to see relief from GERD.

  31. Atlanta Woods
    I’ve had a chronic cough for 9 years and I was told it was from GERD. I basically tried everything I could. The cough was debilitating at time because I coughed all day and night. I have take all sorts of medicine for GERD and nothing helped. The last thing I took was Omeprazole. I finally decided to try the Keto diet! I’ve been on the diet for 2 weeks now and I’m no longer coughing!!! I was told that weight loss would help, but I didn’t know it would help this much!
  32. Minnie Mouz
    I too have suffered from GERD and esophagitis. I suspected that wheat could be a trigger but most of my MD’s look at me like I’m crazy ( biopsy negative for celiac). My gastroenterologist put me on 80mg of omeprazole daily along with Pepsid before bedtime with no plans to reduce the dosages. I have developed osteopenia and my creatinine is slightly elevated I think from the PPI,s. My GI doc did all of these esophageal tests and didn’t do a full upper GI X-rays which includes the stomach. It was discovered finally that gastroparesis and a moderate hiatal hernia were existing with the GERD. I started keto diet and lost 20lbs in three weeks and noticed a big improvement in my reflux. I also drink low acid coffee now and am trying to tweak the reflux disturbance due to aspiration pneumonia. Smaller meals, cut off eating anything a few hours before bedtime, and large quantities of fat and meat is also difficult for the stomach to process. I feel losing weight is essential to relief of many of these GI symptoms. Keto has solved so many of my health issues. Good luck finding your triggers and remember MDs are not Gods, they are people and sometimes don’t think outside of their routine boxes.
    Reply: #234
  33. Mimic Mouz
    Michael I tried going healthy green veggies and my reflux got worse . One of the reasons I had GERD was due to gastroparesis ( stomach nerves don’t function well and food doesn’t leave the stomach for hours. Hi fiber and high fat foods are difficult to digest. I try to get my raw veggies now with a smoothie but due to keto must greatly limit the fruit. There may be many different underlying reasons for a person to suffer from acid reflux. Hopefully you can combine your low carb lifestyle with your physical limitations and come up with your own ideal routine. I am very grateful that others here in this forum are sharing what is working for them.
  34. Charlotte Zwart Team Diet Doctor

    I too have suffered from GERD and esophagitis. I suspected that wheat could be a trigger but most of my MD’s look at me like I’m crazy ( biopsy negative for celiac). My gastroenterologist put me on 80mg of omeprazole daily along with Pepsid before bedtime with no plans to reduce the dosages. I have developed osteopenia and my creatinine is slightly elevated I think from the PPI,s. My GI doc did all of these esophageal tests and didn’t do a full upper GI X-rays which includes the stomach. It was discovered finally that gastroparesis and a moderate hiatal hernia were existing with the GERD. I started keto diet and lost 20lbs in three weeks and noticed a big improvement in my reflux. I also drink low acid coffee now and am trying to tweak the reflux disturbance due to aspiration pneumonia. Smaller meals, cut off eating anything a few hours before bedtime, and large quantities of fat and meat is also difficult for the stomach to process. I feel losing weight is essential to relief of many of these GI symptoms. Keto has solved so many of my health issues. Good luck finding your triggers and remember MDs are not Gods, they are people and sometimes don’t think outside of their routine boxes.

    Thank you for sharing your experience!

  35. wplogin-f5404183-2f5c-4d1c-b3af-53d20b360547
    Besides eliminating foods, I have found it very helpful to add in probiotics. After GERD for so many years, my stomach -- indeed my whole body -- needed help, so I began a program with an herbalist who gave me probiotics, trace minerals (which the proton pump inhibitors destroy), digestive enzymes and more. I have finally started feeling better. So I would suggest not eliminating over much, but think also about adding vitamins, minerals, and so on back in to get some healing.
  36. Lisa
    Yes! I too was taking GERD medications for almost 20 years for heartburn/reflux. After starting the Keto diet I was able to lose 50 pounds and decided to get off the meds. The low carb keto lifestyle does work for keeping GERD symptoms away. It has been over a year since I have been on the medication. I do notice that if I eat something not keto friendly I will get symptoms again and it is a good reminder to stay the course!
  37. Vijaya
    I started ot with Keto this week. Eating quite healthy. For each meal including 3 to 4 cups of keto friendly vegetables like broccoli and cabbage celery etc.. but from last two days I observed I have burning sensation before sleep. This is totally disturbing my sleep schedule and am ending up eating way beyond my macros to ease burning but eating does not help. Any suggestion?
    Reply: #238
  38. Kerry Merritt Team Diet Doctor

    I started ot with Keto this week. Eating quite healthy. For each meal including 3 to 4 cups of keto friendly vegetables like broccoli and cabbage celery etc.. but from last two days I observed I have burning sensation before sleep. This is totally disturbing my sleep schedule and am ending up eating way beyond my macros to ease burning but eating does not help. Any suggestion?

    It may be caused by something particular that you're eating. It may help to try an elimination to see if you can pinpoint the cause. Some find that eating too close to bedtime can cause issues also.

  39. Debra
    3 years before starting Keto I had an EGD done due to acute throat inflammation. The inflammation had gotten so bad that it caused esophagitis and laryngitis. I suddenly could Not talk beyond a whisper. The diagnosis, GERD. The cure I was given, Nexium. Though I still had occasional flare ups even then. Shortly after starting keto I no longer had any flare ups. And decided to go off the Nexium and see what happened. No problem. Have been off it ever since. Rarely, like 2 - 3 times in the past 4 years plus, I have experienced mild heartburn. Each time successfully treated with one dose of Famotidine. Love Keto!
  40. Amy
    During covid I ended up having a kidney stone and ended up in the hospital. I also had a stent for 6 weeks due to no “elective” medical procedures. I was on three different medications. Suddenly, I noticed that I started coughing after I ate. During covid I was baking more, and would find after I had a cookie I would cough uncontrollably, yet I would still eat them. Even when I ate healthy things, I would cough, in fact , I coughed after I ate anything. I tried omeprazole to make my husband happy, and tried natural means to help the reflux. My doctor retired, so it took me ages to find another to get a referral for an endoscopy. While waiting to get into the doctor, I decided to try keto. Within two days, I stopped coughing. It was incredible! My family noticed and even friends who I met online in the evening realized I wasn’t coughing. My endoscopy showed inflammation, but no need to do anything, and no need for a follow up. I told the Dr. my theory that the medicine for the kidney stone disrupted my biome and the keto stopped my reflux, he looked at me like I as nuts, and said it was a coincidence. When I followed up shortly afterwards with my urologist, and told her, she said of course that could be as there are always consequences to medicines, they don’t only target one bacteria. Then coincidentally I saw a functional medicine doctor who laughed and said the first doctor is only a plumber m so what does he know!
  41. Liz
    Hi Susie, I’m so glad it helped. It’s been almost a year and I randomly stumbled upon my comment again after browsing diet doctor. I’m not sure if you’ll see this (or if I’ll see any replies as I didn’t see your reply for a year!!) I really hope you’ve seen an improvement. I think I’ve been allowing too many histamines to creep into my diet again so you have motivated me to make a few changes again as I’ve had a bit of a flare recently, thank you. x
  42. Mr Man
    Check your vitamin d levels. Low levels can cause inflammatory issues.
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