Passing gas, while embarrassing, is generally normal and not a cause for concern. Acid reflux, however, cannot only be uncomfortable, but it can lead to health complications if left untreated. Both conditions involve the digestive tract, but is there really a link between acid reflux and gas? It’s possible that the two have some overlap. Certain treatments may help relieve symptoms for both.
Gastroesophageal reflux disease (GERD) — also known as acid reflux disease — affects about 20 percent of the U.S. population, according to the National Institute of Diabetes and Digestive and Kidney Diseases. It’s a more serious form of the common condition known as gastroesophageal reflux (GER). GER occurs when the lower esophageal sphincter (LES), a ring of muscles located in the esophagus that works as a valve between the esophagus and stomach, either opens spontaneously or doesn't close properly. This malfunction allows the contents of the stomach to go back up into the esophagus. Digestive juices rise up with the food, causing the most common symptom: a frequent, burning pain known as acid indigestion or heartburn located in the middle abdomen.
You’re considered to have GERD when reflux symptoms are persistent and chronic, occurring more than twice per week. People of all ages may suffer from GERD. It’s most likely to occur in those between the ages of 60 and 70.
It’s unclear why some people develop acid reflux while others don’t. The LES of a person with GER relaxes in an otherwise healthy esophagus. One of the main causes appears to be the presence of a hiatal hernia. This allows the upper part of the stomach and the LES to move above the diaphragm (the wall of muscle that separates the stomach from the chest). A hiatal hernia typically produces no symptoms and is often found in healthy people over 50. Other factors that make acid reflux more likely are:
- drinking alcohol
- connective tissue diseases
Several medications can contribute to acid reflux as well. These include:
- beta blockers (used for high blood pressure and heart disease)
- bronchodilators (used for asthma)
- calcium channel blockers (used for high blood pressure)
- dopamine-active drugs (used for Parkinson's disease)
- birth control
- sedatives (used for anxiety or insomnia)
Whether we admit it or not, everyone has gas at some point. Your digestive tract produces gas and eliminates it either through the mouth (belching) or the rectum (flatulence). The average person passes gas about 13 to 21 times per day, according to the National Institute of Health. Gas is made up mostly of odorless vapors such as carbon dioxide, hydrogen, nitrogen, oxygen, and occasionally methane.
Gas in the digestive tract is caused either by swallowing air (aerophagia) or from the breakdown of undigested foods by bacteria in the colon. Foods that cause gas in one person may not produce it in another. This is because common bacteria in the large intestine can eliminate the gas that another type of bacteria produces. It’s a delicate balance, and researchers believe that the small differences in this balance cause some people to produce more gas than others.
Most foods are broken down in the small intestine, but certain types — especially carbohydrates — may not be broken down. This can be due to a lack or absence of certain enzymes that help digestion. Undigested food moves from the small intestine to the colon, where it’s worked on by harmless bacteria. The unpleasant smell associated with flatulence is caused by sulfurous gases released by these bacteria.
Foods that are notorious gas producers include:
- beans (especially baked beans)
- Brussels sprouts
- carbonated beverages
- chewing gum and hard candy
- some whole grains
So, can acid reflux cause gas? The short answer is maybe. Many of the same things that contribute to gas also cause acid reflux. Making lifestyle changes to treat acid reflux may also help reduce excessive gas. For instance, you can eliminate carbonated beverages like beer to help relieve symptoms of acid reflux. Eating smaller meals more often may reduce the symptoms of both conditions, too.
The reverse also can be true — attempting to release gas may trigger acid reflux. Belching both during and after meals to release air when the stomach is full is normal. However, some people belch frequently and swallow too much air, releasing it before it enters the stomach. Many people mistakenly believe that belching will help relieve the symptoms of acid reflux, but they may be doing more harm than good. It’s also possible to swallow air in an attempt to clear your throat or mouth after stomach acid backs up.
A small number of people who’ve had fundoplication surgery to correct GERD may develop a condition known as gas-bloat syndrome. The surgery prevents normal belching and your ability to vomit. Gas-bloat syndrome usually resolves on its own within two to four weeks following surgery. However, sometimes it can persist. In more serious cases, you may need to change your diet or receive counseling to help break your belching habit. In the most serious cases, additional surgery may be required to correct the problem.
Although the connection between acid reflux and gas isn’t completely clear, lifestyle changes may be helpful in reducing the symptoms of both. Keeping a record of foods that cause acid reflux and gas can help you and your doctor figure out dietary changes.
Getting treatment for acid reflux may also help you to avoid swallowing more air, which can reduce gas and bloating.
You asked, we answered
- Many of my favorite fruits and vegetables have been shown to increase gas. What are some healthy foods that won’t increase gas? Should I simply take anti-gas medicine when I eat beans and broccoli?
You can eat beans and broccoli and take gas medicine, but you may have some abdominal pain and breakthrough flatulence despite the medicine. Your best bet is to try to avoid foods that are likely to cause gas.
The following are examples of foods that are less likely to cause gas:
Low-carbohydrate vegetables: bok choy, carrots, eggplant, endive, greens, lacto-fermented vegetables such as kimchi, mushrooms, scallions, sea vegetables, tomatoes
Veggies that are a bit higher in carbohydrates, but are still viable options: celeriac, chives, dandelion greens, peppers (except green, which are difficult to digest), snow peas, spaghetti squash, yellow or green summer squash, yellow wax beans, zucchini
Low-sugar fruits: apples, apricots, berries, grapefruit, kiwis, lemons, limes, melons, nectarines, papayas, peaches, pears, plums, rhubarb
Non-gassy proteins: beef (lean), cheese (hard), chicken (white meat), eggs, fish, peanut butter, turkey (white meat)
Low flatulence wheat alternatives: cereal grains (corn, millet, rice, teff, and wild rice); non-cereal grains (quinoa flour); nut meal; pasta in rice, corn, and quinoa varieties; rice bread
Non-flatulence producing dairy substitutes: soy and tofu cheese, almond milk, oat milk, rice milk, soy milk, soy yogurts, yeast flakes- Graham Rogers, MD