Chocolate and acid reflux

Acid reflux is also called gastroesophageal reflux (GER). It’s a backward flow of acid into the esophagus, the tube that connects your throat to your stomach. These acids can make your esophagus hurt or cause unpleasant heartburn.

Twenty percent of the American population has acid reflux. If your reflux happens two or more times per week, you may have gastroesophageal reflux disease (GERD). If it’s left untreated, GERD can lead to serious health complications.

When you visit your doctor about your reflux, they may ask you to provide a food diary. Occasional acid reflux usually occurs due to the foods people eat.

If you search online, you’ll likely come across various diets designed to help people with acid reflux. Many of these plans, like the GERD Diet, share a list of foods to avoid because they can make GERD symptoms worse. Chocolate is one of the foods that are most commonly on the list of what not eat.

What the research says

Researchers have mixed responses regarding this issue. Dr. Lauren Gerson at Stanford University says that people with acid reflux can eat chocolate and drink wine without ill effects. She says that coffee and spicy foods shouldn’t be off limits, either. She also says there’s a lack of evidence to truly prove that certain foods make reflux worse.

She explains that avoiding certain trigger foods may be enough to help a mild case of acid reflux. Most studies in this area have focused on either a food’s effect on sphincter pressure or its increase of acidity in the stomach, not if avoiding the food helps with symptoms.

For more advanced cases of reflux, she says to go ahead and keep eating chocolate. Medication that helps reduce acid production is the most effective means to relief. Some studies indicate that dark chocolate may decrease the chemicals your body releases in response to stress. Some people report that stress increases stomach acid production, but researchers don’t have proof of this.

Risks and warnings

Cons

  • Ingesting cocoa can cause a surge of serotonin. This surge can cause your esophageal sphincter to relax and gastric contents to rise.
  • Caffeine and theobromine in chocolate may also trigger acid reflux.

The cocoa powder in chocolate is acidic and may cause your symptoms to increase. Cocoa can cause the intestinal cells that relax the esophageal sphincter to release a surge of serotonin. When this muscle relaxes, gastric contents can rise. This causes a burning sensation in the esophagus.

Chocolate also contains caffeine and theobromine, which can increase symptoms.

Other things that may relax the lower esophageal sphincter include:

  • citrus fruits
  • onions
  • tomatoes
  • coffee
  • alcohol
  • smoking

Treatment options for acid reflux

Mild cases of acid reflux may respond well to over-the-counter (OTC) medicines:

  • Antacids such as Tums can help neutralize stomach acids and provide quick relief.
  • H2 blockers, such as cimetidine (Tagamet HB) and famotidine (Pepcid AC), can reduce the amount of acid your stomach produces.
  • Proton pump inhibitors, such as omeprazole (Prilosec), also reduce stomach acids. They can also help heal the esophagus.

If lifestyle changes and OTC medications don’t work for you, make an appointment with your doctor. They can prescribe stronger medications and let you know whether you can take these medications together.

Prescription-strength H2 blockers include nizatidine (Axid) and ranitidine (Zantac). Prescription-strength proton pump inhibitors include esomeprazole (Nexium) and lansoprazole (Prevacid). These prescription medications slightly increase your risk of vitamin B-12 deficiency and bone fracture.

Depending on the severity of your symptoms, your doctor may suggest a medication that strengthens your esophagus, like Baclofen. This drug has significant side effects, including fatigue and confusion. Still, it may help to reduce how often your sphincter relaxes and allow acid to flow upward.

If prescription medications don’t work or you want to avoid long-term exposure, surgery is another option. Your doctor may suggest one of two procedures. LINX surgery involves using a device made from magnetic titanium beads to strengthen the esophageal sphincter. Another type of surgery is called a Nissen fundoplication. This procedure involves reinforcing the esophageal sphincter by wrapping the top of the stomach around the lower esophagus.

The bottom line

Many doctors would advise against eating chocolate if you have acid reflux. As with many other conditions, your reflux will likely be unique to you. This means that what triggers and what improves acid reflux symptoms can vary depending on the person.

In the end, it may be best to experiment with eating chocolate in moderation. From there, you can record how chocolate makes you feel and whether it makes your reflux symptoms worse.

Keep reading: Acid reflux diet and nutrition guide »