Passing gas, while potentially awkward, 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 are related. Certain treatments may relieve symptoms for both.
Gastroesophageal reflux disease (GERD), also known as acid reflux disease, affects about 20 percent of people in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). It’s a more serious form of the common condition known as gastroesophageal reflux (GER). GER occurs when the lower esophageal sphincter (LES) either relaxes spontaneously or doesn't tighten properly. The LES is a ring of muscles located in the esophagus that works as a valve between the esophagus and stomach. With GER, the acidic contents of the stomach go back up into the esophagus. The LES relaxes in an inappropriate manner. 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 and chest.
You’re considered to have GERD when reflux symptoms are persistent and chronic, occurring more than twice per week. People of all ages may experience GERD. Complications from GERD can be serious and may include the following:
- precancerous changes known as Barrett’s esophagus
It’s unclear why some people develop acid reflux and others don’t. One risk factor for GERD is the presence of a hiatal hernia. A larger-than-normal opening of the diaphragm allows the upper part of the stomach to move above the diaphragm and into the chest cavity. Not all people with hiatal hernias will have GERD symptoms.
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:
- anti-inflammatory medications and NSAIDs, such as ibuprofen (Advil), aspirin (Bayer), and naproxen (Naprosyn)
- certain antibiotics
- beta-blockers, which are used for high blood pressure and heart disease
- calcium channel blockers, which are used for high blood pressure
- medications for osteoporosis
- some birth control
- sedatives, which are 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, via belching, or the rectum, via flatulence. The average person passes gas about 13 to 21 times per day. Gas is made up mostly of carbon dioxide, hydrogen, nitrogen, oxygen, and methane.
Gas in the digestive tract is caused by either swallowing air or from the breakdown of foods by bacteria in the colon. Foods that cause gas in one person may not do so 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. However, some people cannot digest certain foods and substances, such as lactose, 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:
- Brussels sprouts
- some whole grains
So, can acid reflux cause gas? The short answer is maybe. Many of the things that contribute to gas also lead to acid reflux. Making lifestyle changes to treat acid reflux may help reduce excessive gas. For instance, you can eliminate carbonated beverages such as beer to relieve symptoms. 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 relieve the symptoms of acid reflux, but they may be doing more harm than good. Studies have shown that swallowing air increases stretching of the stomach, which triggers the LES to relax, making acid reflux more likely.
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 of surgery, but sometimes it persists. 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 the right dietary changes to make.
Getting treatment for acid reflux may also help you avoid swallowing more air, which can reduce gas and bloating.
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 flakesGraham Rogers, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.