The People's Perspective on Medicine

Will Intermittent Fasting Give You Heartburn?

Some readers report that intermittent fasting reduces their symptoms of heartburn. For others, however, fasting triggers indigestion.
Heartburn is a feeling of burning in people chest, and is a symptom of Acid reflux or GERD. A woman suffering from heartburn on a gray background.

If you have trouble with acid reflux, you probably try to avoid foods, beverages and situations that can trigger heartburn symptoms. Stretching out on the sofa after enjoying Thanksgiving dinner might be tempting; remembering the last time you did so and ended up in distress could lead you to take an after-dinner walk instead. One reader recently recommended intermittent fasting as an approach to controlling reflux. Another objected rather strenuously.

Does Intermittent Fasting Result in Reflux?

Q. Recently a reader wrote about being able to cease using acid-blocking drugs by controlling his/her diet. This included intermittent fasting.
Fasting can trigger acid reflux, too. Some of my worst episodes were from not eating.

On the Yom Kippur holiday, one woman at our temple was taken via ambulance to the hospital. The “heart attack” she thought she was having was simply acid reflux from fasting.

Different Strokes for Different Folks:

A. Over the decades that we have been writing about indigestion, we have learned that no one strategy works for everyone. Some people insist that apple cider vinegar eases their heartburn. Others find that it aggravates their symptoms.

This may also be the case with fasting. The reader you refer to found that intermittent fasting could help control acid reflux, but research is inconclusive.
One study noted that people fasting during Ramadan had less severe GERD (gastroesophageal reflux disease) symptoms (Acta Medica Indonesiana, July 2016).  Another study reported an increase in reflux disease when people were fasting during Ramadan (European Archives of Oto-Rhino-Laryngology, Nov. 2012).

Cutting Carbs to Reduce Reflux Symptoms:

Clearly, there is no consensus on the effects of intermittent fasting on heartburn. Cutting back on carbs, however, may be beneficial for some people. Studies have shown that people on a low-carbohydrate diet are less likely to suffer reflux symptoms than when they are eating lots of carbs (Journal of the Formosan Medical Association, Nov. 2018; Alimentary Pharmacology & Therapeutics, Nov. 2016). Some people may find following a low-carb high-fat diet easier to accomplish than intermittent fasting. 

Beyond Reflux: 

People who practice intermittent fasting experience other benefits beyond less indigestion. Years ago, researchers in Utah questioned 200 people undergoing angiography to detect heart disease (American Journal of Cardiology, June 1, 2012). They asked the patients, mostly Mormons, about fasting. Those who reported fasting once a month as part of their spiritual practice were 58 percent less likely to have diseased coronary arteries than those who did not. 

If you would like to learn more about this, you may wish to listen to our interview with Dr. Jason Fung. It is Show 1143: Can You Control Your Blood Sugar by Fasting?

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    About the Author
    Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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    Citations
    • Mardhiyah R et al, "The effects of Ramadhan fasting on clinical symptoms in patients with gastroesophageal reflux disease." Acta Medica Indonesiana, July 2016.
    • Hamdan Al et al, "Effect of fasting on laryngopharyngeal reflux disease in male subjects." European Archives of Oto-Rhino-Laryngology, Nov. 2012. DOI: 10.1007/s00405-012-2038-z
    • Wu KL et al, "The effect of dietary carbohydrate on gastroesophageal reflux disease." Journal of the Formosan Medical Association, Nov. 2018. DOI: 10.1016/j.jfma.2017.11.001
    • Pointer SD et al, "Dietary carbohydrate intake, insulin resistance and gastro-oesophageal reflux disease: A pilot study in European- and African-American obese women." Alimentary Pharmacology & Therapeutics, Nov. 2016. DOI: 10.1111/apt.13784
    • Horne BD et al, "Relation of routine, periodic fasting to risk of diabetes mellitus, and coronary artery disease in patients undergoing coronary angiography." American Journal of Cardiology, June 1, 2012. DOI: 10.1016/j.amjcard.2012.01.379
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    Because of acid reflux, I haven’t eaten an evening meal in 20 years. I rarely eat anything after lunch. It’s worked extremely well for me at stopping reflux.

    I find clients who consume a lot of carbs can’t go directly to fasting comfortably. And those on reflux meds need a ketogenic diet before fasting to ease symptoms like heartburn and reflux. I’ve seen clients who previously suffered heartburn stop experiencing it entirely by removing all grains. I hope this is helpful.

    As a faster for the last 6 months, I have experienced little acid reflux. I had a major problem with this for over 10 years and was briefly on meds. If I have any trouble, I take a bit of baking soda with water, and that fixes it. I drink coffee and can eat pretty much eat anything I want.

    I think the problem arises because of associated problems linked to diet (types of foods), the digestive system and gut bacteria. We are all not at the same levels, and other factors may cause problems while fasting. In any event, in my opinion drugs are not the long-term solution because they do not address the root problems.

    * Be nice, and don't over share. View comment policy^