Intermittent Fasting for GERD: Exploring Benefits and Research FindingsPublished on Wednesday, August 30, 2023 by
Unveiling the Potential of Intermittent Fasting in Alleviating Gastroesophageal Reflux Disease (GERD) Symptoms
Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal (GI) conditions seen at doctor’s offices, affecting around 20% of adults in the United States. Between medication prescriptions and diagnostic testing, over 18 billion US dollars is spent annually on GERD.
Proton pump inhibitors (PPIs) are the most prescribed medication for GERD; many take them long-term. Many people are looking at lifestyle changes in hopes of helping reduce GERD and, in turn, helping them get off long-term medications.
An increasing focus has been on intermittent fasting (IF) recently. IF is often promoted for helping improve blood pressure, cholesterol levels, inflammatory disorders, obesity, and blood sugar control, and now researchers are looking at how IF could be beneficial in helping with GERD symptoms.
What is Intermittent Fasting (IF)?
Intermittent fasting is an eating pattern that involves cycling between fasting and eating, focusing less on the types of food eaten and instead on when you eat foods. Here are a few common patterns.
- Fast (do not eat) for 16 hours; eat during an 8-hour window
- 14/10 method
- Fast for 14 hours; eat during a 10-hour window
- 5:2 method
- Limit your calories to 500 for two days a week. During the other five days of the week, you eat a healthy/normal diet.
- Alternate day fasting
- Every other day, eat 25% of your normal intake. On non-fasting days, resume your regular diet.
- 24-hour fast
- Fasting for 24 hours; is often done once or twice a week.
Could Intermittent Fasting Help Improve GERD Symptoms?
The impact and proposed mechanisms appear to be disease-dependent but include anti-inflammatory effects, weight loss, and changes in various hormones.
A 2022 Journal of Clinical Gastroenterology study examined a small population of 25 participants. Only 9 of those participants were compliant with a 16:8 IF regimen. They looked at 35 days of IF vs. 65 days of no IF. In those participants compliant with the 16:8 fasting regimen, their GERD symptoms improved quickly and steadily throughout the study.
A 2023 study from The Cureus Journal of Medical Science focused on Ramadan fasting and its impact on GI issues. Ramadan is a holy month observed by Muslims, who refrain from food, water, and sexual activity from sunrise to sunset for 30 days. It looked at 130 people divided into fasting and non-fasting groups using a GERD questionnaire. They concluded that GERD symptoms were less severe during Ramadan than during the non-Ramadan months. However, a 2018 study from the Journal of Nutrition, Fasting and Health found that Ramadan fasting does not affect the symptoms of GERD in patients taking antisecretory medications such as H2 blockers and PPIs.
On another note, a 2021 study in the American Journal of Clinical Nutrition reported significant remodeling of the gut microbiome during Ramadan-associated IF in healthy non-obese individuals. The species noted in the remodeling connects to intestinal butyrate production and improved health. Learn more on the basics of the gut microbiome here.
Keep in mind that research is limited, and although there is some promising research available, there is a need for more research studies with randomized control trials and larger sample sizes before truly determining if IF has a place as an effective strategy for reducing GERD symptoms. If you are interested in IF, please consult with your doctor or a registered dietitian to ensure this method is a safe and appropriate option for you.
- Antunes, C., Aleem, A., & Curtis, S. A. (2022, July 4). Gastroesophageal Reflux Disease. In StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK441938/
- Young, A., Kumar, M. A., & Thota, P. N. (2020). GERD: A practical approach. Cleveland Clinic journal of medicine, 87(4), 223–230. https://doi.org/10.3949/ccjm.87a.19114
- hollowc2. (2023, January 30). Intermittent fasting: What it is, types and how it works. Cleveland Clinic. https://health.clevelandclinic.org/intermittent-fasting-4-different-types-explained/
- Jiang, Y., Sonu, I., Garcia, P., Fernandez-Becker, N. Q., Kamal, A. N., Zikos, T. A., Singh, S., Neshatian, L., Triadafilopoulos, G., Goodman, S. N., & Clarke, J. O. (2022). The Impact of Intermittent Fasting on Patients With Suspected Gastroesophageal Reflux Disease. Journal of clinical gastroenterology, 10.1097/MCG.0000000000001788
- Tibi, S., Ahmed, S., Nizam, Y., Aldoghmi, M., Moosa, A., Bourenane, K., Yakub, M., & Mohsin, H. (2023). Implications of Ramadan Fasting in the Setting of Gastrointestinal Disorders. Cureus, 15(3), e36972. https://doi.org/10.7759/cureus.36972
- Rahimi, H., & Tavakol, N. (2018, December 1). Effects of ramadan fasting on the symptoms of gastroesophageal reflux disease. Journal of Nutrition,Fasting and Health. https://jnfh.mums.ac.ir/article_12304.html
- Su, J., Wang, Y., Zhang, X., Ma, M., Xie, Z., Pan, Q., Ma, Z., & Peppelenbosch, M. P. (2021). Remodeling of the gut microbiome during Ramadan-associated intermittent fasting. The American journal of clinical nutrition, 113(5), 1332–1342. https://doi.org/10.1093/ajcn/nqaa388
Haley McGahaRDN, CSO, LD