By: Laurie Edwards for Reflux1Bolstering the claim that lifestyle behaviors significantly influence acid reflux disease, the results of a study performed by Scandinavian researchers found that smoking and salt intake increased the risk of developing the disease by 70 percent. Surprisingly, other behaviors commonly associated with acid reflux, such as drinking coffee or alcohol, were found to have little impact on the disease.
Acid reflux, also called gastro-esophageal reflux disease (GERD), is one of the most common causes of indigestion. In patients with acid reflux, stomach acid flows back into the esophagus, causing heartburn, belching, and in more severe cases, respiratory problems. For these patients, the muscle at the top of the stomach wall is weakened or opens at inappropriate times, which allows the acid to flow back.
The study, published in the December edition of Gut, aimed to determine which lifestyle habits are most strongly associated with acid reflux. Using the results of two extensive public health surveys over the course of two decades in Norway, researchers analyzed the odds linking acid reflux to smoking, exercise, consuming tea, coffee, alcohol, salt and fiber among several thousand people.
Participants who regularly used table salt were 70 percent more likely to have acid reflux, and those who ate salted meat or fish three or more times a week were 50 percent more likely to experience acid reflux than those who didn’t. In addition, people who smoked every day for more than 20 years were also 70 percent more likely to have acid reflux than their non-smoking counterparts.
Its authors wrote that the study “indicates an important role for exogenous exposures in the form of lifestyle-related factors in the etiology of GERD.”
Other experts agree, hoping that with a better understanding of its causes, the study will foster more research into acid reflux in terms of preventative strategies.
“This study bring up the under-appreciated point that life-style related factors may bring on the very common symptoms of heartburn … And maybe we try to prevent the disease process from starting,” said A. Mark Fendrick, MD, a professor of internal medicine and health management and policy at the University of Michigan Medical School, who is also a member of the medical advisory board of the National Heartburn Alliance.
Other researchers worry that the results might be somewhat misleading and may cause people to return to behaviors that could still be harmful. The study establishes that there is a connection between lifestyle and acid reflux, but it does not specifically determine whether one caused the other.
Experts wonder if the results can be accurately generalized to the US population, where many still believe that even though alcohol, coffee and tea are have not been scientifically linked to acid reflux, they are still contributors.
“I would love to see this survey duplicated here or across several nations,” said Edward Zurad, MD, who practices family medicine in Tunkhannock, Pa. “In our American population, both from a pragmatic and anecdotal standpoint, we believe there is a causal connection.”
Some view the study with skepticism since the study relied on self-reporting from patients rather than a clinical diagnosis of patients’ symptoms. Some physicians wonder if modifying these behaviors would make a difference for those already experience acid reflux.
For those trying to avoid acid reflux, the study found regular exercise and a high-fiber diet reduced the risk.
