Dear Dr Benson,
Is it possible to suffer from reflux, indigestion and discomfort in the chest and just under the ribs from eating diary?
I recently had a tube put down my throat to see why the reflux was so bad but nothing came of it.
I have stayed off dairy for a while and feel better for it, but yesterday had some mini quiche and forgot that they have cheese etc in them and I have now been suffering all night and day.
What are the common causes (could it be dairy?) and what can I do about it?
From Burning Chest
Dear Burning Chest,
“Reflux” occurs when stomach acid rises up into your oesophagus (food pipe) and causes discomfort. The delicate lining of the oesophagus is unable to withstand the acid like the lining of the stomach can.
Over a long period of time this can lead to some very serious problems, such as strictures (narrowings) and even oesophageal cancer, so it should always be dealt with!
This is the reason people often have an endoscopy, to look for any complications of constant reflux, not to look for the cause.
Unfortunately the cause is most likely that sufferers simply have a weak sphincter (muscle) at the bottom of the oesophagus, and are probably just born with this.
Occasionally sufferers may also have a Hiatus Hernia (protrusion of the upper part of the stomach into the chest cavity through a tear or weakness in the diaphragm), but this rarely requires any change in treatment.
However, certain things are thought to make reflux worse such as being overweight, eating large meals, eating within 3 hours of bed, eating quickly, alcohol (especially spirits), smoking, tight clothing, and even stress.
A number of foods are also commonly implicated – and vary for each individual person – but may include chocolate, fatty and fried foods, chilli, spices, peppermint, spearmint, onions, garlic, capsicum, citrus, tomato products, fizzy drinks and caffeine.
Dairy is not one of those, and in fact milk used to be used as a treatment for reflux and ulcer disease many years ago before we had more effective medications.
The lactose in dairy products can sometimes cause digestive problems in people who are lactose intolerant, but these symptoms generally include abdominal pain, bloating, distension, flatulence and diarrhoea.
It is possible, but I think very unlikely therefore to have anything to do with dairy products, so instead look to see if it could have been any of those other foods mentioned.
As for treatment of reflux, it sounds like you should definitely be on some anti-acid medications to improve your symptoms.
Most effective are the proton-pump inhibitors, examples of which include Nexium, Pariet and Somac, so ask your doctor, but remember some work better than others in particular people.
In the meantime the use of antacids (e.g. Mylanta Double Strength Suspension) should provide temporary relief…