Can you have GERD and IBS

Do you have IBS and GERD gastro-oesophageal reflux disease (GERD)? If so, you have probably wondered whether both gastro-intestinal (GI) conditions can occur at the same time and

Perhaps you feel confused as to how to manage both conditions.

In this article, I will uncover exactly what gastro-oesophageal reflux disease (GERD) is, if GERD is a characteristic feature of IBS and how to manage both GI disorders simultaneously.

What is GERD?

GERD is an upper gastro-intestinal (GI) disorder that occurs when the contents of your stomach acid flow back up into your oesophagus (1).

Heartburn is one of the main symptoms of GERD as well as chest pain, regurgitation, a nocturnal cough and aspiration (1).  

There are a range of factors that can increase the risk of developing GERD. These include (1):

• Smoking
• Obesity
• Medications such as non-steroid-anti-inflammatory drugs (NSAIDs)
• Pregnancy
• Stress and anxiety
• Hiatus hernia
• Clinical condition where part of your stomach moves into your chest)

Do IBS and GERD go together?

The exact causes of IBS and GERD are currently unknown (2). Research suggests that a variety of physiological, genetic, dietary and behavioural factors could be involved in both GI disorders. Evidence has also shown that there could be a potential link between the factors involved in the development of both GI disorders (3). 

GERD is not a characteristic feature of IBS and both GI conditions do not go together. This is primarily because GERD affects the upper GI tract and IBS impacts the small bowel. 

Also, both GI conditions have their own range of distinct causes and symptoms including the role of the gut-brain axis in some patients with IBS (4).

But, even though IBS and GERD are distinct GI conditions, they can both occur at the same time. Having IBS and GERD at the same time could potentially worsen your symptoms of either of the two GI disorders (3). This is why understanding the management of both GI disorders can be very helpful.

How do you deal with IBS at the same time as GERD?

As IBS and GERD are two different GI conditions, they may require individual approaches to their management. 

“First line treatment advice” is considered the primary traditional treatment option for both conditions and it is based on healthy eating and lifestyle changes. Following this advice to deal with IBS and GERD may help to alleviate your GI symptoms, prevent GERD complications and improve your quality of life. 

Healthy Eating and Lifestyle Changes for IBS and GERD

There are a range of similarities between the first line dietary and lifestyle treatment advice for IBS and GERD.

Similarities between IBS and GERD (5, 6):

• Limit alcohol and caffeine intake
• Limit intake of spicy and high fat foods
• Eat regular meals
• Do not skip meals or eat late at night
• Chew your food and eat slowly
• Exercise regularly
• Take time to relax
• Avoid smoking

Other first-line treatment advice for GERD includes that you ensure that your head is elevated while sleeping to avoid acid reflux (5).

First line dietary and lifestyle advice does not always work for everyone. If this is the case, you will need to seek more specialist secondary advice for both conditions. 

Second Line Treatment for IBS and GERD

IBS and GERD may require specific pharmacological, medical and psychological treatment as secondary approaches to their management (7, 8). If you have severe acid reflux symptoms with GERD you may require a surgical approach to its treatment (8).

The Low FODMAP Diet for IBS

If your IBS symptoms persist after following first line treatment for both IBS and GERD, the low FODMAP diet can be used as a secondary approach. Research has shown beneficial effects of the low FODMAP diet in reducing IBS symptoms (9). 

To date there has not been any research evidence to confirm that the low FODMAP diet is beneficial in alleviating the symptoms of GERD.

How to eat with GERD

There are some useful tips that can help you understand how to eat with GERD and alleviate symptoms. These include (1): 

• Eating smaller meals throughout the day and avoid drinking large amounts of fluid with meals 
• Ideally, try and eat your last meal 3-4 hours before going to bed 
• Ensure that you are sitting upright when eating 
• Avoid bending, lifting or lying down straight after meals 
• Avoid certain food and drink that may trigger your GERD symptoms including garlic and onion, tomatoes and tomato based foods, citrus fruits and carbonated drinks

So, when thinking about how to deal with both IBS and GERD at the same time, the best approach may be to follow the first line dietary advice recommendations based on healthy dietary and lifestyle changes for both GI conditions. Following a low FODMAP diet can also be incorporated to control your IBS symptoms.

Can I take buscopan for acid reflux?

Buscopan is an antispasmodic medication that is used to reduce abdominal pain in IBS. Buscopan is not a medication that can be used to relieve symptoms of acid reflux.

You can read more about buscopan in our other article here.

There are other pharmacological approaches to managing your acid reflux symptoms including Gaviscon which can be advised by your community pharmacist or medical doctor. These medications are advised to be used in combination with dietary and lifestyle advice (5).

Summary

So, although IBS and GERD are distinct GI conditions they can both occur at the same time. This is because they are both very common GI conditions. When it comes to managing IBS and

GERD at the same time, they may require different approaches depending on your specific symptoms as they are not related to each other.

Post written by Emily Stynes BSc. in Human Nutrition and reviewed by Kirsten Jackson