Nutritionist makes errors in listing causes of acid reflux

22 September 2023
What was claimed

The only main causes of acid reflux are H. pylori infection, yeast overgrowth, gallbladder issues and mineral deficiencies.

Our verdict

The main causes of acid reflux are lifestyle factors like obesity and smoking, as well as pregnancy and hiatus hernia.

A Facebook video viewed over 600,000 times contains false claims about the causes of acid reflux. The same video has also been watched more than 300,000 times on TikTok.

In the video, nutritionist Reece Mander, who has over 340,000 followers across the two platforms, claims that there are “only four main causes of acid reflux” and that these are H. pylori infection, yeast infections, gallbladder issues and mineral deficiencies.

This is not true. Some of these conditions can cause acid reflux, but they are not the main causes. The NHS lists pregnancy, hiatus hernia, medications and lifestyle factors like smoking, diet or being overweight among the causes, as well as saying that often the underlying cause is not clear.

Full Fact contacted Mr Mander about this, who told us his videos “come from a host of experience”. He also said: “I don’t have studies for everything I talk about”. 

Bad information about health can cause harm by confusing people about the causes of diseases and undermining public health messaging and medical professionals. We have written before about false health claims by people with large social media followings, including about the causes of diseases.

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Acid reflux

Acid reflux describes stomach acid entering the oesophagus (gullet), which can cause symptoms felt as indigestion or heartburn. It can happen from time to time, or consistently, in which case it is called gastro-oesophageal reflux disease (GORD).

It is important that frequent acid reflux is properly diagnosed and treated—not just to improve people’s symptoms, but because the condition is a risk factor for cancer in the oesophagus.

H. Pylori

Infection with helicobacter pylori, or H. pylori, is common and is usually harmless. It can irritate the lining of the stomach and neutralise stomach acid around these cells, increasing their risk of damage. It can also cause an increase in overall acid production, though the mechanism for this is unclear.

This damage to the lining can cause ulcers in the stomach or small intestine and increase the risk of stomach cancer in the longer term.

Long-term H. pylori infection has actually been linked with lower acid reflux, perhaps by reducing the acidity of the stomach, potentially evidenced by lower rates of oesophageal cancer associated with infection with the bacteria. 

A meta-analysis (research pulling together the results of many different studies) from 2020 showed an increased risk of developing GORD for people who had H. pylori eradicated from their bodies, suggesting that the bacteria may be preventing reflux for some people.

There are a number of tests available for H. pylori. Treatment is with antibiotics, and you will be tested after the course to check that the bacteria have been cleared.

Yeast infection

The NHS does not list yeast infection as a cause of GORD. 

Yeast infection, also known as thrush or candidiasis, can occur in the mouth or oesophagus. Oesophageal candidiasis is much more common in people with compromised immune systems. A yeast infection in the mouth can be seen fairly clearly, and a yeast infection in the oesophagus would be seen on endoscopy (a camera test down the throat). 

Thrush causes discomfort in the mouth and can cause difficulties swallowing in the oesophagus, among other symptoms that are similar to those experienced with acid reflux. It is treated with antifungal medication.

Biliary reflux

Mr Mander says that the third main cause of acid reflux “is not having a gallbladder or having problems with your gallbladder, having stones inside your gallbladder, almost all of those can cause reflux”. 

The gallbladder is a small organ that sits under the liver and provides storage for bile produced there. Bile is a digestive fluid released into the small intestine when eating. Gallstones can form within it, causing issues releasing the bile, and potentially leading to painful inflammation or infection.

Gallbladders are fairly commonly removed to treat gallstone disease. We don’t need gallbladders to live, as the bile will still be produced and will just drip into the intestine rather than being stored and released intermittently. 

Removal can lead to bile reflux, which is when bile travels back into the stomach, causing irritation. This can exacerbate acid reflux issues if it then travels into the oesophagus. 

Mineral deficiencies 

Mr Mander refers to deficiencies “from people taking long term omeprazole, vegetarians and vegans”. Omeprazole (and other drugs like it) can cause low sodium (hyponatraemia) and low magnesium (hypomagnesaemia) as side effects. 

Omeprazole can also cause vitamin B12 deficiency. B12 is also an important consideration for vegetarians and vegans, as it is essentially only found in animal products. We were unable to find any evidence that B12 deficiencies lead to acid reflux.

It’s also unclear how any mineral deficiencies caused by omeprazole could be the cause of someone’s acid reflux, given that the drug would often be prescribed to treat the reflux in the first place.

We asked Mr Mander what mineral deficiencies he was referring to, but he did not respond to the question.

Featured image courtesy of BruceBlaus

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