Fiber for your heartburn?

If you've stubbornly been sticking with white bread rather than multigrain, scientists have yet another reason for you to make a switch. A new study shows that diets that are high in fiber may help douse heartburn.

Doctors have long extolled the benefits of fiber in helping to prevent colon cancer, heart disease and diabetes, but this is apparently the first time high-fiber diets have been shown to protect against heartburn, the most common symptom of gastroesophageal reflux disease, or GERD.

The study, reported in January in the journal Gut, involved 371 employees of the Houston Veterans Affairs Medical Center who were questioned about heartburn symptoms and about their eating habits.

The researchers found that participants who ate lots of fatty, high-cholesterol foods experienced heartburn more often. Those who followed a diet high in fiber were 20 percent less likely to have heartburn.

Inflammation and erosion of the esophagus was also more frequent in those who ate more fat and protein.

Cases of heartburn and GERD appear to be on the rise in America, experts say. About 40 percent of Americans have symptoms once a month, and 7 percent get heartburn every day, says Dr. David C. Metz, a professor of medicine in the division of gastroenterology at the University of Pennsylvania Health System in Philadelphia.

Part of the reason for the rise could be diet: Americans are eating a lot of high-calorie fast foods that are high in fat and low in fiber.

Reflux occurs when stomach acids seep back up into the esophagus, causing the burning sensation known as heartburn. Serious cases of GERD can increase the risk of esophageal cancer and lead to other serious complications.

Experts aren't sure how a high-fiber diet improves heartburn. But there are several theories.

First, it's possible that people who are consuming lots of fiber are just eating a generally healthier diet, says Dr. Hashem El-Serag, the new study's lead author and an associate professor of medicine at the Baylor College of Medicine in Houston.

But it's also possible, says El-Serag, that "the fiber is binding to certain noxious agents — oxidative agents. And that way it protects the esophagus."

There are other studies that show that high-fiber diets protect against cancer of the esophagus, El-Serag says.

Another explanation may be that fiber sops up acid, says Dr. Mary Maish, an assistant professor of surgery at the David Geffen School of Medicine at the University of California at Los Angeles and surgical director of the UCLA Center for Esophageal Disorders.

"Fiber absorbs and dilutes substances in the gut," she adds. "When someone ingests something poisonous, one way to help is to give a big dose of fiber."

Fiber also speeds digestion, Maish says.

"That's why people who suffer from constipation benefit from fiber," she adds. "It increases transit time from the upper gastrointestinal tract as well as the colon. That results in the stomach being empty more often, preventing upward pressure on the LES (lower esophageal sphincter). If there's nothing in the stomach, there's nothing to reflux up."

There are plenty of reasons to switch to high fiber even if it doesn't completely extinguish heartburn.

"In general, a high-fiber diet is good idea for the entire gastrointestinal tract," Maish says. "You get a couple of bangs for the buck — not only does it help protect your esophagus from cancer, but it also decreases the risk of other forms of cancer, such as colon cancer."

Even if you're not a fan of whole-grain foods, there are plenty of other sources of fiber that can do the trick. Fruits, vegetables, nuts and beans all are high in fiber.

And, if you're looking to bump up the amount of fiber in your diet, choose the actual fruits and vegetables rather than juices.

In a pinch, you might turn to concentrated sources of fiber, such as Metamucil or Citrucel, experts say.

While there's currently no data to show that fiber from whole foods is better than the condensed versions, Maish says many experts believe it's probably better to get your fiber from food.

Linda Carroll is a health and science writer based in New Jersey


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