Managing Acid Reflux on GLP-1s Guide

Acid reflux is more than just that thing you’re warned about in the Gaviscon commercials—it’s real for millions of Americans, and it’s something that can be dealt with.

We often get acquainted with acid reflux (also called heartburn) through its symptoms: a burning pain in the chest after eating. What’s happening is that stomach acid and/or bile flows up into your esophagus (your food pipe) and irritates its sensitive lining.

As your body adjusts to your GLP-1s, acid reflux can be more likely to occur as a natural side effect of food taking more time to exit the stomach. The official name for this condition is “delayed gastric emptying,” and it can also cause some nausea and constipation. Naturally, we’ve put together some tips to help you deal with any and all of it.

If you’re already experiencing acid reflux, we recommend over-the-counter aids. The liquid versions (Mylanta, Maalox) break down acid faster, but the chewable ones (Tums) have more staying power. There’s also the option to try effervescent antacids like Alka-Seltzer, but remember that they contain aspirin. If you’re experiencing heartburn all the time, you might want to try a histamine blocker, like Pepcid AC; these reduce the histamines that tell your stomach to produce more acid. Use these medications for no more than two-to-four weeks, and note whether they help with your symptoms. 

Another option for managing acid reflux is a class of medications called Proton Pump Inhibitors (PPIs) such as Esomeprazole (Nexium) and Lansoprazole (Prilosec). PPIs are not indicated for immediate relief but can help prevent acid reflux from recurring. They need to be taken on an empty stomach in the morning to be most effective. Again, we advise using these temporarily for 2-4 weeks unless otherwise instructed by your doctor.

There are also lifestyle changes you can undertake to help reduce the occurrence of acid reflux in the first place. These include:

• Limit caffeine and chocolate - Chocolate is double trouble; it’s acidic, and the pleasure it gives you (along with the caffeine) causes the sphincter between your stomach and esophagus to relax, letting in more acid.
• Avoid acidic foods such as oranges - Oranges and other citrus fruits like grapefruits are known for irritating the soft lining of your esophagus.
• Eat fewer tomatoes - Tomatoes (and tomato sauce) have both malic and citric acid, which makes your stomach’s gastric acid overflow.
• Cut down on high fat foods - Fatty foods like to hang out in your stomach, which gives gastric acid all the time it wants to make its way up to your esophagus. Fatty foods’ specialty is giving you heartburn when you lie down for bed.
• Limit alcohol intake - When you drink, your lower esophageal sphincter relaxes, letting up more stomach acid.
• Avoid lying down immediately after eating - Gravity is digestion’s friend. You can help your esophagus do its job by staying vertical until your food is digested.
• Eat smaller meals - When you eat a large meal, your stomach expands, which makes it harder for the esophageal sphincter to close.

If you continue to experience the symptoms of acid reflux, and especially if it’s keeping you up at night, you can take additional steps, like eliminating solid foods in the evenings (stick to soups, or even high-protein shakes or smoothies). Another helpful step can be to eliminate eating for two-to-three hours before bedtime. 

Mealtimes should be about enjoying your food and feeling good. Acid reflux can unravel those efforts; these tips can help you get ahead of it.