Why the Mediterranean diet is the best cure for acid reflux: Study found patients who ate plenty of fish and veg had fewer symptoms and avoided side effects of medication

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Sticking to a Mediterranean diet is just as effective at controlling reflux as medicines prescribed to millions of people each year, research suggests.

Patients who ate primarily fish, vegetables and whole grains - and drank alkaline-heavy water - reported a greater reduction in their symptoms than those on proton pump inhibitors (PPIs), the small study found.

PPIs are the most widely-prescribed form of medication in the US, accounting for more than $10 billion a year in healthcare costs. 

The drugs neutralize acid in the stomach and are widely prescribed by doctors for people with different types of reflux such as laryngopharyngeal reflux (sometimes called silent reflux) and gastroesophageal reflux disease, which produces typical heartburn symptoms.

However, they have been linked to severe side effects and an increased risk of death.

Cure for acid reflux? Patients who ate fish, vegetables and whole grains reported a greater reduction in symptoms than those on proton pump inhibitors (PPIs), the study found

Gastric, or oesophageal, reflux describes the traveling of stomach contents back up into the esophagus — a reversal of the normal flow.

This is due to a poorly functioning lower esophageal sphincter, a ring of muscle at the top of the stomach that normally shuts to stop the contents of the stomach leaking out and up the foodpipe. 

The contents are mixed with the hydrochloric acid produced by the stomach lining to aid digestion, so they are highly acidic — but the lining of the osophagus is not adapted to this.

As the acidic liquid moves up the esophagus, the result is inflammation, which can be severe and may cause both cramp-like spasm and pain — classic symptoms of reflux.

Repeated reflux over many years can damage the esophagus lining, a condition known as Barrett's esophagus.

In the new study, published in the journal JAMA Otolaryngology - Head & Neck Surgery, experts compared 85 patients treated with PPIs with 99 who followed a 90 percent plant-based, Mediterranean-style diet, who also drank alkaline water.

The diet consisted mostly of fruits, vegetables, grains and nuts and barely any dairy or meat including beef, chicken, fish, eggs and pork.

People were also told to avoid known triggers of reflux, including coffee, tea, chocolate, fizzy drinks, greasy and fried food, spicy food, fatty food and alcohol.

The team of experts from the Feinstein Institute for Medical Research in New York and New York Medical College said the diet should help people with laryngopharyngeal reflux or gastroesophageal reflux disease.

Patients on the plant-based diet also lost weight and needed fewer medicines for other conditions, including high blood pressure and high cholesterol.

Lead author of the study, Craig Zalvan, said: 'Although effective in some patients, I felt medication couldn't be the only method to treat reflux and recent studies reporting increased rates of stroke and heart attack, dementia and kidney damage from prolonged PPI use made me more certain.

'I did research and saw a lot of studies using plant-based diets to treat patients for many other chronic diseases, so I decided to develop a diet regimen to treat my laryngopharyngeal reflux patients.

'The results we found show we are heading in the right direction to treating reflux without medication.'