Does chocolate cause heartburn

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Study Offers Hope For Chocolate-Loving Reflux Disease Sufferers

But there may be new hope for those suffering chocolate-lovers.

Results from a new study at the University of Michigan Health System, presented today at the Digestive Diseases Week meeting in Atlanta, not only reveal the mechanism by which chocolate irritates the digestive tract of those who suffer with chronic heartburn – also known as gastroesophageal reflux disease, or GERD – but also suggests a novel treatment.

“We demonstrated that chocolate induces GERD symptoms by compromising the ability of the lower esophageal sphincter to prevent the stomach acids from creeping back up the esophagus,” says Chung Owyang, chief of the U-M Division of Gastroenterology and professor of internal medicine in the U-M Medical School. “We also found that a medication commonly used for nausea may ease these painful symptoms,” adds Owyang, the study’s principal investigator.

In the study, seven GERD patients underwent a series of tests. A tube containing a pH monitor was placed in the esophagus to measure acidity. A second tube was inserted into the first part of the small intestine, the duodenum, to deliver chocolate directly to the gut.

After the chocolate infusion, researchers measured the acidity in the esophagus and how long it took the acidity to rebound to normal levels. Researchers also determined the pressure of the lower esophageal sphincter, located at the junction between the stomach and the esophagus.

In a person who does not suffer from GERD, the sphincter acts as a valve and allows substances to go from the esophagus down to the stomach only. In GERD sufferers, the sphincter does not function properly, allowing acid and other substances in the stomach to pass back up to the esophagus.

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The researchers found that chocolate significantly increased the number of reflux events and the acid exposure time in the esophagus for the seven patients.

“We found that the chocolate causes a large amount of serotonin to be released from the cells in the intestines,” says Wei Ming Sun, Ph.D., research scientist, U-M Department of Internal Medicine. “The serotonin causes the lower esophageal sphincter to relax. The relaxation means the ‘door’ between the esophagus and stomach is opened and acid is allowed to flow back up to the esophagus.”

After documenting the effects, patients were given granisetron – a substance commonly used to counteract nausea. Granisetron was shown in earlier U-M studies to reduce the effects of chocolate on patients who did not have GERD.

“When the patients with GERD took the granisetron, which is a serotonin blocker, there was a significant decrease in the numbers of reflux events, the acid exposure time and the acid clearance time,” Owyang says.

Specifically, the chocolate caused an average of 5.4 reflux events in a 30-minute time period. After treatment with granisetron, the events were down to 3.3 in 30 minutes. Acid exposure time decreased by more than a third after granisetron, and acid clearance time decreased from an average of 8.3 minutes just after the chocolate infusion, to 5.9 minutes with granisetron.

This novel approach may provide alternative effective methods for the treatment of GERD without inhibiting normal acid secretion, which is important to digestion and control of bacterial growth.

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Next, the researchers plan to conduct a double blind, multi-center trial to confirm this observation.

Chocolate and Acid Reflux: Can Chocolate Cause GERD?

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CHOCOLATE!!! Do I have your attention? If you’re anything like me, I do. I love chocolate! Luckily over the years, I’ve gravitated to eating dark chocolate and cacao, varieties considered to be superfoods. They’re full of antioxidants, vitamins, and minerals. Eaten in moderation dark chocolate and cacao are considered healthy… if you pick the right products.

Benefits of Chocolate

Benefits of chocolate are claimed to include:

  • Improved heart health
  • Reduced stroke risk
  • Improved brain function
  • Appetite control
  • Potentially reduces cancer risk
  • Improved cholesterol levels
  • Improved blood flow
  • Improved vision
  • Lowers blood pressure
  • Protects skin against UV damage
  • Promotion of fetal growth and development
  • Improved muscle and nerve function
  • Improved athletic performance
  • Improved mood
  • Decreased blood sugar
  • Diarrhea relief
  • Cough relief
  • and many more claims

BUT there are health precautions concerning chocolate especially for those prone to acid reflux.

Chocolate and Acid Reflux

Is chocolate causing your heartburn? I’m sorry to say it may be. Chocolate is one of the heartburn trigger foods that may cause problems for those with chronic acid reflux otherwise known as gastroesophageal reflux disease (GERD).

How Does Chocolate Cause Acid Reflux? Essentially chocolate can lead to a compromised lower esophageal sphincter (LES).1 The LES is a valve at the base of the esophagus that closes to keep contents in the stomach and out of the esophagus. When the LES is weakened in some way, stomach acid can back up (reflux) into the esophagus to cause a number of acid reflux symptoms including the irritation we know as heartburn.

Chocolate is high in cocoa, fat, caffeine, and theobromine. Each of these contributes to acid reflux. There are also health issues caused by eating chocolate that triggers acid reflux. But what if I told you there was also a component of chocolate that could reduce the pain of heartburn in some people? After all, we are all different and respond differently to foods.

Caffeine and Theobromine in Chocolate Cause Acid Reflux

Chocolate contains the methylated xanthines (methylxanthines) caffeine and theobromine. Methylxanthines block adenosine receptors. This results in the increased release of the hormones norepinephrine and serotonin.2 The elevation of methylxanthines levels contribute to acid reflux and heartburn in the following ways:

Serotonin Hormones

Serotonin may enhance our moods but it also causes smooth muscle tissue to relax. The LES is made of smooth muscle tissue. When the LES relaxes, stomach acid can reflux into the esophagus.3

One study of GERD patients looked at blocking the effect of chocolate on the LES by giving the serotonin blocker, granisetron, to GERD patients. These patients had fewer events of acid reflux and that the duration of acid exposure was lessened. This treatment method proved to be effective without the need for acid-neutralizing or acid-blocking medications. It is important to remember that acid needed for proper digestion and for controlling the growth of harmful bacteria in the gastrointestinal tract. Heartburn medications can provide relief from heartburn but they aren’t a cure and they do have side effects that can disrupt proper digestion.4

Norepinephrine Hormones

Norepinephrine, also known as noradrenaline, is a stress hormone vital to the fight-or-flight response of the human body. The fight-or-flight response prepares the body to react or retreat from a perceived threat.5

There is debate as to whether stress causes acid reflux. What is known for sure is that increased stress results in heightened senses and thusly increases the sensitivity to the pain of heartburn.

Methylxanthines

Methylxanthines also prompt the secretion of stomach acid. Higher levels of stomach acid can increase esophageal irritation when acid reflux occurs, thus increasing heartburn pain and the risk of acid erosion.6

Fat in Chocolate Causes Acid Reflux

Chocolate contains fat in varying amounts. Higher the fat content greater the risk of experiencing acid reflux.

Fatty foods slow the digestive process. The stomach empties slower when digesting fats. This digestive delay can lead to added pressure on the LES. Fatty foods can also cause an increase in stomach acid production. When the pressure on the LES is great enough, stomach acid will reflux into the esophagus and cause heartburn.

Cocoa Increases Acid Reflux Symptoms

Chocolate is made from cocoa powder. Which is ground from roasted cocoa beans, the seed of the Theobroma cacao tree. Cocoa powder is acidic. If reflux occurs, the increased acid can increase the irritation of heartburn.

Health Issues Caused by Eating Chocolate Can Cause Acid Reflux

The following list of side effects from eating chocolate can typically be avoided by limiting consumption.

  • Gas
  • Bloating
  • Constipation
  • Weight gain

Gas, bloating, constipation, and weight gain all increase abdominal pressure. Increased abdominal pressure weakens the closure of the LES allowing acid to reflux.

Milk Chocolate, Dark Chocolate, or White Chocolate?

High quality, organic dark chocolate containing 70% or higher cocoa content is considered healthiest from a nutrition standpoint. But what form is best for people who regularly experience acid reflux? Milk chocolate, dark chocolate, or white chocolate?

Well, the best option may be to avoid chocolate altogether. This is the suggestion provided by many researchers and doctors alike.

That said, people can experience acid reflux for different reasons. Different foods, medications, lifestyles, and health conditions may cause acid reflux in one person but not another. You may find that chocolate isn’t a food that triggers your heartburn, or that you can eat chocolate in small amounts, or you can eat chocolate if other heartburn trigger foods and situations are avoided around the time of consumption. Maybe try an alternative to chocolate like carob. Carob tastes similar but is lower in fat and free of caffeine and theobromine. You will have to find out by trial and error.

If you don’t want to eliminate chocolate from your diet, experiment to see if the fat content or the level of caffeine and theobromine cause you greater issue with acid reflux and heartburn.

  • Dark chocolate is lower in fat but has higher levels of caffeine and theobromine.
  • Milk chocolate and white chocolate have higher fat content.
  • White chocolate doesn’t contain cocoa solids and therefore contains only trace amounts of caffeine and theobromine.
  • Additionally, if you’re buying chocolate with other ingredients like nuts or fruit, consider if these other ingredients might be triggering your acid reflux.

1) Murphy, DW, & Castell, DO. “Chocolate and heartburn: evidence of increased esophageal acid exposure after chocolate ingestion.” National Center for Biotechnology Information, U.S. National Library of Medicine, The American Journal of Gastroenterology, June, 1988.

2) Monteiro, JP, Alves, MG, Oliveira, PF, & Silva, BM5. “Structure-Bioactivity Relationships of Methylxanthines: Trying to Make Sense of All the Promises and the Drawbacks.” National Center for Biotechnology Information, U.S. National Library of Medicine, Molecules, July 27, 2016.

3) He-Fei, Liu, Jun-Feng , Zhang, KE, & Yong Feng. “Expression of serotonin receptors in human lower esophageal sphincter.” National Center for Biotechnology Information, U.S. National Library of Medicine, Experimental and Therapeutic Medicine Journal, January, 2015.

4) B.H. Kim, Han-chun Lien, Wei Ming Sun, Mark McDermott, & Chung Owyang. “Blockage of 5HT3 pathways reduces gastroesophageal reflux (GER) induced by intraduodenal chocolate.” Gastroenterology, April 2000, Volume 118, Issue 4, Part 1, Page A884.

5) Kara Rogers. “Norepinephrine.” Encyclopædia Britannica, (n.d.).

6) Kathrin Ingrid Liszt, Jakob Peter Ley, Barbara Lieder, Maik Behrens, Verena Stöger, Angelika Reiner, Christina Maria Hochkogler, Elke Köck, Alessandro Marchiori, Joachim Hans, Sabine Widder, Gerhard Krammer, Gareth John Sanger, Mark Manuel Somoza, Wolfgang Meyerho, & Veronika Somozaa. “Caffeine induces gastric acid secretion via bitter taste signaling in gastric parietal cells.” National Center for Biotechnology Information, U.S. National Library of Medicine, Proceedings of the National Academy of Sciences of the United States of America, July 25, 2015.

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“Doc, what can I eat or drink that won’t make my heartburn worse?” While we often hear about triggers for heartburn, it’s important to balance out that discussion with foods, drinks, and medications that are safe. It’s all about controlling the level of acidity in your gut, so let’s take a look.

Foods

Heroes

  • Starchy foods. Rice, couscous, potatoes and crackers are a great place to start if you’ve been struggling with heartburn symptoms.
  • Legumes. Beans and lentils are also good options.
  • Other veggies. Turn to those with lower acidity. A neutral pH, around a pH of 6, is good—it’s neither strongly acidic nor alkaline. Neutral foods include kale, yellow squash, asparagus, and corn.
  • Safe fruits. Acidic fruits like oranges and pineapples are bad for heartburn. The winners in the fruit category are cantaloupe, dates, watermelon, and honeydew melon.
  • Poultry. Chicken and roast turkey both have a low acidity and are fairly lean, so those are good options.
  • Seafood. Most freshwater fish, shrimp, salmon and herring have low acidity with a high pH (higher than 6).

Villains

While there may be many food villains out there, folks with severe heartburn symptoms tend to have heartburn because they are more likely to eat or drink things on this list. Especially for these people, limiting these foods has been shown to improve symptoms.

  • Fried foods. Oil can make heartburn symptoms worse and foods drenched in oil like french fries, fried chicken or fish, and doughnuts are no exception.
  • Peppermint. Peppermint in any form, shape, or size is a known cause of heartburn.
  • Chocolate. Chocolate—specifically dark chocolate more than milk chocolate—can cause stomach acid to rise up into the esophagus, causing acid reflux and heartburn.
  • Tomatoes. It’s not a 100% “no” here. Tomato paste, tomato juice, and canned tomatoes are more acidic than whole, raw tomatoes, so it’s possible that some forms of tomato may not trigger acid reflux for you.
  • Ketchup and mustard. Most folks know of ketchup’s relationship to heartburn because of the tomatoes, but mustard is also makes symptoms worse.

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Drinks

Heroes

  • Dairy. Winners here are milk, eggs, and Swiss cheese. Remember, milk has a “neutral” pH, so it’s just as acidic as it is alkaline.
  • What you should know about alcohol. If you are going to drink alcohol, know these tidbits:
    • Wine. White wine is more acidic than red wine, so it may cause more heartburn.
    • Beer. Beer is very acidic, and it’s carbonated. Those two things are bad for heartburn. But, compared to other alcohol beverages, beer has a relatively lower alcohol content—and that’s good in the world of heartburn. There is evidence that people who drink liquor have more heartburn than beer drinkers.
    • Hard alcohol. Darker alcoholic drinks contain more naturally occurring compounds called congeners, which can increase stomach irritation and heartburn symptoms. Clear alcohols like vodka and gin contain fewer congeners than darker drinks like brandy, whisky, and rum. Just sayin.’

Villains

  • Alcohol, take two. Like I mentioned, alcohol content isn’t good for heartburn. Alcohol causes heartburn symptoms in four ways: by keeping acidic content in the stomach longer, by stimulating the stomach to make more acid, by impairing the esophagus from keeping food down, and by making it easier for acid to rise up into the esophagus from the stomach. Whew! When it comes to alcohol, watch out for three things: how much you drink, carbonation, and alcohol content (how strong the drink is).
  • Soft drinks. Carbonation causes the esophagus to become more acidic. Whether caffeinated or caffeine-free, it doesn’t matter. Carbonated drinks and sodas make nighttime heartburn symptoms much more likely.
  • Carbonated water. Surprise! Carbonated water is just as bad as coke. Experiments in healthy individuals have shown that cola and carbonated water both allow food to return to the esophagus from the stomach to the same extent.
  • Coffee. Whether decaf or regular coffee, coffee is a heartburn trigger. Why? Coffee is acidic, with a low pH of 4.

Medications

Heroes

  • H2 blockers. H2 blockers (also known as histamine-2 antagonists) are a class medications that decrease stomach acid and include popular drugs like famotidine (Pepcid), ranitidine (Zantac), and cimetidine (Tagamet). You can start with these for heartburn relief. Once your heartburn improves, stop the medication. Almost all H2 blockers don’t work well after 2 – 6 weeks because the stomach adapts, and they become much less effective.
  • Proton-pump inhibitors, when H2 blockers don’t help. If, after a couple weeks of taking H2 blockers, your heartburn is still there, try taking a proton-pump inhibitor (PPI) medication once daily. These include omeprazole (Prilosec), pantoprazole (Protonix), and esomeprazole (Nexium), all now available in prescription and over-the-counter strengths. If a PPI gets your heartburn symptoms under control, continue taking it for 8 weeks. Otherwise, this is when you’ll come see us, your primary care doctors.

Villains

  • NSAIDS and aspirin. NSAIDs like ibuprofen (Advil, Motrin) and naproxen (Aleve), as well as aspirin, are very well-known triggers of heartburn. People tend to forget this, thinking these drugs are harmless as they are available over the counter.
  • Other medications. Doxycycline, medications for osteoporosis, and other common drugs may also cause heartburn as a side effect. A list of stand-out offenders is covered in detail in this blog post here.

– – –

Hope this helps.

Dr O.

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  • Is Chocolate Causing Your Heartburn?

    Chocolate may be the ultimate comfort food, but unfortunately it can be responsible for the discomfort of gastroesophageal reflux disease (GERD).

    Ironically, the very reason that chocolate comforts and calms so many of us is the same reason it can cause painful reflux episodes for others. It contains high amounts of serotonin, a neurotransmitter that helps regulate our moods, emotions, appetites, and sleep patterns. But researchers have found that serotonin also has the ability to relax the lower esophageal sphincter, which would normally prevent the reflux of acid into the esophagus.

    If you’ve been diagnosed with GERD and find this news about chocolate disheartening, don’t despair — GI disorders affect people on an individual basis, and what might keep one person up all night with reflux may not even bother another. But do watch closely for flare-ups following chocolate consumption, since it is often the foods we suspect the least that torment us the most. Try to limit yourself to small servings of chocolate to avoid symptoms.

    Get more tips to prevent heartburn

    You can’t walk through a store right now without bumping into rows of chocolate bunnies and peanut butter cups wrapped in pastel paper. It’s hard to resist them! But for many people with GERD, chocolate can trigger a painful attack of heartburn. For almost everyone, it is not on a recommended GERD diet menu. But keep reading for ways to satisfy that sweet tooth without paying for it later.

    When it comes to avoiding foods that trigger GERD, chocolate is high up on the no-no list. But how can something that tastes to so delicious wreak such havoc on your GERD symptoms?

    Does chocolate really trigger GERD?

    Well, as with many of the dietary recommendations for people with GERD, there isn’t any conclusive evidence one way or the other about the effect of eating chocolate on heartburn symptoms. Some believe that chocolate is one of the foods that trigger GERD because the caffeine and cocoa (a main ingredient in chocolate) somehow make the LES less effective. Others point to the high fat content as the problem. As people living with GERD know all too well, fatty foods are not part of a diet for acid reflux because they take longer to digest and increase the likelihood of an episode of reflux.

    The reality is that we just don’t know what the connection is – or even if there is one at all! But if you notice that chocolate brings on the heartburn, then your best bet is to avoid it.

    Satisfying your sweet tooth – sweets on a GERD diet menu

    Fresh fruit

    Always a healthy choice, fresh fruit can fill you up and curb your sweet tooth. Reach for an apple and you just might find you don’t want that candy bar after all.

    Angel food cake

    Looking for a sweet that won’t give you acid reflux? Try a slice of angel food cake. It’s lower in fat than many other desserts, which makes it easier on the stomach.

    Low fat candies like gummy bears, red licorice, and jellybeans

    All of these options are low in fat, which makes them easier on the digestive system. They also are really chewy, which can keep you from eating too much too fast. Keep in mind, though, that they are loaded with sugar and that’s not so good for your waistline.

    Opt For Dark or White Chocolate

    If you can’t stand to give up chocolate completely, try dark or white chocolate. Dark chocolate is lower in fat than milk chocolate, so it might not upset your GERD symptoms as much as milk chocolate can. White chocolate is an even better bet because it doesn’t contain cocoa.

    The bottom line

    The bottom line is this: If chocolate makes your symptoms worse, avoid it. If you keep track of things to eat and not to eat, then take it off your GERD diet menu and forget about it. Also remember that controlling your weight is one of the best things you can do for your GERD symptoms, so sweets like chocolate and other candy should only be an occasional treat.

    Next steps

    Learn more about the most common reflux triggers and how adjusting your diet can help you manage your symptoms.

    For those suffering from heartburn, a piece of chocolate may start as a joy to the tongue, but can end with a raging fire in the stomach. But there may be new hope for those suffering chocolate-lovers. A new study presented on May 23rd at the Digestive diseases week in Atlanta, US, revealed how chocolate irritates the digestive tract of those who suffer with chronic heartburn – also known as gastro-oesophageal reflux disease, or GERD. “We demonstrated that chocolate induces GERD symptoms by compromising the ability of the lower oesophageal sphincter to prevent the stomach acids from creeping back up the oesophagus,”​ says Chung Owyang, chief of the University of Michigan Division of Gastroenterology and professor of internal medicine in the University of Michigan Medical School. “We also found that a medication commonly used for nausea may ease these painful symptoms,”​ adds Owyang, the study’s principal investigator. In the study, seven GERD patients underwent a series of tests to measure acidity in the oesophagus and how long it took the acidity to go back to normal levels. Researchers also determined the pressure of the lower oesophageal sphincter, located at the junction between the stomach and the oesophagus. The researchers found that chocolate significantly increased the number of reflux events and the acid exposure time in the oesophagus for the seven patients. “We found that the chocolate causes a large amount of serotonin to be released from the cells in the intestines,”​ says Wei Ming Sun, Ph.D., research scientist, University of Michigan Department of Internal Medicine. “The serotonin causes the lower oesophageal sphincter to relax. The relaxation means the ‘door’ between the oesophagus and stomach is opened and acid is allowed to flow back up to the oesophagus.”​ After documenting the effects, patients were given granisetron, which is used against nausea. Granisetron was shown in earlier University of Michigan studies to reduce the effects of chocolate on patients who did not have GERD. “When the patients with GERD took the granisetron, which is a serotonin blocker, there was a significant decrease in the numbers of reflux events, the acid exposure time and the acid clearance time,”​Owyang says. This novel approach may provide alternative effective methods for the treatment of GERD without inhibiting normal acid secretion, which is important to digestion and control of bacterial growth. Source: University of Michigan Health System​

    5 Foods That Can Cause Terrible Heartburn

    A man with heartburn | Source: iStock

    Every wonder what’s going on when you eat one too many greasy slices of pizza and suddenly your chest is tight and the unmistakable sting of heartburn takes over? It may be something you ignore at first, but over time this burning sensation may become more painful and more frequent. When you eat, everything you consume gets mashed up (thanks to your teeth) before sliding down your esophagus and into your stomach where the food mixes with your body’s digestive juices. Gastroesophageal reflux (GERD), also known as heartburn, happens when the stomach’s acid or other stomach contents back up into the esophagus. The backwash or reflux irritates the lining of your esophagus and causes GERD.

    An estimated 60 million Americans get heartburn at least once a month and while it may seem common enough, heartburn is easily avoidable. By leaving a few simple foods out of your daily diet, you can help head off the pain.

    1. Tomatoes

    Tomatoes | Source: iStock

    Salsa, ketchup, spaghetti sauce, and tomato soup are just a few of the many tomato-based substances that you may eat religiously. As much as you may love to top almost everything with a squirt of ketchup or can’t imagine life without cherry tomatoes crowning your salad, this vitamin packed vegetable is also packed with citric and malic acid, which can make the stomach over-produce gastric acid. The gastric acid is responsible for breaking down food and when the volumes of this digestive acid get too high the acid can flow back up into the esophagus leading to heartburn.

    2. Chocolate

    If you have a sweet tooth, chances are you consume a little chocolate almost daily. Whether you opt for milk or dark chocolate, this treat seems to cause more heartburn than any other food. Chocolate contains caffeine and other stimulants, which are proven to cause reflux. In addition, chocolate is high in fat and contains varying levels of cocoa, both of which lead to reflux. While it may be difficult, this may be one treat to cut back on if you tend to have regular heartburn.

    3. Alcohol

    Alcohol | Source: iStock

    You may not like to hear it, but throwing back a few brews with the guys may be a major contributor to your heartburn woes. Red wine and beer are particularly bad, especially when being consumed with a meal. Alcohol relaxes the valve to your esophagus, allowing stomach acid to creep up from below leading to that annoying burn. If you aren’t ready to give up your beer and burger, make a point to eat less to minimize your risk of heartburn.

    4. Citrus

    Fruits like grapefruit, oranges, lemons, and limes are considered to be part of the citrus family, a group of fruits that are classified together due to their high levels of citric acid (hence the name). Whether you drink their juices or eat them whole, these fruits increase acid production in your stomach, which leads to heartburn. Pineapple is also high in citric acid, while lemons and limes have the most citric acid of any fruit. Watch out for citric acid in soft drinks and sweets that have a tart taste.

    5. Fried foods

    Fried food | Source: iStock

    Guy’s night may not feel the same without wings and onion rings, but fried foods can be brutal for a person prone to acid reflux. Anything fried contains high levels of oil and the high fat content makes it harder for your body to digest. Unlike foods that pass through your stomach quickly, fried foods may hang out for a bit while they get broken down. This slow process puts pressure on your stomach and esophagus. Save calories and give your stomach a break by choosing grilled items over fried.

    More from Health & Fitness Cheat Sheet:
    • The 3 Cancers Men Are More Likely to Get
    • How to Kick Your Soda Habit for Good
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    How to Eat Chocolate with Acid Reflux

    I’ve had acid reflux my entire life. After a bad flare-up during my senior year of high school, I started taking medication and have been managing it actively ever since (~15 years). Until about 2010, taking medication and adhering to best acid reflux practices (i.e. not laying down after eating, not eating several hours before heading to bed) kept my acid reflux at bay the majority of the time. I didn’t have any food triggers.

    Then one day, it was like a light switch flipped and chocolate started triggering reflux. I don’t think chocolate was the only thing triggering reflux during this period. But I went through a bad reflux flare-up, one of the worst I’ve had since high school. It was really frustrating, and the fact that chocolate was playing a clear role in it made the flare-up that much more frustrating.

    I know not being able to eat chocolate is a first world problem. But when you love a food, and you can’t eat it anymore, it’s rough. I LOVE chocolate and for many years, would eat it daily. A little square of Dove dark chocolate is a great way to finish a meal. When I would order dessert at a restaurant or when I would have my choice of desserts at a party or other social function, I’d always go for the chocolate dessert.

    After a fair amount of denial, ultimately, it got to the point that I felt bad enough that I knew something had to change. I quit eating chocolate daily and slowly started saying no to or taking a pass on chocolate elsewhere. My flare-up did subside, and I’ve been doing pretty well ever since. I still have an occasional rough reflux day (usually due to stress), but I haven’t had any other major incidents.

    So why is this post called how to eat chocolate with acid reflux?

    I gave up chocolate altogether, right? For several years, I did give up chocolate almost completely. Rich chocolate desserts were no longer appealing, and I really didn’t want another bad flare-up. I learned to enjoy lots of non-chocolate desserts, and many days, I honestly didn’t miss it.

    However, avoiding chocolate altogether is still difficult because let’s face it: chocolate is an amazing food. It’s been over five years since my last bad flare-up and I have a much better understanding of when and how chocolate triggers reflux for me. Consequently, I’ve felt comfortable re-introducing it on a more regular basis. No, I don’t eat chocolate every day. And I’m pretty careful about what chocolate I eat, and when I eat it. But so far, reintroduction has been successful.

    I know I’ve given a lengthy introduction before getting to my tips for how to eat chocolate with acid reflux. I think it’s important to understand where I’m coming from and that it’s taken me years of living with reflux to develop these strategies. I’m not just sharing a few quick tips I found from online articles. I’m sharing my tried-and-true tactics I’ve learned through many years of living with reflux.

    Please note that I am not a physician. I have consulted with multiple physicians about reflux medications and symptom management strategies, which has helped guide my current medication regiment and general life routines. I can’t guarantee that any strategy that works for me will work for anyone else. If you ever have questions or concerns, please talk to your doctor.

    Before I get into the tips for eating chocolate with acid reflux, I want to address one more point.

    Which type of chocolate is best with acid reflux?

    I get a ton of people arriving at this post who are looking for advice about which type of chocolate is best to eat if you have acid reflux or GERD. The short of it is that all chocolate is bad for acid reflux. Cocoa powder is acidic, which can trigger reflux. Chocolate contains caffeine and theobromine, which can further trigger reflux Additionally, chocolate has a high fat content, which may also heighten reflux symptoms.

    With that being said, the sweeter the chocolate, the more it’s likely to trigger acid reflux. As such, dark chocolate may not trigger reflux as quickly or significantly as milk chocolate or white chocolate. I don’t provide this information as an invitation to eat as much dark chocolate as you like. Dark chocolate can definitely still trigger reflux, but it won’t trigger it as significantly. It’s also better for you than milk chocolate or white chocolate, which is a nice bonus.

    Eat chocolate in small doses alongside non-reflux-triggering foods

    I know eating chocolate in small quantities alongside foods that don’t trigger reflux sounds like a ridiculous strategy. But it’s been the single most effective way for me to re-introduce chocolate without triggers. Obviously, eating chocolate in small quantities versus large quantities is a good strategy in and of itself. Eating chocolate alongside another food or eating chocolate and then finishing a snack or dessert with something non-chocolate is almost guaranteed to squash any reflux that does start to creep up.

    Personally, I love salty-sweet combinations so pairing a few squares of chocolate or a chocolate chip cookie with cashews or peanuts works well for me. Of course, you shouldn’t feel limited to this pairing. If you’re in a social setting with a big food spread, it’s often easy to eat a bit of chocolate and then finish snacking with a helping of fruit or veggies, which works really well, too.

    Embrace non-chocolate desserts

    Embracing non-chocolate desserts don’t help you eat more chocolate, but it does make you more excited for the occasions you’ve avoiding chocolate. No, you aren’t going to eat the chocolate cake you love so much at your favorite restaurant. But you are going to eat their cheesecake, which is also amazing. Yum! While I do love chocolate desserts, there are lots of non-chocolate desserts I love, too. It’s so much more productive to get excited about desserts you love and can eat than get depressed over the desserts you love but can’t eat.

    Don’t eat chocolate in combination with reflux-triggering foods

    Say you have a mild to moderate dairy allergy. Having a bowl of macaroni and cheese or a slice of pizza is okay. But you don’t want to follow it with a huge serving of ice cream. The same principle applies to acid reflux. If you’ve just had a spaghetti dinner with lots of marinara sauce, onions, and garlic, don’t follow it up with chocolate. If you’re going to eat chocolate after dinner, don’t pair it with coffee or tea.

    Prioritize chocolate over other reflux-triggering foods

    Similarly, if you want to eat chocolate without triggering reflux, you may have to give up or significantly cut back on other reflux-triggering foods. If you have severe reflux, any trigger food may prove harmful, but for many people with reflux, there are ways to eat trigger foods in moderation without harmful side effects. In many instances, the prioritization may be as simple as choosing salmon and steamed broccoli for lunch instead of the spaghetti with marinara sauce so you can have some chocolate later that afternoon.

    Prioritization does not mean that you can eat as much chocolate as you want without consequence. I wouldn’t be writing a 1,000+ word post on this topic if there were such an easy fix. Skipping the garlic and onion heavy entree will not give you some free pass to eat a huge amount of chocolate. Instead, it will allow you to eat a small serving without triggering reflux.

    Save chocolate splurges for chocolate you really love

    When you can only eat a limited amount of chocolate each week, make it count. Don’t waste your chocolate intake on cheap candy or something you don’t really love. I used to take chocolate for granted. Now that I only eat it a few times per month, I appreciate it so much more. A huge part of this appreciation comes from choosing chocolate I love. When I eat a homemade chocolate chip cookie or a piece of high-quality dark chocolate with almonds, it tastes like the best chocolate I’ve ever had.

    Avoid chocolate several hours before going to sleep

    Eating several hours before going to sleep is a big no for acid reflux, so it goes without saying that eating chocolate several hours before going to sleep is a huge no. In general, I don’t eat chocolate after about 5:00 p.m. If you stick to this rule the majority of the time, most likely you’ll be able to break the rule once in a while, especially if you’re good about taking your meds and adhering to other acid reflux practices. Eating chocolate at night every night will leave you feeling lousy, but an occasional dessert at a restaurant or party will be okay.

    Avoid chocolate during bad flare-ups

    When you’re having a bad flare-up, it doesn’t take much to keep setting it off. Eating chocolate will further aggravate your symptoms, making them even worse. If you’re like me and often get minor flare-ups due to stress, steering clear of chocolate is the worst. A little chocolate should be a bright spot during a tough day. Unfortunately, it’s not when you have acid reflux. Steer clear of chocolate and any other major acid reflux trigger foods until you’re feeling better.

    Pay attention to your body

    Again, I’ve shared the strategies that have worked best for me for eating chocolate with acid reflux. It’s taken me years to figure out these strategies and to develop new habits for eating chocolate without feeling lousy. I’ve had to pay close attention to what does and doesn’t make me feel good and to steer clear of certain foods or avoid chocolate altogether when I’m stressed or something else is triggering my reflux. You need to do the same thing. No one else has your exact same body and will be able to tell you exactly what will or won’t work for you.


    Do you have any tips for how to eat chocolate with acid reflux?
    If you have acid reflux, I’d love to hear your insight on this topic!

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