Fasting and Acid Reflux: What You Need To Know

People choose to fast for any number of reasons — sometimes religious, sometimes health-related. While you might think that going without food could not cause digestive upset, many people do experience the uncomfortable symptoms of acid reflux while fasting.

According to the American College of Gastroenterology, more than 60 million Americans experience acid reflux at least once a month, with 15 million having symptoms daily. Acid reflux goes by many names, including GERD (gastroesophageal reflux disease), acid indigestion, sour stomach, heartburn and dyspepsia.

No matter what you call it, the mechanism behind this condition is the same. Essentially, the acid from your stomach "misfires," flowing up into your esophagus, the tube that runs from your mouth to your stomach. When this happens, it can irritate the lining of the esophagus, causing pain, burning or a sour taste in the back of your throat. People who get acid reflux regularly may also experience symptoms like a dry cough, sleep problems or difficulty swallowing.

Billions of people around the world practice fasting as part of their religious practice. And with the increasing popularity of intermittent fasting as a weight-loss tool, millions more have begun to embrace the idea of going for longer periods without food.

There's no doubt that the practice of fasting can have many benefits, both spiritual and physical, but one unfortunate side effect is that it changes the balance of acid in the stomach. This can lead to reflux, says Peyton Berookim, MD, a gastroenterologist with the Gastroenterology Institute of Southern California in Beverly Hills.

"When there are no contents or food in the stomach for it to break down, such as when one is fasting, stomach acid levels can start to increase," says Dr. Berookim. "But if there's no food in the stomach to 'soak up' the acid, this can result in harmful acid buildup that can cause epigastric pain, discomfort (heartburn) and regurgitation of the acid into the esophagus (acid reflux)."

For this reason, many people also experience the worst of their acid-related stomach pain upon waking up with an empty stomach.

Tools do exist to help relieve acid reflux while fasting. "Some strategies include drinking water, especially alkaline water," suggests Dr. Berookim. "Also, warm water can help settle the stomach. In addition, small quantities of water would be suggested, as large quantities may fool the stomach that it's full and thus secrete acid." He recommends skipping extra ingredients, like lemon in your water, because they may trigger more discomfort.

Another home remedy is drinking ginger tea. Ginger is known for its anti-inflammatory properties and has been used for centuries to calm digestive distress. Research published in the journal ‌Children‌ in September 2014 found that ginger provided significant symptom relief from GERD in kids.

Ginger tea's close cousin, chamomile tea, is another smart choice for quelling fasting-induced heartburn. A November 2010 review paper in the journal ‌Molecular Medicine Reports‌ found that an extract of chamomile tea lowered stomach acid as effectively as an over-the-counter antacid. One cautionary note: Although it's been used since ancient times, it hasn't been well studied, says the National Center for Complementary and Integrative Health. People taking blood thinners should talk to their doctor before taking chamomile. There's also a potential risk of allergic reaction in people with allergies to ragweed or related plants, it says.

According to Harvard Health Publishing, to prevent reflux, it's also best not to drink carbonated beverages and to sleep with your head elevated — ideally, 6 to 8 inches higher than your feet. You can also protect your stomach and esophagus by avoiding non-steroidal anti-inflammatory (NSAID) medications like aspirin or ibuprofen.

The good news, says Dr. Berookim, is that, with time, your body will likely regulate an acid imbalance from fasting. "In general, after a little while of allowing one's body to adjust to the fasting, the stomach will begin to reduce the amount of acid secreted," he says.

Talk to your doctor before beginning a lengthy fast, says Dr. Berookim. Besides the risk of acid reflux, there are medical reasons why some people shouldn't go for long stretches without food. If you do fast, be sure to stay hydrated while fasting by drinking plenty of water or other non-caloric, non-carbonated beverages.

And if heartburn impairs your quality of life or becomes severe (whether during fasting or any other time), seek help from a specialist.