How to Manage Acid Reflux with Crohn’s Disease

Because acid reflux occurs in the esophagus, doctors often don’t consider it a symptom of inflammatory bowel disease (IBD). The condition can affect any part of the GI tract, but it most commonly affects the small and large intestines.

I’ve been living with IBD and acid reflux (also known as heartburn) for years — and it turns out, I’m not alone.

In a 2017 study, 63.9 percent of people with Crohn’s disease reported heartburn. Even though it’s common, IBD needs, like lactose sensitivity and vitamin deficiencies, can make treating heartburn more difficult.

I’ve learned some valuable lessons on the journey to treat my heartburn while living with Crohn’s disease. Here are my tips for managing acid reflux alongside IBD.

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Track your heartburn and IBD flare-up symptoms

People with IBD may experience acid reflux during an IBD flare-up or during a period of remission. Tracking your reflux symptoms may help you notice a connection between your flare-ups and heartburn symptoms.

I personally notice an increase in acid reflux and indigestion when I’m heading for a flare-up, so heartburn is a useful indication that I should call my IBD team.

Make sure your heartburn medications are IBD-compatible

Some heartburn medications may cause complications for people living with IBD. Many popular antacids, like Tums, contain calcium carbonate to neutralize stomach acid. Long-term consumption of calcium can cause your magnesium levels to decline.

It’s important to note that magnesium deficiency is already a common IBD complication, according to the National Library of Medicine.

I stuck to antacids for years, because I was reluctant to take another medication. In my mind, heartburn seemed like a relatively common problem, and I already had medication for my autoimmune disease. To counteract magnesium deficiency, I applied magnesium lotion before bed and checked my levels regularly.

But over time, antacids became less effective for me. I finally started a new medication, a proton pump inhibitor called omeprazole that decreases the amount of acid the stomach produces.

At first, I experienced nausea and diarrhea, the very symptoms I was trying to avoid, and I worried my IBD symptoms were worsening. But after a week, omeprazole’s side effects subsided, and the medication notably reduced my heartburn symptoms.

Vitamin B12 deficiency is another common IBD complication, and omeprazole decreases the absorption of vitamin B12, according to the National Library of Medicine. Because my IBD occurs in the ileum, where vitamin B12 is absorbed, I decided to wean off of omeprazole.

I noticed a huge improvement in my heartburn when I started taking Humira a year ago. Although Humira doesn’t claim to alleviate acid reflux, it has helped control my lower GI symptoms and impacted my entire digestive tract.

There’s no denying that medication is important if you’re experiencing long-term acid reflux. Untreated long-term heartburn can cause complications, so making sure your medications are IBD-compatible is key.

Consider how diet affects your acid reflux symptoms

The most common heartburn remedy is a glass of cow’s milk. As a source of calcium, milk is often recommended to neutralize stomach acid. But for lactose-sensitive people living with IBD, dairy may worsen symptoms.

An estimated 70 percent of people living with IBD are lactose sensitive, according to a study published by the National Library of Medicine. To treat my heartburn, I drink calcium-enriched dairy-free milk instead.

It’s also recommended to eat a high fiber, veggie-filled diet to treat acid reflux. But during an IBD flare-up, we’re advised to eat the opposite: a low fiber diet.

In my experience, foods that reduce IBD symptoms help reduce my acid reflux, too. Grilled, low fat chicken and fish, mashed potatoes, and rice are my go-to choices.

Conversely, my IBD trigger foods, like alcohol and spice, can worsen heartburn symptoms. The only exception is peppermint tea, which soothes my bowel cramps but worsens acid reflux.

Try other lifestyle changes

I’ve made a few other lifestyle changes to manage my acid reflux alongside IBD.

Evenings are my time to relax after a busy day juggling work and a toddler. But I’ve found that a big meal before bed causes evening heartburn. Eating less before bedtime has reduced my evening reflux and nighttime trips to the toilet. Having a cut-off time, like 2 hours before bed, helps me stick to the routine.

Low intensity exercise, like yoga, has also helped my acid reflux. But more intense cardio, like running, temporarily worsens my acid reflux symptoms.

Keeping a diary of your heartburn symptoms may help you identify other lifestyle changes for alleviating your acid reflux.

The takeaway

Even though heartburn can be uncomfortable, remember it’s common among people living with IBD.

Tracking your symptoms can help you identify a connection between your acid reflux and IBD flare-ups. And different treatment choices, such as medication, diet, and lifestyle changes, can make your symptoms easier to manage.