Digestive Diseases and Sciences

, Volume 51, Issue 8, pp 1307–1312 | Cite as

A Very Low-Carbohydrate Diet Improves Gastroesophageal Reflux and Its Symptoms

  • Gregory L. AustinEmail author
  • Michelle T. Thiny
  • Eric C. Westman
  • William S. YancyJr.
  • Nicholas J. Shaheen
Original Paper


Obese patients with gastroesophageal reflux disease (GERD) may experience resolution of symptoms utilizing a very low-carbohydrate diet. The mechanism of this improvement is unknown. This studied aimed to prospectively assess changes in distal esophageal acid exposure and GERD symptoms among obese adults initiating a very low-carbohydrate diet. We studied obese individuals with GERD initiating a diet containing less than 20 g/day of carbohydrates. Symptom severity was assessed using the GERD Symptom Assessment Scale—Distress Subscale (GSAS-ds). Participants underwent 24-hr esophageal pH probe testing and initiated the diet upon its completion. Within 6 days, a second pH probe test was performed. Outcomes included changes in the Johnson-DeMeester score, percentage total time with a pH<4 in the distal esophagus, and GSAS-ds scores. Eight participants were enrolled. Mean Johnson-DeMeester score decreased from 34.7 to 14.0 (P=0.023). Percentage time with pH<4 decreased from 5.1% to 2.5% (P=0.022). Mean GSAS-ds score decreased from 1.28 to 0.72 (P=0.0004). These data suggest that a very low-carbohydrate diet in obese individuals with GERD significantly reduces distal esophageal acid exposure and improves symptoms.


Gastroesophageal reflux disease Very low-carbohydrate diet Obesity 24-hr ambulatory esophageal pH monitoring 


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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Gregory L. Austin
    • 1
    • 3
    Email author
  • Michelle T. Thiny
    • 1
  • Eric C. Westman
    • 2
  • William S. YancyJr.
    • 2
  • Nicholas J. Shaheen
    • 1
  1. 1.Division of Gastroenterology and Hepatology and the Center for Esophageal Diseases and SwallowingUniversity of North CarolinaChapel HillUSA
  2. 2.Division of General Internal MedicineDuke UniversityDurhamUSA
  3. 3.Bioinformatics Building CB#7080UNC-CHChapel HillUSA

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