Can Sugar in a Child’s Diet Trigger Gastroesophageal Reflux Disease?

One of the things, I truly love about becoming a nurse and working in the healthcare profession, is that it is constantly evolving and researching ways to improve the health of people like you and me.  We that are your healthcare professionals are constantly challenging conventional wisdom and thinking, as well as, reevaluating traditional treatment modalities.

This type of thinking can result in some fantastic discoveries, which can alter how diseases are treated and managed. A recent example to this is the research that has taken place with gastroesophageal reflux disease, also known as, GERD. For years (approximately 80 to be exact) the healthcare community have been lead to believe that this digestive disorder was caused by stomach acids backing up into the esophagus. This can result in burning, irritation and even damage to your esophagus. However, a new study published in the Journal of the American Medical Association (JAMA) appears to be questioning this line of thinking. The research from this study seems to suggest that the damage caused by GERD is not the result of stomach acid entering the esophagus. The study proposes that the damage caused by GERD is a result of an inflammatory response prompted by cytokines, which are inflammatory messenger proteins.

The researchers took a group of 12 men who were on proton pump inhibitors to use as their sample group. Proton Pump inhibitors, otherwise known as PPI’s, is a medication that reduces the amount of acids produced in the stomach.  When you have less acids produced in the stomach you diminish the harmful effects (the burning, the irritation, and the damage). 

The men were asked to stop taking their PPI’s for 2 weeks. The researchers expected to see a resumption in the symptoms.  What the researchers did find, however, is that in 11 of the 12 men, there was changes in the esophagus. The change in the lining of the esophagus was not indicative of burns (which is what the researchers expected).  What they discovered is that the esophagus was stimulated by the stomach acid, to produce cytokines. This led to the beginning of a cascade of inflammatory processes which led back to the disease.

Their research concluded that it is not the stomach acid that is causing the problem but rather it is the cytokine messengers. They believe that the development of GERD is cytokine-mediated and not the result of chemical injury.

So now, you might be asking the question, “why is this finding and change in thinking so important?” Well, the answer is that it tells the medical community that we might be placing our focus in the wrong area.  When you consider that this is a disease that affects millions of people, this could be huge.  Perhaps, we need to place our focus on cytokine blockers and inflammation since this appears to be the catalyst to the development of this disease.

Why should we reduce cytokines?

The problem with cytokines is that when activated, they drives chronic, low-grade inflammation process. This type of inflammation is linked to certain diseases such as Diabetes,

Cancer ‘and Heart Disease.  In regards to the link between cytokines and GE Reflux Disease, we certainly need to see more research, to justify changing our treatment modalities but it does sound promising.

So, the question you might ask at this point is, what if additional research does prove that cytokines are the cause of the damaging effects of GERD?  What would be the next step? The next step would probably be to find ways to lower their presence in your body. And that would not be hard to do, considering there are cytokine blockers currently in use to treat some of our most formidable inflammatory diseases, such as, Arthritis, Inflammatory Bowel Disease (Crohn’s) and Psoriasis. Some clinical trial leaning in that direction might prove them to be effective against GERD. To the medical community and sufferers of this disease, this is exciting news! 

So, what could you do in the meantime? Well, your healthcare professionals at yourkidshealth.net have several suggestions to offer. One way you can help your child is by lowering their intake of sugar.  It is sugar that triggers the release of cytokines.  You can also increase your intake of anti-inflammatory omega-3 fatty acids. If taking omega-3 supplements aggravates your child’s reflux (which has been known to happen in some cases) you can always eat foods rich in omega-3. Meals containing salmon, mackerel, trout, albacore tuna, and sardines two or three times a week would be adequate. And, of course, with GERD you want to avoid highly acid foods (oranges, lemons, tomatoes, etc.) and spicy foods.

Reference

Dunbar KB, et al. JAMA. 2016;315(19):2104-112.

Tony is a Registered Nurse, who has 25 years of pediatric experience. He has practiced as a Staff Nurse, Charge Nurse, and as a Nurse Manager at Cook Childrens Medical Center in Fort Worth, Texas. He also has experience in the adult arena, most recently as a nurse in a Cardiovascular ICU and as a Hemodialysis Nurse. He has a wife and two children. His hobbies are Bible study, physical fitness, working with children, writing and blogging.