If you have acid reflux, you may wonder if drinking milk and eating yogurt will make your symptoms worse. While certain foods are commonly considered triggers of acid reflux, the American College of Gastroenterology's 2013 clinical practice guidelines outline that there is not enough evidence to support blanket food restrictions in acid reflux management. In general, milk and yogurt can be part of a healthy and balanced diet even if you have acid reflux, but individual tolerance may guide your choices. In addition, there are some who do not tolerate dairy because of a cow's milk allergy, and sometimes this allergy can mimic acid reflux symptoms.
Acid Reflux Lifestyle Guidelines
Acid reflux is the result of acidic stomach contents traveling up into the esophagus, often causing a burning sensation referred to as heartburn. Evidence-based lifestyle changes such as losing weight and sleeping with the head of the bed elevated are often recommended to manage acid reflux symptoms. While other potential triggers exist, food restrictions should be based on individual tolerance and symptoms. For example, because high-fat foods are digested more slowly and spend more time in the stomach, regurgitation of stomach contents and worsening of acid reflux could be more likely to occur after drinking whole milk or milkshakes. Chocolate is known to relax the muscle between the esophagus and stomach, making stomach contents more likely to travel back up into the esophagus, so food items such as chocolate milk or hot cocoa are also potential trigger foods. Because the gravity of being upright helps speed digestion, eating any high-fat foods in the hours before bed could also worsen symptoms.
Milk and Reflux
Milk can be a nutritious addition to the diet, since throughout the lifespan, consuming calcium-rich foods such as milk supports healthy bones. But if high-fat foods worsen reflux, nonfat or low-fat milk may be better tolerated compared to whole milk. If chocolate makes your reflux symptoms worse, white milk may be better tolerated than chocolate milk. Some people have lactose intolerance, with symptoms of gas, bloating and diarrhea caused by the incomplete digestion of lactose -- the natural sugar in milk. While lactose intolerance is not linked to acid reflux, people can suffer from both conditions, and removing the offending foods can help manage symptoms. Plant-based beverages such as rice, soy, cashew and almond milk, when calcium-fortified, are good alternatives if you don't tolerate cow's milk or if you have lactose intolerance.
Yogurt and Acid Reflux
In general, yogurt is well tolerated and does not worsen acid reflux symptoms. If high-fat foods worsen your symptoms, choose wisely since different types and brands of yogurt vary in fat content. Like milk, yogurt is rich in calcium and protein and is often fortified with vitamin D. Most yogurt also contains health-promoting bacteria referred to as probiotics -- living microorganisms with health benefits that extend beyond basic nutrition. Although quality research is lacking, there is preliminary data suggesting that probiotics may improve acid reflux symptoms. A study published in the September 2011 issue of "Scandinavian Journal of Gastroenterology" linked probiotic supplementation with a decreased number of stomach and intestinal symptoms, including nausea and regurgitation. Because this study was not focused on acid reflux, more research is needed to clarify if probiotic-rich yogurt or probiotics in general help acid reflux management.
Cow's Milk Allergy and Acid Reflux
According to the August 2011 issue of "Gut and Liver," some forms of severe acid reflux have been associated with cow's milk allergy in children. According to this article, a diagnosis of cow's milk allergy was considered in one-third of the pediatric cases with signs and symptoms of acid reflux disease. The authors summarize that cow's milk allergy can mimic or aggravate the signs and symptoms of severe acid reflux in infancy. This study was completed on children under the age of 2, so additional research is needed to determine if this also applies to adults.
Next Steps and Precautions
The relationship of diet to acid reflux can be quite individualized and not simply managed by blanket diet restrictions. While milk and yogurt should not worsen the symptoms of acid reflux, the full-fat versions may aggravate symptoms in some people. If you aren't sure which food items trigger your symptoms, it helps to keep a diary and symptom log. If your reflux symptoms are frequent or severe, it is important that you see your doctor. Left untreated, acid reflux can lead to serious health complications such as damage to the esophagus, breathing difficulties and sleep disruptions.
Is This an Emergency?
- American College of Gastroenterology: Diagnosis and Management of Gastroesophageal Reflux Disease
- American Journal of Clinical Nutrition: Dairy Products, Yogurt and Bone Health
- American Journal of Clinical Nutrition: Yogurt and Gut Function
- Gut: Dietary Intake and the Risk of Gastroesophageal Reflux Disease: A Cross Sectional Study in Volunteers
- Gut and Liver: Cow’s Milk Allergy Among Children With Acid Reflux Disease
- Scandinavian Journal of Gastroenterology: Dose-R Effect of Bifidobacterium Lactis HN019 on Whole Gut Transit Time and Functional Gastrointestinal Symptoms in Adults