Pattern of food intolerance in patients with gastro-esophageal reflux symptoms

Minerva Med. 2017 Dec;108(6):496-501. doi: 10.23736/S0026-4806.17.05379-4. Epub 2017 Sep 7.


Background: Many food items have been involved in gastro-esophageal reflux disease pathogenesis and dietary modification has been proposed as first-line treatment. Test-based exclusion diets have shown to significantly reduce reflux symptoms. We aimed to assess the patterns of food intolerance in a series of patients with typical gastro-esophageal reflux symptoms (GERS).

Methods: We retrospectively evaluated all patients with typical reflux symptoms, attending the Centre Study Association on Food Intolerance and Nutrition of Ferrara from January 2010 to October 2015, who resulted positive to at least one food item at the Leucocytotoxic Test. The presence and severity of typical GERS (heartburn and/or acid regurgitation) were assessed using the Gastro-esophageal Reflux Disease Impact Scale (GIS) questionnaire. Only individuals with a GIS Score of at least 5 points were included.

Results: Almost all patients (91.1%) were intolerant to at least 5 food items. The most frequent food intolerance (more than 33% of patients) were found for milk (55.4%), lettuce (46.4%), coffee (43.7%), brewer's yeast (42.9%), pork (42.9%), tuna (37.5%), rice (35.7%), sole (34.8%), asparagus (34.8%) and eggs (33.9%). Nine different clusters of food intolerance were detected.

Conclusions: Patients with typical gastro-esophageal reflux symptoms seem to have intolerance to multiple food items, some of which (lettuce, brewer's yeast, tuna, rice, sole and asparagus) have not yet been associated to gastro-esophageal reflux disease.

MeSH terms

  • Adult
  • Female
  • Food / adverse effects
  • Food / classification
  • Food Hypersensitivity / complications
  • Food Hypersensitivity / diagnosis*
  • Gastroesophageal Reflux / etiology*
  • Humans
  • Leukocytes / drug effects
  • Male
  • Middle Aged
  • Milk Hypersensitivity / complications
  • Milk Hypersensitivity / diagnosis
  • Retrospective Studies
  • Severity of Illness Index
  • Symptom Assessment