Can Gluten Flare Up GERD? Understanding the Connection

January 2, 2026 •

4 min read

According to a 2024 review of multiple studies, people with celiac disease who consume gluten were found to be three times more likely to have GERD than control groups. This growing body of evidence suggests a strong correlation between gluten and the flare-up of GERD symptoms, particularly in those with gluten-related disorders.

Quick Summary

The relationship between gluten intake and GERD involves inflammation from celiac disease and non-celiac gluten sensitivity, gut microbiome changes, and compromised digestive function, which can worsen acid reflux. A gluten-free diet often improves GERD symptoms in sensitive individuals.

Key Points

Celiac and GERD Correlation: Untreated or newly diagnosed celiac disease is strongly linked to a higher prevalence of GERD symptoms due to intestinal inflammation.
Gluten-Free Diet Effectiveness: Adhering to a gluten-free diet can significantly reduce or eliminate GERD symptoms in individuals with celiac disease and non-celiac gluten sensitivity.
Inflammation is a Key Factor: The immune and inflammatory response to gluten in sensitive individuals can disrupt normal digestive processes, contributing to acid reflux.
Systematic Evaluation is Crucial: Before starting a gluten-free diet, it is important to be tested for celiac disease to ensure an accurate diagnosis.
Non-Celiac Gluten Sensitivity: People with NCGS may also experience acid reflux flare-ups after consuming gluten, even without the intestinal damage seen in celiac disease.
Dietary Overlap: Symptoms can be influenced by other wheat components like FODMAPs, not just gluten itself.

Is there a link between gluten-related disorders and GERD?

While gluten is not considered a direct cause of GERD for the general population, a significant body of research indicates a strong connection for individuals with gluten-related disorders like celiac disease (CD) and non-celiac gluten sensitivity (NCGS). For these people, consuming gluten can initiate inflammatory and autoimmune responses that can directly or indirectly trigger or exacerbate GERD symptoms. This occurs through several mechanisms, including intestinal damage, altered gut motility, and immune responses that can affect the entire digestive tract.

The autoimmune connection: Celiac disease

Celiac disease is an autoimmune condition in which the ingestion of gluten leads to damage in the small intestine. This intestinal inflammation and damage, known as villous atrophy, is a key reason for the strong correlation observed between celiac disease and GERD. A 2011 study highlighted that a high percentage of newly diagnosed or untreated celiac patients experienced significant GERD symptoms. This is believed to be due to:

Systemic inflammation: The immune response triggered by gluten creates widespread inflammation, which can affect the esophagus and the lower esophageal sphincter (LES).
Altered gut motility: Intestinal damage can disrupt the normal movement of the digestive tract, potentially leading to increased reflux.
Poor nutrient absorption: Malabsorption caused by celiac disease can impact overall digestive health and function.
Microbiome imbalance: The gut microbiome is often altered in individuals with celiac disease, which can influence GERD symptoms.

Non-celiac gluten sensitivity (NCGS) and reflux

Even without a celiac diagnosis, many people experience symptoms when they consume gluten, a condition known as non-celiac gluten sensitivity. Research suggests that for some with NCGS, gluten can act as a trigger for digestive discomfort, including acid reflux. A study mentioned by Root Functional Medicine found a high prevalence of gluten sensitivity in people with severe acid reflux, with many reporting symptom improvement on a gluten-free diet. The mechanism is not fully understood but likely involves increased intestinal permeability and inflammation.

The effect of a gluten-free diet on GERD

Evidence strongly supports that for those with gluten-related issues, removing gluten can lead to a significant reduction in GERD symptoms. A 2011 study found that celiac patients experienced rapid relief from reflux symptoms after adopting a gluten-free diet. This benefit is often more sustained than relief from some medications, as shown in studies comparing the long-term effects of a gluten-free diet versus PPI therapy in certain patient groups. The therapeutic effect comes from addressing the root cause of the inflammation and digestive disruption rather than just managing the symptoms.

Can wheat itself be the problem?

It's also important to distinguish between gluten sensitivity and a broader wheat intolerance. Wheat contains other components besides gluten, such as fermentable carbohydrates known as FODMAPs. These carbohydrates can cause digestive distress like bloating and gas in sensitive individuals, which can put pressure on the stomach and trigger reflux. For some, a gluten-free diet might relieve symptoms simply by reducing their intake of wheat-based FODMAPs, not just gluten. This highlights the complexity of diagnosing dietary triggers for GERD and the need for a careful elimination process.

Comparison: Gluten's Impact on Digestion vs. Classic GERD Triggers


Factor	Gluten's Impact (in sensitive individuals)	Classic GERD Triggers (e.g., spicy, fatty foods)
Mechanism	Triggers inflammation, autoimmune response, or sensitivity in the digestive tract, leading to altered gut function.	Directly irritates the esophagus or relaxes the lower esophageal sphincter (LES), allowing acid to back up.
Onset	Can be delayed; symptoms may appear hours or a day after consumption.	Often immediate or within a short time after eating.
Symptom Profile	Gastrointestinal (bloating, pain, diarrhea) and non-GI (fatigue, headaches), often overlapping with GERD symptoms.	Primarily heartburn, acid regurgitation, and throat irritation.
Diagnosis	Requires celiac screening or an elimination diet to identify NCGS.	Diagnosis based on symptoms, sometimes confirmed with procedures like endoscopy.
Treatment	Lifelong strict gluten-free diet for celiac; elimination for NCGS.	Lifestyle modifications (avoiding triggers, smaller meals) and medication (PPIs, antacids).

Conclusion: Navigating your diet for GERD

For those who suspect their GERD symptoms are related to gluten, a systematic approach is key. While not a universal trigger, a clear connection exists for people with celiac disease or non-celiac gluten sensitivity. A diagnostic approach should be followed, which may include screening for celiac disease before attempting a strict gluten-free diet. In many cases, eliminating gluten can lead to a marked and persistent improvement in reflux symptoms by addressing the underlying inflammation and digestive dysfunction. Remember that a gluten-free diet should be well-planned to remain nutritious, focusing on whole, unprocessed foods like fruits, vegetables, and naturally gluten-free grains. Always consult a healthcare professional, such as a gastroenterologist or registered dietitian, to determine the best course of action. This ensures proper diagnosis and that a new dietary approach is both safe and effective. You can find more information about celiac disease symptoms on the Celiac Disease Foundation's website.

Frequently Asked Questions

No, gluten does not directly cause GERD for the general population. The link is specifically observed in individuals with celiac disease or non-celiac gluten sensitivity, where gluten triggers an inflammatory or autoimmune reaction that can exacerbate reflux.

To determine if your GERD is related to gluten, a healthcare professional may first test for celiac disease. If celiac is ruled out, a supervised elimination diet where you remove gluten for several weeks and then reintroduce it can help pinpoint if it's a trigger for your symptoms.

Celiac disease is a serious autoimmune disorder that causes intestinal damage in response to gluten, requiring a lifelong, strict gluten-free diet. Non-celiac gluten sensitivity is a condition where a person experiences symptoms from gluten but does not have the autoimmune response or intestinal damage characteristic of celiac disease.

If you have a diagnosed gluten-related disorder, a gluten-free diet can be highly effective in controlling and sometimes resolving GERD symptoms. However, if gluten is not your trigger, a gluten-free diet will not cure your GERD, and other dietary or lifestyle factors may need to be addressed.

A gluten-free diet for someone with GERD focuses on naturally gluten-free whole foods like fruits, vegetables, lean proteins, and gluten-free grains such as quinoa and brown rice, while also avoiding other common GERD triggers like spicy and fatty foods.

No, you must be consuming gluten for several weeks prior to a blood test for celiac disease to ensure the results are accurate. Avoiding gluten beforehand can lead to a false negative result.

Yes, it is possible. If the digestive tract has sustained damage, it may take time to heal. Other triggers besides gluten, such as high-fat foods, acidic foods, or lifestyle factors like stress, could also be contributing to your GERD.