Q) After using Peptest to measure Pepsin levels, I saw a high overnight reading after an evening meal of pastry and mincemeat but a very low day time reading following an oatmeal breakfast, veg soup and salad lunch and a small yoghurt and apple for tea.

Is there any evidence that the amount of pepsin produced in one’s stomach is proportional to the amount of protein being consumed in your diet?

Professor Peter Dettmar says: “Diet does play a large role in reflux disease and when we recommend lifestyle changes we always recommend changes in diet either by eating smaller meals or cutting out certain foods.

Cells in the stomach secrete pepsin to help you digest – it breaks down proteins into smaller compounds called peptides.

Naturally, with pepsin being the main digestive enzyme its volume will increase if high volume protein meals are consumed and this will include meals high in red meat.

This does not mean that GERD and reflux sufferers should become vegetarians, but it means that care needs to be taken in what you eat and when you eat.

For example, we will always recommend not eating four hours before going to bed to allow the digestive process to have taken place before lying down to sleep – this especially applies to high protein meals where the process can take even longer.

We also recommend that GERD and reflux sufferers eat smaller meals more often.

There have been many studies in this area studying the influence of diet on reflux and this includes in some sufferers reducing the amount of acidic foods (including some fruits) and eating more alkaline foods.

In summary, you will need more pepsin to break down higher protein containing foods, such as red meat, and patients who control their diets by cutting out reflux trigger foods – bread in many cases – and eating more salads and vegetables, can experience less reflux-like symptoms.

But the big tip is to eat smaller meals and do not eat late at night.

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