What is gastroesophageal reflux disease (GERD), and how can good nutrition help?
Gastroesophageal reflux disease, or GERD, occurs when the lower esophageal sphincter (LES) does not close properly and stomach contents leak back into the esophagus. The LES is a ring-like muscle at the bottom of the esophagus that acts like a valve between the esophagus and stomach. Heartburn occurs when refluxed stomach acid touches the lining of the esophagus, causing a burning sensation in the chest. Heartburn that occurs more than two times a week may be considered GERD, and it can eventually lead to more serious health problems.
The purpose of this diet is to reduce the reflux of stomach fluid into the esophagus and to avoid foods that irritate the esophageal mucosa. It may be necessary to lose weight, since excess weight increases stomach pressure.
Avoiding the following foods may help with reducing symptoms:
- Caffeine (regular coffee, regular tea, chocolate)
- Citrus fruits/juices
- Carbonated beverages
- Mints (peppermint, spearmint)
- Tomato products
- Fried, greasy foods
- Spicy foods
- Garlic and onions
- Achieve and maintain a healthy weight.
- Eat small, frequent meals. Large meals may increase stomach pressure, and therefore reflux.
- Fat takes the longest time to leave the stomach; therefore, reduce the total amount of fat that you eat at a meal by decreasing the amount of margarine, butter, oils, salad dressings, gravy, fatty meats, and full-fat dairy/milk products such as sour cream, cheese, and whole milk.
- Maintain an upright posture while eating and for 45-60 minutes afterward. Avoid bending over or reaching below your waist after meals to do things like loading the dishwasher, tying your shoes, or picking up items from the ground.
- Avoid eating before bedtime. It takes the stomach four to five hours to fully empty a meal, so wait at least three hours after eating to go to bed.
- Avoid clothing that is tight in the abdominal area.
- When sleeping, raise the head of the bed 6-8 inches, using wooden blocks under the bedposts. Extra pillows will not work.
- Stop smoking.
- Reflux triggers vary from person to person. Try eliminating possible trigger foods for two weeks, then reintroduce one food at a time to determine your tolerance and evaluate severity of symptoms.
- Your doctor may prescribe acid-reducing medications, such as proton pump inhibitors (PPIs). Do discuss with your physician.