GERD, or gastroesophageal reflux disease, is also commonly referred to as acid reflux. Reflux occurs when the lower esophageal sphincter (or LES, the valve between the esophagus and the stomach) either doesn't close completely or opens spontaneously. When this happens, stomach acids and even food can rise back into the esophagus, causing the burning sensation of heartburn. GERD can also occur without heartburn, especially in children, but can cause asthma symptoms, trouble swallowing or a dry cough.
Controlling Symptoms
Although there are a number of medications that have proven effective in controlling GERD, physicians also recommend lifestyle changes to help prevent pain and other symptoms. One of the most common recommendations is a change in diet and eating habits. Reflux symptoms worsen after meals, possibly because the stomach is distended and pressures the LES. Smaller meals can decrease this pressure and allow the esophageal sphincter to close more tightly. Doctors also recommend eating the evening meal earlier in the day, and to avoid nighttime snacking for at least two hours before bed. This helps decrease nighttime symptoms that occur when lying down.
Trigger Foods
Trigger foods are foods associated with an increase in GERD symptoms. Many of the most common triggers have been identified. These include tomatoes and citrus fruits, which are high in acid. Spicy foods such as chilies, garlic and onions cause an increase in stomach acids. Creamy, fried or fatty foods, including many dairy products, are slow to digest and linger in the stomach, putting additional pressure on the LES. And chocolate contains methylxanthine, which relaxes the LES.
There are also a number of beverages that act as triggers. Carbonated beverages can have a double hit. They are often high in acid, and the carbonation creates carbon dioxide in the stomach, leading to increased belching. Alcohol relaxes the LES, and coffee and tea, even decaffeinated, increase heartburn.
Identifying Triggers
Since all people react differently to food, there is no one-size-fits-all GERD diet, with good foods and bad foods. It is necessary for each individual to identify his own triggers. One of the best ways to do this is to keep a detailed food diary. Record all food or drinks consumed and the time of day, along with any symptoms experienced. It will only take a few days to begin recognizing patterns, making it possible to eliminate problem foods.
Diet Recommendations
The book "Natural Stomach Care" outlines a basic diet that is healthy and balanced and will help minimize GERD symptoms. Approximately 35 percent of the diet should come from grains, preferably whole grains. About 40 percent should be high-fiber fruits and vegetables. When possible opt for fresh over frozen or canned, and emphasize the vegetables over the fruit. Only 15 percent of the diet should come from meat, eggs and oils, and restrict dairy products to 10 percent. Live-culture dairy items like yogurt are encouraged, but avoid heavy cream and butter. Avoid very spicy or rich foods, as well as carbonated beverages, alcoholic beverages and chocolate.
Other Lifestyle Changes
In addition to diet changes, there are other lifestyle modifications that are recommended for GERD patients. One of the most important factors in GERD control is to maintain a healthy weight, since obesity increases pressure on the stomach. Avoid belts and tight-fitting clothes around the waist, which also squeeze the stomach. Smokers should also make every effort to quit. Nicotine relaxes the LES and stimulates the production of stomach acid, increasing symptoms.
Another change proved to decrease GERD symptoms is elevating the head several inches while sleeping. A wedge-shaped pillow that elevates both the head and shoulders may be effective. Another option is to raise the head of the bed itself with a sturdy riser, such as blocks or bricks. The goal is to elevate the head approximately 6 to 8 inches while also inclining the torso. Raising just the head on extra pillows without also angling the body will actually worsen reflux.
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