Originally written by Megan Erickson, former SDSU Extension Nutrition Field Specialist.
Gastroesophageal Reflux Disease (GERD)
Do you suffer from constant indigestion or experience symptoms such as heartburn? When this occurs frequently it may be more known as gastroesophageal reflux disease (GERD). You are not alone. It is a growing problem and affects nearly 20% of Americans.
GERD is a digestive disorder in which stomach acids, food and fluids flow back into the esophagus. It varies from person to person and may occur at any age. The most common symptom of GERD is known as heartburn but not everyone experiences this.
New Research on GERD
For years, gastroenterologists thought that GERD develops when the frequent backflow of stomach acid irritates and eventually causes damage and erosion to the lining of the inside of the esophagus. However, a recent study published in the Journal of American Medical Association showed that GERD may actually be a response to inflammation in the lining of the esophagus, rather than to the acid erosion. In the article, they looked at people who were prescribed proton pump inhibitor (PPI) medication, and saw that when the patients’ stopped the medication, their acid production increased and their symptoms returned. The researchers examined the changes that occurred and saw an increase in T-cells in all of the subjects, but not loss of surface cells, which was expected from chemical damage. Therefore, while scientists still recommend medications and dietary changes to reduce acid production and backup into the esophagus, it may also be important to recommend diet and lifestyle changes that help to reduce inflammation in those with GERD.
Since everyone experiences different symptoms, what works for some, may not work for others. There are a variety of diet and lifestyle changes worth exploring to see if they reduce the symptoms of GERD. Below are a few lists that identify some of the factors that contribute to or worsen GERD symptoms, foods that may be associated with reflux, and some lifestyle changes that may help to manage GERD.
Contributing Factors
- Alcohol use
- Medications that delay emptying of the stomach or that increase the backup of acid into the esophagus
- Overweight
- Pregnancy
- Smoking
Foods that might cause a problem
- Peppermint and spearmint
- Chocolate
- Alcohol
- Caffeinated beverages, such as tea, coffee, pop, energy drink, etc.
- Pepper
- High-fat foods (butter, desserts, fried foods, oil)
- Citrus fruit (grapefruit, lemons, limes, oranges)
- Onions
- Raw garlic
- Spicy foods
- Tomato- based foods (chili, pizza, spaghetti sauce)
Lifestyle changes for GERD management
- Raise the head of your bed by 6-8 inches by placing blocks of wood under the bedposts (not extra pillows).
- Eat a low-fat diet.
- Avoid alcohol.
- Stop smoking.
- Maintain a healthy body weight.
- Eat smaller meals.
- Wear loose-fitting clothing.
- Do not lie down for at least 3 hours after a meal.
- Drink liquids between meals, instead of with meals.
- Avoid lying down, bending over, or straining after eating.
- Chew gum after meals to help neutralize stomach acid.
- Reduce sources of inflammation such as smoking, foods high in saturated or trans fats , refined and high-sugar carbohydrates, and corn and soybean oils.
- Eat a diet rich in anti-inflammatory foods, such as omega-3 fats from fish, walnut, or flaxseeds, leafy green vegetables, and berries.
In Summary
Working with a registered dietitian can help you to develop a personalized eating plan that helps you to incorporate more anti-inflammatory foods and manage the symptoms associated with GERD. If you are experiencing symptoms of GERD, it may be helpful to keep a log of the food and symptom you are experiencing to help identify trigger foods, and to help you keep track of the changes you are wanting to make.
References:
- Academy of Nutrition & Dietetics. What You Need to Know About GERD.
- Dunbar KB, Agoston AT, Odze RD, et al. Association of acute gastroesophageal reflux disease with esophageal histologic changes. JAMA. 2016;315(19):2104-12. doi:10.1001/jama.2016.5657.
- Gastroesophageal reflux disease (GERD). Cleveland Clinic website.
- Mahan LK, Escott-Stump S, Raymond JL. Krause’s Food and the Nutrition Process. 13th ed. St Louis, MO: Elsevier Saunders; 2012.
- National Digestive Diseases Information Clearinghouse (NDDIC). Gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD) in adults. NIH publication 13-0882. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH) website.
