Nutrition Guidelines for Gastroesophageal Reflux Disease

Nutrition Guidelines for Gastroesophageal Reflux Disease (GERD)/Heartburn

Dietary Therapies for Gastroesophageal Reflux Disease (GERD)/Heartburn

Lifestyle Changes for Gastroesophageal Reflux Disease (GERD)/Heartburn

Many people complain of pain or a burning sensation in their chest and/or throat during and after meals. These sensations, the symptoms of gastroesophageal reflux disease (GERD), are often referred to as “heartburn.”

Warning: Although GERD/heartburn is unrelated to heart disease, some symptoms of heart attack (myocardial infarction), including chest pain that may radiate to the left arm, shoulder, or neck, are similar to the symptoms of GERD/heartburn. In particular, the principal symptom of a heart attack -- chest pain that steadily worsens -- may be mistaken for severe GERD/heartburn, angina, or simply indigestion. If a heart attack is suspected, call 911 or your doctor immediately.

Heartburn is caused when stomach acid flows upward (reflux) from the stomach into the esophagus, the tube that carries food from the throat to the stomach. Stomach-acid reflux occurs when the lower esophageal sphincter (LES) -- a ring of muscles at the lower end of the esophagus -- fails to keep the esophagus properly closed. (When it is functioning properly, the LES relaxes to allow food to pass through to the stomach but remains constricted otherwise.) When stomach acid comes in contact with the walls of the esophagus, an uncomfortable pain or burning sensation behind the sternum can result, sometimes radiating toward the mouth. The condition is often referred to as GERD when stomach-acid reflux is frequent or severe enough that it significantly disrupts a person’s lifestyle and/or damages the esophagus.

If you suffer from severe or long-lasting symptoms of GERD/heartburn, you should consult your doctor. But if your symptoms are mild or infrequent, a combination of dietary therapies, lifestyle changes, and over-the-counter medications may relieve your discomfort. The most common medications used to treat GERD/heartburn are antacids (ask your doctor to recommend the antacid that is right for you). The following sections provide information on recommended dietary therapies and lifestyle changes for GERD/heartburn.

Diet Therapies for Gastroesophageal Reflux Disease (GERD)/Heartburn

Dietary therapies may be helpful in treating mild or infrequent Gastroesophageal Reflux Disease (GERD)/heartburn by improving the constriction of the lower esophageal sphincter (LES), decreasing irritation in the esophagus, and reducing the frequency and volume of reflux.

Improve Constriction of the Lower Esophageal Sphincter (LES)

The dietary suggestions below may help to improve the constriction of the LES:

· Increase your intake of protein.

· Decrease your intake of fat to less than 45 grams a day, and avoid particularly fatty or greasy foods. Refer to the Low-Fat Diet for guidance.

· Avoid food and drink that is flavored naturally or artificially with peppermint or spearmint.

· Avoid alcohol, coffee, chocolate, and strong tea.

Decrease Irritation in the Esophagus

The following dietary tips may help to decrease irritation in the esophagus:

· Avoid ingesting potential irritants, such as alcohol, beverages containing caffeine (coffee, chocolate milk, hot chocolate, colas, tea), carbonated beverages, citrus juices, tomato-based products, and spicy foods.

· Select foods that are easy to digest, such as gelatins, puddings, and yogurts. See The Bland Diet for further information and suggestions.

Reduce the Frequency and Volume of Reflux

You may be able to reduce the frequency and volume of reflux by taking the following preventative steps:

· Instead of eating three large meals daily, try smaller, more-frequent meals (one every 2-3 hours).

· Eat slowly and chew food well. Get in the practice of putting down your fork after every bite and chewing each mouthful at least 10 times.

· Drink liquids one hour before or after meals instead of with meals. If you must drink during a meal, sip only small amounts as you eat.

· Reduce your weight if you are overweight. See Weight Loss Management for helpful dietary information and suggestions.

· Include enough fiber in your diet to avoid constipation, which can lead to an increase in intra-abdominal pressure. For information and guidelines, see the High-Fiber Diet and Constipation.

Lifestyle Changes for Gastroesophageal Reflux Disease (GERD)/Heartburn

Simple lifestyle changes may help in the treatment of mild or infrequent Gastroesophageal Reflux Disease (GERD)/heartburn. If you have GERD/heartburn, try following the strategies:

· Do not lie down for 2-3 hours after meals. This may help to reduce the frequency and volume of reflux and, in turn, reduce irritation in the esophagus.

· When sleeping or resting, elevate the head of your bed approximately four inches. (Try placing blocks under the legs at the head of your bed.) This may also help to reduce the frequency and volume of reflux and reduce irritation in the esophagus.

· Wear comfortable clothing that is loose around the waist. Tight clothing around the waist may have the effect of weakening the lower esophageal sphincter (LES) and, in turn, increasing the frequency and volume of reflux.

· Avoid chewing gum, and avoid smoking immediately following meals. The air that you swallow while chewing gum or smoking may lead to belching and reflux.

For related information, consult the following links:

Bloating

Heartburn During Pregnancy

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