Features » Health

Subscribe

Dietitians Dish: What is GERD?

Lindsay Adams
  • By Lindsay Adams
  • Originally published January 22, 2013 at midnight, updated January 22, 2013 at midnight

Do you ever get a burning sensation in your chest after eating? If so, you may be experiencing symptoms of gastroesophageal reflux disease (GERD) or what many people casually call heartburn. When you eat, food passes from the throat through the esophagus and to the stomach. Once food is in the stomach, the lower esophageal sphincter, or LES, a ring of muscle fibers, prevents food from moving upward, back into the esophagus.

If this sphincter muscle doesn't close well because of lack of pressure, excess food, liquid or stomach acid can leak back into the esophagus. This is when the burning feeling, or reflux, occurs. Several other factors that can affect the pressure of the LES that leads to reflux include increased secretion of certain hormones, presence of other medical conditions such as hiatal hernias or scleroderma, cigarette smoking, obesity and consumption of certain foods known to be triggers.

Besides heartburn, other symptoms of GERD can include dysphagia, or difficulty swallowing, increased salivation and burping. The pain can often be very intense and may radiate toward the neck and jaw. If GERD persists overtime, complications can arise such as dysphagia, aspiration, ulcers, perforation or stricture of the esophagus, or a condition called Barrett's esophagus.

Luckily, there is a number of things you can do to help prevent or decrease the symptoms and complications of GERD. The main treatment is aimed at decreasing gastric acidity to lessen the symptoms and involves making some changes in your dietary habits and, if needed, using certain medications. Always discuss medications with your health care provider, but the dietary changes are ones that you can make yourself.

In general, peppermint, spearmint, chocolate, alcohol, caffeinated or decaffeinated coffee and tea, any other caffeinated beverages and pepper are common irritants for people with GERD. High-fat foods are also commonly associated with GERD because fat delays stomach emptying into the intestines for digestion.

Additionally, the effect of high-fat meals on digestion hormones may also cause a decrease in LES pressure. Examples of high-fat foods are 2 percent milk, whole milk, cream, high-fat cheeses and yogurt, any fried foods, bacon, sausage, pepperoni, salami, bologna, hot dog wieners, nuts and nut butters, pastries and other high-fat desserts.

The goal is to stay below 8 teaspoons of fat products (i.e. oil, butter, nut butter, shortening, etc.) per day. Regardless of whether these high-fat foods cause reflux for you, limiting your intake is a good idea since they are not high in valuable nutrients.

Spicy foods, acidic foods, fruits, fruit juices and vegetables may also cause symptoms for some people. It is often helpful to eliminate these common irritants from your diet and then add them back one by one, noting which ones cause symptoms for you. Keeping a food diary while you go through this process can help you keep track of which foods you need to avoid.

You can also make changes in your lifestyle that can help. Try to exercise at least 3-4 times/week, wear loose-fitting clothing, do not smoke and eat several small meals throughout the day rather than three large ones. Take your time while eating meals (20-30 minutes/meal) and try to make sure you eat at least three hours before lying down for bed. It may be helpful to raise the head of your bed about 6 to 9 inches, which can be done by placing a foam wedge under the top part of your mattress.

GERD is a common issue, but there are plenty of common changes that you can make to help prevent or decrease the symptoms and complications. As always, be sure to consult your healthcare provider if symptoms persist.

Lindsay Adams is a registered dietitian with DeTar Health Systems. Send questions or comments to dietitians@vicad.com.