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GERD

GERD

What is GERD?

GERD, or gastroesophageal reflux disease, results when contents of the stomach retract into the esophagus (the tube that carries food from the mouth to the stomach). GERD can be caused by physical conditions and lifestyle factors, but it is most commonly cause by decreased lower esophageal sphincter (LES) pressure. The LES is serves as a barrier between the esophagus and the stomach, but certain factors can lower its ability to hold food in the stomach. Factors that increase the likelihood of GERD include eating large meals, lying down after eating, obesity, pregnancy, or wearing tight fitting clothes around your waist or stomach. Symptoms of GERD may include difficulty swallowing, heartburn or belching.

How is GERD treated?

GERD is treated using various approaches, depending on the cause and symptoms. Often medication is prescribed to decrease stomach acidity. Lifestyle modifications, such as wearing loose fitting clothing, smoking cessation and remaining upright after eating, are important steps to manage GERD and reduce its symptoms. Nutrition therapy is highly individualized with GERD, and individuals should pay special attention to what triggers symptoms.

How can nutrition help?

Because most individuals identify GERD symptoms with certain foods, nutrition is a key component to decreasing symptoms and irritation. With irritants identified, individuals can work with a Registered Dietitian to construct a well balanced diet plan to fit their lifestyle.

What are the nutrition guidelines?

There are certain foods that relax the LES, leading to reflux. These include peppermint, spearmint, chocolate, fried foods, high fat foods, alcohol and coffee (caffeinated and decaffeinated) and should be limited in any individual who experiences symptoms of GERD.

Other food groups need to be monitored closely in order to determine which foods are symptomatic for each individual. The following foods may need to be avoided if they cause irritation or any GERD symptoms.

  • Beverages: coffee, cola, tea or alcohol
  • Dairy: high fat milk (including 2%), cream, high fat yogurt or chocolate milk
  • Protein sources: fried meats, bacon, sausage, pepperoni, salami, bologna or hot dogs
  • Fruits and veggies: limit only those that are symptomatic
  • Fat: as tolerated. Fat is one of the most likely causes of GERD aggravation.
  • Grains: In general, grains should not be avoided because they typically do not cause symptoms.

Remember, each person is different, and this list will vary depending on what aggravates your symptoms.

Tips

  • Reduce your intake of foods and beverages that aggravate your GERD symptoms
  • Keep in mind that the foods that irritate your symptoms will not be the same as another individuals
  • Eat smaller, more frequent meals in order to avoid a very full stomach, which can increase GERD symptoms
  • Do not eat within two hours of going to bed
  • Keep your head elevated at a 45 degree angle after eating
  • If obese or overweight, strive to reach a healthy weight

Links to additional resources

http://www.nlm.nih.gov/medlineplus/esophagusdisorders.html
http://digestive.niddk.nih.gov/ddiseases/pubs/barretts/
http://www.vivo.colostate.edu/hbooks/pathphys/digestion/pregastric/esophagus.html

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