GERD is an abbreviation for gastroesophageal reflux disease, a chronic digestive disease characterized by backwards flow of stomach contents into the esophagus. In most cases, according to MedlinePlus, a doctor can diagnose GERD on the basis of history and physical examination findings. For severe symptoms or to assess your response to treatment, you may require diagnostic tests performed by a gastroenterologist or radiologist. Treatment begins with diet change. Beverages, in particular, are common culprits for people with GERD.
Types
In their 2004 book, "Heartburn and Reflux for Dummies," writer Carol Ann Rinzler and gastroenterologist Ken DeVault explain that, in terms of their effects on GERD, all beverages are not created equal. Beverages that pose special problems for people with GERD include coffee, tea, cocoa, carbonated beverages, alcohol, milk and acidic juices such as orange, tomato, cranberry and pineapple juice.
Chemical Properties
Rinzler and DeVault say that caffeine in coffee, tea, cola, cocoa and energy drinks weakens the contraction of the muscles that normally seal off the esophagus from the stomach. Alcohol and milk proteins have the same effect as caffeine. In addition to caffeine, Rinzler and DeVault note that cocoa contains methylxanthines that have the same effect as caffeine, alcohol and methylxanthine.
Physical Properties
Rinzler and DeVault say that acidic beverages such as citrus, pineapple, cranberry and tomato juice pose a problem because they directly irritate the lining of the esophagus. They are actually less acidic than the acids the stomach produces on its own, so they rarely bother people with a healthy digestive tract. They cause discomfort for people with GERD because the esophagus is already damaged. In the case of carbonated beverages, Rinzler and DeVault caution that acidic stomach contents often join carbon dioxide as it bubbles back into your esophagus.
Considerations
The more food and liquid in your stomach, the higher the pressure in the stomach and the higher the probability that some of the contents will be pushed back into the esophagus. Therefore, Rinzler and DeVault suggest enjoying beverages between meals rather than with them. It also helps to consume smaller servings. A standard beverage serving size is 8 oz., or 1 cup. This is equivalent to a small coffee at most coffee shops. By contrast, a can of soda contains 12 oz. Plastic bottles contain 20 to 24 oz. Some large or super-size drinks at fast-food restaurants and convenience stores contain 40 oz.
Alternatives
Rinzler and DeVault suggest that you make water your staple. Among other beverages, good choices for people with GERD include herbal tea -- except herbal tea that contains mint -- low-acid orange juice, apple juice and diluted sports drinks. For die-hard coffee, tea and cola fans, Rinzler and DeVault say that choosing decaffeinated versions may not be enough because other compounds in these beverages can potentiate acid secretion in the stomach. However, GERD triggers vary from person to person. Rinzler and DeVault suggest that, whatever you drink, you keep a log of your symptoms so you know what beverages work for you and what beverages do not.
References
- MayoClinic.com: GERD: Symptoms
- MedlinePlus: Gastroesophageal Reflux Disease
- "Heartburn and Reflux for Dummies"; Carol Ann Rinzler, M.A. and Ken DeVault, M.D.; 2004
