GERD stands for gastro-oesophageal reflux disease, a chronic digestive disease in which acid stomach contents reflux into the esophagus, causing damage. According to Harvard gastroenterologist Raj K. Goyal in the 2008 edition of "Harrison's Principles of Internal Medicine," heartburn -- often within 30 to 60 minutes of a meal -- is the most common symptom of GERD. Diet plays a key role in controlling symptoms.
Portion Size
Large meals are more likely to trigger GERD symptoms than small ones. This is because large meals exert more pressure on the stomach, increasing the probability that some contents will push into the esophagus. To prevent this, replace large meals with more frequent, small ones. Decreasing portion sizes is also a strategy for losing weight. If you are overweight, losing weight may help control your GERD.
Timing
Goyal says GERD symptoms often worsen when you bend, bounce or lie down. To avoid this, refrain from eating for one hour before and two hours after exercise. Eat your last meal at least three hours before you plan to go to bed. If GERD still interferes with your sleep, buy a wedge-shaped pillow or use blocks to elevate the head of your bed by four to six inches.
Foods to Avoid
What you eat also influences GERD symptoms. Cow's milk dairy products, caffeine, alcohol, mint and chocolate relax the lower esophageal sphincter that normally keeps stomach contents out of the esophagus. Fatty foods are more difficult for your stomach to digest, so they remain in the stomach longer and cause it to secrete more acid -- two factors that increase the likelihood of reflux. Acidic and spicy foods irritate the esophagus on their way to the stomach.
Foods to Enjoy
People with GERD should focus on foods that are low in fat. This means choosing lean cuts of meat, fish and poultry and using healthy cooking techniques such as baking, broiling, steaming or braising them. Fruits, vegetables and grains are mostly fat-free. If they still cause trouble, select soft or cooked versions. Replace cow's milk dairy products with low-fat dairy versions made from sheep, goat or soy milk.
Expert Insight
In the 2004 edition of "Heartburn and Reflux for Dummies," Carol Ann Rinzler and gastroenterologist Ken DeVault suggest a few other food-related strategies for controlling GERD. Chewing sugar-free gum for 30 minutes after a meal keeps saliva flowing, which helps wash away acids that accumulate in the esophagus. Wearing loose-fitting clothing or letting out a few buttons when you eat is another good idea, according to Rinzler and DeVault.
Considerations
Diet does not replace conventional medications or surgery for the treatment of GERD and acid reflux. Attend all follow-up appointments, even if you think your symptoms seem under control. Goyal says complications such as bleeding and the formation of scar tissue can develop in the absence of recognizable symptoms.
References
- "Harrison's Principles of Internal Medicine, 23rd Edition"; Anthony S. Fauci, M.D. et al.; 2008
- "Integrative Medicine"; David Rakel, M.D.; 2007
- "Heartburn and Reflux for Dummies"; Carol Ann Rinzler, M.A. and Ken DeVault, M.D.; 2004
