By Peter Denk, MD, FACS
Most of my Fort Myers and Naples patients with acid reflux disease (GERD) simply want their painful symptoms to stop. There are several treatment options to accomplish that goal: anti-reflux medications, repair of the damaged lower esophageal sphincter (the muscle that keeps stomach contents where they belong, in the stomach), and lifestyle/diet changes. As a GERD specialist, I believe that my patients should understand every option and actively partner with me to develop a personal plan for relief and good health.
Almost without exception, my patients ask for more information about the dietary and lifestyle changes they can make to control their symptoms. I am delighted to counsel my patients on these things because they are critical to managing GERD over time. While the powerful anti-reflux medications available today effectively control symptoms, they do nothing to stop reflux from happening. Since GERD is progressive, this continued reflux may further damage the lower esophageal sphincter. In addition, these medications have the potential to cause serious side affects if taken daily over the long term. Therefore, I always encourage a modified diet as the first line of defense against GERD. The very best place to start this treatment model is to identify the foods, beverages, and behaviors that trigger episodes of acid reflux.
I recently read an article on RefluxMD.com titled Five GERD Diet Rules for a Healthier Life, and I was surprised to learn that 75% of those trying to control their reflux with changes to their diet either failed or, even worse, never started to begin with because they weren’t sure how to design a GERD-friendly diet. In the article, the first two rules were to “manage your portion size” and “avoid your trigger foods.” Those two rules are at the top of my list for my patients as well, and I’d like to address the importance of identifying and avoiding your trigger foods here.
First, it is important to note that everyone is different. Foods that trigger heartburn and other GERD symptoms for one person may not have the same effect on someone else. Trial and error is a quick and simple means to determine your trigger foods – your symptoms won’t hesitate to provide you with the answers you need.
What you eat and drink might not be the only factors contributing to your symptoms. How you consume your meals and what you do immediately after eating can also play an important role. For example, eating large meals forces your digestive system to work harder and lying down shortly after eating makes it easier for the contents of the stomach to rise up into the esophagus.
Unfortunately, there’s no real way to predict what will cause symptoms until they develop. During meal times, make a note of what you’re consuming, including the quantities and the time of day. Maintaining a diet log is an easy way to do this, allowing you to easily reference what and how you ate prior to an episode of reflux. Also note your symptoms and when they develop. You will quickly begin to discover what causes your heartburn, so you can then make the necessary changes to your diet.
With that in mind, I put together the following list of suggestions to help you get started managing your acid reflux through healthy diet and lifestyle changes:
Avoid eating large meals
Stomach distention puts undo pressure on the lower esophageal sphincter, and over time this will damage the muscle.
Do not recline after a meal
We all love that lounge chair after dinner, but it is not your friend. Gravity is very effective at keeping that dinner in your stomach, so sit up straight for several hours after dinner.
Try not to exercise after a meal
Work schedules are difficult, so it can be a challenge to exercise before dinner. However, strenuous workouts after a meal will put pressure on your abdomen that can trigger regurgitation.
Wait at least three hours after dinner to go to bed
When you lay down to sleep, the prone position allows the contents of your stomach to flow easily up into your esophagus causing heartburn. You will have a much better chance of getting a good night’s sleep if your dinner has digested before going to bed.
Identify your trigger foods
The following list includes the most common foods that trigger heartburn symptoms. However, as I noted above, only trial and error will allow you to determine if they are trigger foods for you.
. Carbonated beverages
. Citrus fruits
. Drinks with caffeine
. Garlic and onions
. Spicy foods
. Fatty or fried foods
. Tomato-based foods
There is one more item that I must add to this list, and it needs a special comment – alcohol. Alcoholic beverages are enjoyable and help many adults to relax. Unfortunately, those that suffer from acid reflux disease should limit or avoid alcohol all together since it is known to trigger heartburn and other GERD symptoms. It is also believed that alcohol weakens the lower esophageal sphincter, creating a double-whammy effect, so be prudent in your choices.
I hope this list helps you start down the path to better health. If you’re like many who suffer from reflux disease, the long-term management of your symptoms may be within your control. Your self-treatment begins with identifying the foods and behaviors that contribute to your acid reflux. Then, make the necessary changes to eliminate your symptoms. If you are still not satisfied with your results, see a GERD specialist. There are many alternatives to manage these symptoms, so don’t let them control the quality of your life.
GI Surgical Specialists
Ft Myers Office
13710 Metropolis Ave. #101
Fort Myers, FL 33912
8340 Collier Blvd. Suite 205
Naples, FL 34114