Acid reflux is probably the most common gastrointestinal problem my patients’ have. Some people deal with it on occasion while others struggle with it on a daily basis. People may experience acid reflux in different ways. Some people feel a burning in the chest (hence why it’s called heart burn), some have an acidic or bitter taste in the back of their throat, and others have less obvious symptoms like having a hoarse voice, trouble swallowing or having more saliva than normal.
So where does this acid come from and why does it go where it doesn’t belong? Our stomachs produce lots of acid to help with digestion. We have something called a lower esophageal sphincter, or LES, that opens to let the food we swallow into the stomach, and then it closes to keep the acid in the stomach where it belongs. Sometimes, our LES doesn’t always do a great job. Nobody’s perfect, right? The LES could be malfunctioning due to a variety of things including pregnancy, obesity, stress or certain medical issues like a hiatal hernia.
Having reflux once in a great while is probably not a big concern. It can be uncomfortable and painful and possibly disrupt your sleep, but it will go away. If reflux in happening regularly though, this is a reason for concern. The highly acidic contents of the stomach can cause damage to the esophagus leading to something called Barrett’s esophagus and possibly esophageal cancer. If you’re concerned about this, ask your doctor if you should have an endoscopy done.
Luckily, changes in diet and lifestyle can often improve reflux quite a bit! Let’s talk about what you can do to help.
Being overweight or obese definitely increases your risk of GERD (gastroesophageal reflux disease). The reasoning for this is not totally known, but it can be assumed that extra fat around the midsection puts pressure of the stomach causing the reflux. Losing weight is obviously going to take time, so it’s not going to fix your issues overnight, but it’s an ideal long term solution.
Eat Smaller Portions
Eating large meals often causes reflux in people that are prone to it. Your stomach is pretty big, about the size of a football, but it can only hold so much. Once it’s out of room, the stomach contents have to go somewhere. Eating smaller and more frequent meals and snacks can make a big difference.
Be Mindful of What You’re Drinking
Alcohol is often the culprit for reflux. Alcohol doesn’t just relax you, it relaxes your LES as well, causing it to get a little lazy. Caffeinated and carbonated beverages are often offenders as well. Even some decaf coffee can bother certain individuals.
The nicotine in cigarettes also causes the LES to relax. The more you smoke, the more likely it is to be a problem. Add this to the long list of reasons to quit smoking!
Avoid High Fat Foods
High fat foods can be a trigger for reflux. Avoid fried foods, high fat dairy products, pastries, and high fat meats like sausage, bacon, bologna and hot dogs. Even healthy fats like nuts, nuts butters and oils can cause acid reflux.
Avoid Other Common Diet Triggers
Other foods that can cause reflux include chocolate, peppermint, spearmint, garlic, onion and spicy foods. You may have other diet triggers as well. Keeping a food diary and tracking symptoms can sometimes help you determine what affects you personally.
Often people say they were told to avoid tomato sauce or orange juice due to the high acid content. The acid your stomach produces is WAY stronger than any food you would eat, so this shouldn’t be much of a concern. However, some people do feel that acidic foods do makes their reflux worse. Again, this is going to vary from person to person.
This is kind of a tricky one. Regular exercise can help decrease reflux long term, but specific exercises can actually make it flare up. You’ll have to see how your body reacts. Generally, high intensity exercise and sit ups can cause reflux. Some people do better if they wait at least 2 hours after a meal to exercise.
Try Other Lifestyle Changes
There’s other things you can do besides just changing your diet to help improve reflux. Try the following:
Remain upright after eating- don’t take a nap after a meal or eat dinner too close to bedtime
Wear loose-fitting clothing
Raise the head of the bed
Work on stress management
Don’t Skip the Meds!
Many people are on a proton pump inhibitor (PPI) such as Prilosec, Prevacid, Protonix, Zegrid or Nexium for acid reflux. The job of these medications is to decrease the amount of acid the body produces. If you skip a dose or stop taking them all together your stomach is going to make acid like crazy making the reflux much worse! If you want to stop taking your PPI, talk to your provider about weaning yourself off of them or taking a different kind of reflux medication until your body adjusts.