What Causes GERD:
GERD or gastro esophageal reflux occurs when the low esophageal sphincter (LES) relaxes and allows the acid contents of the stomach to flow back into the esophagus. Due to the acidity of the stomach contents, this causes the burning feeling which gives this condition the common name of heart burn or acid reflux.
Why is GERD Concerning:
Although occasional reflux is normal, chronic exposure of the esophagus to acid from the stomach increases the risk of esophageal cancer. The more often the cells of the esophagus are damaged by acid the more likely that they will permanently damaged and become cancerous.
Treatment:
Although there are medications to manage GERD, the best treatment is to make lifestyle modifications to prevent GERD from happening. Diet-wise this means avoiding foods that are high acid, foods that relax the LES and foods that delay gastric (stomach) emptying. Foods that do not fall into these categories can continue to be enjoyed!
High fat foods delay gastric emptying and increase the risk of GERD as the stomach remains full for a longer period of time. Avoid pastries, nut butters/nuts fried foods, high fat dairy (ice cream, whole milk) and high fat meats. Include both animal and plant sources of protein in your diet. Prepare foods without added fat (oil, butter). High fiber foods can also contribute to delayed gastric emptying. Some people find that they tolerate cooked fruits and vegetables better than raw.
Caffeine and alcohol should be avoided as they relax the LES and cause GERD. Caffeine-free tea can be enjoyed, but avoid peppermint or spearmint flavors as they also relax the LES. When using seasonings avoid pepper or other spicy seasonings. All spicy foods should be avoided. Chocolate can also cause the LES to relax and should be avoided.
Foods that are high in acid should be avoided as they increase the amount of acid in the stomach and can increase GERD. Foods that are high in acid include citrus fruits, onions/garlic, tomatoes, soda/carbonated beverages.
There are also several habits you can add to your daily routine to help decrease GERD (unsurprising they are also great tips for anyone!)
· Exercise 3-4 times per week
· Do not smoke
· Wait 3 hours after eating before laying down
· Eat several small meals throughout the day and avoid eating large meals
· Eat in a calm environment and do not rush
· Maintain a healthy weight
Symptom Tracking:
As we are all different, you may find that some of the foods mentioned above do not cause GERD or even that foods not listen cause GERD. An important step in a successful diet modification is to track your symptoms with different foods. You may notice that different preparation methods or amounts of a certain food cause GERD. Note which foods you don’t tolerate well and avoid those foods as much as possible to prevent GERD.
Can I never have any of the foods that contribute to GERD?
No, you won’t have to give up chocolate cold turkey, but the stricter you follow these recommendations the less GERD you will have and the healthier you will be! Also, as mentioned in the section above you may not experience GERD with all of these foods. If you do want to enjoy a food that causes you GERD follow the following steps:
1) Limit your intake to 1 food that causes GERD
2) Before consuming that food take an antacid such as TUMS
3) Enjoy a moderate portion of that food and eat it slowly
4) After eating it be sure to remain upright for 3 hours
Finals Notes:
If your doctor is interested in prescribing you medication for GERD be sure to discuss with them that you would like to trial a GERD diet/lifestyle modification to see if that can be an effective way to manage your symptoms. Everyone has different success with different methods of GERD management and you may require a combination of treatment methods. If you need support in making these changes reach out for a free 15-minute consultation to learn about my nutrition counseling services.
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