GASTRO-ESOPHAGEAL REFLUX DISEASE
Gastro esophageal reflux disease,
commonly referred to as GERD or acid
reflux, is a condition in which the
liquid content of the stomach
regurgitates (backs up or refluxes) into
the esophagus. The liquid can inflame
and damage the lining (esophagitis) of
the esophagus although visible signs of
inflammation occur in a minority of
patients. The regurgitated liquid
usually contains acid and pepsin that
are produced by the stomach. Acid is
believed to be the most injurious
component of the refluxed liquid. GERD
is a chronic condition. Once it begins,
it usually is life-long. Once treatment
for GERD is begun, therefore, it usually
will need to be continued indefinitely.
As is often the case, the body has ways
(mechanisms) to protect itself from the
harmful effects of reflux and acid. For
example, most reflux occurs during the
day when individuals are upright. In the
upright position, the refluxed liquid is
more likely to flow back down into the
stomach due to the effect of gravity. In
addition, while individuals are awake,
they repeatedly swallow, whether or not
there is reflux. Each swallow carries
any refluxed liquid back into the
stomach. Finally, the salivary glands in
the mouth produce saliva, which contains
bicarbonate. With each swallow,
bicarbonate-containing saliva travels
down the esophagus. The bicarbonate
neutralizes the small amount of acid
that remains in the esophagus after
gravity and swallowing have removed most
of the liquid.
Several changes in eating habits can be
beneficial in treating GERD.
Certain foods are known to reduce the
pressure in the lower esophageal
sphincter and thereby promote reflux.
These foods should be avoided and
include chocolate, peppermint, fatty
foods, alcohol, and caffeinated drinks.
The lower esophageal muscle can be
weakened by factors other than food.
The following recommendations may be
helpful in reducing symptoms:
1. Stop using tobacco in all forms.
Nicotine weakens the lower esophageal
2. Avoid chewing gum and hard candy.
They increase the amount of swallowed
air which, in turn, leads to belching
3. Do not lie down immediately after
eating. Avoid late night snacks.
4. Avoid tight clothing and bending over
5. Eat small, frequent portions of food
and snack if needed.
6. Lose weight if overweight. Obesity
leads to increased reflux.
7. Elevate the head of the bed six to
eight inches to prevent reflux when
sleeping. Extra pillows, by themselves,
are not very helpful.
8. Certain foods aggravate acid reflux,
and should be avoided like fatty or
fried foods, peppermint and spearmint,
whole milk, oils, chocolate, creamed
foods or soups, and most fast foods.
9. The foods that irritate an inflamed
lower esophagus and may need to be
limited or avoided like citrus fruits
and juices, coffee (regular and
decaffeinated), caffeinated soft drinks,
tea and other caffeinated beverages.
10. Spicy or acidic foods may not be
tolerated by some individuals.
11. Probiotics in your diet or in a
supplement naturally restore digestive
balance and health.
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