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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 muscle.

2. Avoid chewing gum and hard candy. They increase the amount of swallowed air which, in turn, leads to belching and reflux.

3. Do not lie down immediately after eating. Avoid late night snacks.

4. Avoid tight clothing and bending over after eating.

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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