Gastroesophageal Reflux Disease
General Characteristics of GERD
Gastroesophageal reflux disease or GERD, is a very common disorder and occurs when stomach acid refluxes into the lower esophagus through the lower esophageal sphincter (LES.) The LES is a band of muscles that act as a protective barrier against reflux material by contracting and relaxing. IF this barrier is relaxed at inappropriate times or otherwise compromised, reflux occurs.
Chronic or reoccuring reflux allows prolonged contact of stomach contents with the lower esophagus, leading to the symptoms of GERD. IN general four underlying conditions are associated with GERD:
- Decreased lower esophageal sphincter pressure.
- Irritation of the lining of the esophagus by the stomach contents.
- Abnormal clearance of esphoageal acid.
- Delayed stomach emptying.
Symptoms Associated With GERD
GERD is characterized by symptoms and/or tissue damage that results from repeated or prolonged exposure of the linging of the esophagus to the acidic contents of the stomach.
The primary symptom of GERD is persistent heartburn, a burning discomfort felt in the upper chest or abdomen. Symptoms of GERD, however, vary from person to person and at times there may be no symptoms at all. The majority of people with GERD have mild symptoms, with no visible evidence of tissues damage and little risk of developing complications.
Dietary Modifications
Decrease total fat intake - High fat meals and fried foods tend to decrease LES pressure and delay stomach emptying thereby increasing the risk of reflux.
- Avoid large meals - Large meals increase the likelihood of increased gastric (stomach) pressure and reflux.
- Decrease total caloric intake if weight loss is desired - Since obesity may promote reflux, weight loss may be suggested by your healthcare provider to control reflux. Reducing both total fat and caloric intake will aid in weight loss.
- Avoid chocolate - Chocolate contains methylxanthine, which has been shown to reduce LES pressure by causing relaxing of the smooth muscle.
- Avoid Coffee depending on individual tolerance.
- Avoid other known irritants - Alcohol, mint, carbonated beverages, citrus juices and tomato products all may aggravate GERD.
Other Modifications for Treating GERD
- Maintain upright posture during and after eating
- Stop Smoking
- Avoid clothing that is tight in the abdominal area
- Avoid eating withing 3 hours before bedtime
- Lose weight if you are overweight
- Sleep on your left side
- Chew non-mint gum which will increase saliva production and decrease acid in the esophagus
- Elevate the head of your bed 4-6 inches by placing bricks under the headboard