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You can prevent acid reflux by watching diet

There’s a children’s rhyme about how when our food does not like the atmosphere of our stomach, it “pops back up to say hello.”

For many of us, this all-too-common second greeting is a most unwelcome situation. It turns out much of the underlying cause of the problem lies in the way we choose to eat in the first place.

Gastro-esophageal reflux disease, also known as GERD, affects up to 20 percent of the U.S. adult population. It results from abnormal displacement of caustic acid outside the stomach.

The stomach is connected to the mouth by a tube known as the esophagus, which conveys food there in an organized fashion during eating. At the bottom of this tube lies a muscular valve known as the lower esophageal sphincter, whose job is to prohibit re-entry of stomach contents into the esophagus.

While the stomach has a lining that protects it from acid damage, the mucous membranes of the esophagus, throat and mouth are susceptible to acid-induced injury.

GERD produces a range of symptoms including a burning sensation in the chest, burping, a foul taste in the mouth and occasionally the sensation of a lump in the throat. So-called “silent” symptoms of GERD can include hoarseness and chronic cough resulting from the spill of acid contents into the upper airway, most commonly during sleep.

While anatomical and infectious conditions can contribute to reflux, a combination of food selection, meal timing and mechanical factors can greatly influence the frequency and severity of the condition. Collectively, paying attention to these contributing variables permits the prevention of GERD among many chronic sufferers. The classic scenario is a restaurant meal consisting of fatty foods mixed with onion, garlic and tomato sauce, accompanied by a glass of wine and followed by a chocolate desert and coffee, and a dinner mint with the check. Then it’s out the door and home to bed.

Sounds nice, right? Well, this is basically the perfect recipe for reflux.

Certain foods are known to trigger relaxation of the lower esophageal sphincter, thus permitting a return of stomach contents into the esophagus. Among these are fatty foods, tomato sauce, alcohol, caffeine, chocolate, garlic, onion and mint. Avoiding these foods, or at least avoiding them in large volume or their high-density combination, can help in managing reflux. There are also various mechanical factors that contribute to GERD. Larger volume meals increase pressure in the stomach, thus leading to reflux. Gravity can also work against us, particularly after a large meal. Lying recumbent, such as during sleep, can promote the reflux of stomach acid into the esophagus. For those of us who eat our largest meal of the day in the evening, it certainly gives us pause.

Reducing meal volume and fasting for a few hours before bedtime can reduce GERD symptoms.

Obesity is a contributing factor for reflux because it increases intra-abdominal pressure. Thus weight management is an essential component of GERD management. Of course, there are both over-the-counter and prescription medications that can assist with controlling GERD symptoms. For those suffering chronic symptoms of reflux, a medical evaluation to investigate other causes is recommended.

Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.



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