Late-night dining on spicy wings and greasy fries can turn even the most tolerant tummy into a tumultuous tyrant. On occasion, everyone experiences heartburn following a large, rich meal. But when the occasional discomfort turns into an ongoing struggle, it is time to make a doctor's appointment.
Gastroesophageal Reflux Disease (GERD) is a chronic digestive disease that occurs when the stomach acid flows back into the esophagus. This leads to a burning sensation in the chest (called heartburn) that can also spread into the throat and mouth, and can lead to dyspepsia (indigestion), chest pain, dysphagia (difficulty swallowing), dry cough, hoarseness, and sore throat.
GERD is not just an annoyance; it can be very dangerous. Stomach acid doesn't just irritate the esophagus, but it can also bring about inflammation, erosion, bleeding, scar tissue, breathing problems, and an increased risk for cancer of the esophagus. Over-the-counter medications and lifestyle interventions are the first line of defense; while prescription medications and surgery are necessary treatment options to reduce the symptoms in others.
When working with your physician to determine the most helpful and appropriate GERD treatment plan, you may find it beneficial to also discuss some lifestyle and complementary approaches. The options listed below should never be used as a replacement for your medical plan, but rather an enhancement. Talk to your doctor about these options; discuss dosage, how long you should try the option, possible interactions (with other foods, supplements or medications), and potential adverse reactions. Together, you and your physician can determine the most effective approach in dealing with your diagnosis of GERD.
Food & Lifestyle Modifications to Relieve Heartburn
- Learn your triggers. Keep a food log to you track all foods and beverages as well as your symptoms. You may recognize a pattern and discover foods that worsen your condition. High-fat meals, large meals, onions, garlic, dairy products, wheat and gluten are sometimes noted as problematic for people with GERD.
- Stop drinking alcohol. If you do drink, limit to only 1 serving of alcohol with a meal on occasion.
- Limit caffeine intake. Caffeine relaxes the lower esophageal sphincter, the valve that opens and closes between the esophagus and the stomach. When relaxed, stomach contents can enter the esophagus causing a burning sensation. Caffeine also stimulates acid secretion, which can worsen GERD. Keep caffeine intake as low as possible by slowly cutting back on caffeine-containing foods and beverages. Use decaf tea and coffee and caffeine-free beverages. Energy drinks should be avoided. Talk to your doctor about medications and over-the-counter medications that may contain caffeine.
- Eat smaller meals and include snacks throughout the day to meet your calorie and nutrient needs. Large meals can add unnecessary pressure to the stomach and chest area.
- Snack smart at night. A high-fat snack can take hours of digestion time before it leaves the stomach. Couple this with the loss of gravity when you lie down at bedtime, and you've set the stage for heartburn hell. Keep snacks at night to no more than 150 calories, using foods composed primarily of carbohydrate and protein while low in fat, such as low-fat or fat-free Greek yogurt, plain air-popped popcorn, cereal with low-fat milk (or dairy alternative), or crackers and low-fat cheese.
- Stop using tobacco. Tobacco products are irritants to the esophagus and stomach.
- Lose weight. It is estimated that nearly 40 percent of people who are overweight or obese experience GERD symptoms, but relief is often noted with even moderate amounts of weight loss. In fact, a recent study involving more than 200 overweight or obese subjects, 38 percent of those with GERD, found that a structured weight-loss program led to a complete resolution of GERD symptoms in subjects who lost weight on the program. Talk to your doctor about locally available weight loss treatment programs or the use of an online weight loss community such as SparkPeople.com. Learn more about GERD and weight loss.
- Reduce stress. Stress affects your gut and intestines, resulting in an array of gastrointestinal disorders including GERD. Practice relaxation strategies that can help lessen stress. These techniques may include cognitive behavioral therapy, stress management programs, hypnotherapy, relaxation therapy, deep breathing, and even acupuncture. Check with your doctor or local hospital regarding reputable resources in your community.
Dietary Supplements That May Relieve Heartburn
(Over-the-counter dietary supplements are not tested or regulated for safety or efficacy the way drugs are. Dietary supplements can also interact with prescription medications. Before using any supplement, talk to your doctor about what is right for you.)
- A specific combination supplement product called Iberogast, from Medical Futures, Inc. contains angelica, caraway, celandine, clown's mustard plant, German chamomile, lemon balm, licorice, milk thistle, and peppermint leaf. Taking 1 milliliter orally, 3 times daily, over a period of four weeks significantly reduced acid reflux, esophagus pain and gastric pain, according to research.
- Taking a combination supplement of caraway oil and peppermint oil seemed to relieve heartburn symptoms in a preliminary study.
- Artichoke leaf extract may be somewhat effective in the treatment of heartburn by its ability to stimulate bile flow.
- Calcium carbonate, taken orally as an antacid, has been shown to be effective for the treatment of heartburn and dyspepsia. It reacts with gastric hydrochloric acid to decrease the acidity. Calcium carbonate has received approval as an antacid from the Food and Drug Administration.
- There is preliminary evidence suggesting that capsicum (red pepper powder) in capsule form may decrease heartburn when taken before meals.
- Fenugreek, when taken before the two largest meals of the day, improved heartburn and stomach discomfort in subjects with GERD in a short, two-week trial test. More research is needed.
- Magnesium taken orally as an antacid has been shown to be an effective treatment for hyperacidity of the stomach and GERD. Different forms are available (magnesium carbonate, hydroxide, oxide or trisilicate). Magnesium hydroxide has the fastest onset of action. Magnesium carbonate is slightly slower due to its crystal structure. Magnesium trisilicate has the slowest onset and longest duration since it is less soluble.
- Melatonin is a hormone found naturally in the body. Preliminary research performed on animals showed that melatonin supplementation (a synthetic form made in a laboratory) can help prevent esophageal injury by protecting the lining of the esophagus from the acid exposure.
- Probiotics may also help since stress has been shown to have negative effects on the healthy bacteria found in the stomach and intestines, and medications used to treat GERD (such as proton pump inhibitors) also have a negative impact on these healthy bacteria by changing the normal gastric acid secretion. As a major consequence, many harmful bacteria can grow in the stomach and intestines, bringing about infection and deterioration in health. Preliminary research using probiotic supplements have been shown to benefit GERD by restoring the healthy bacteria. Probiotics studied to date include Lacobacillus rhamnosus, Lacotbacillus pentosus, Lacobacillus plantarum, and Lactobacillus delbrueckii. Unfortunately, simply eating more yogurt won't necessarily help. When it comes to the treatment of GERD, the correct bacteria type needs to be present in the appropriate amount. Therefore, discuss probiotic supplementation with your doctor.
- Slippery elm can stimulate the nerve endings in the intestines leading to an increase in mucous secretions which may provide protection from excess gastric acidity. More research is needed to determine if supplementation would be beneficial for GERD.
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