Treatment options include lifestyle modifications, medications, surgery, or a combination of methods. Over-the-counter preparations provide only temporary symptom relief. They do not prevent recurrence of symptoms or allow an injured esophagus to heal. They should not be taken regularly as a substitute for prescription medicines – they may be hiding a more serious condition. If needed regularly, for more than two weeks, consult a physician for a diagnosis and appropriate treatment.
While diet does not cause GERD, reflux and its most frequent complaint of heartburn can be aggravated by foods.
Common foods that can worsen reflux symptoms include
- citrus fruits
- chocolate
- drinks with caffeine or alcohol
- fatty and fried foods
- garlic and onions
- mint flavorings
- spicy foods
- tomato-based foods, like spaghetti sauce, salsa, chili, and pizza
Lifestyle Changes
- If you smoke, stop.
- Avoid foods and beverages that worsen symptoms.
- Lose weight if needed.
- Eat small, frequent meals.
- Wear loose-fitting clothes.
- Avoid lying down for 3 hours after a meal.
- Raise the head of your bed 6 to 8 inches by securing wood blocks under the bedposts. Just using extra pillows will not help.
Tip: Don't lie down within 3 hours of eating. That's when acid production is at its peak, so plan early dinners and avoid bedtime snacks.
How to eat
How to eat
How is perhaps more important than what you eat. A large meal will empty slowly from the stomach and exert pressure on the LES. A snack at bedtime is well positioned to reflux when you lie down. It is best to eat early in the evening so that the meal is digested at bedtime. You might try having the main meal at noon and a lighter one at dinnertime. All meals should be eaten in relaxed stress-free surroundings. Trips to the kitchen to fetch food or the performance of other tasks such as minding children should be suspended during, and for a time after, eating. Smaller meals and an upright, relaxed posture should help minimize reflux.
What you eat
Certain foods compromise the sphincter's ability to prevent reflux, and are best avoided before lying down or exertion. These differ from person to person. Many person find that fats, onions, and chocolate as particularly troublesome. Alcohol often provokes heartburn, by compromising the LES, irritating the esophagus, and by stimulating stomach acid production. Common beverages such as coffee (both caffeinated and decaffeinated), tea, cola, tomato juice, and citrus juice may aggravate symptoms by irritating the esophagus or stimulating stomach acid production.[3] Certain other foods may bother some people; upon their discovery a period of avoidance or reduction may be of benefit.
Tip: Experiment to find what does and does not work best for you. Start by reducing fatty foods, onions, and chocolate.
Some oral medications such as potassium supplements or the antibiotic tetracycline will burn if allowed to rest in the esophagus. To be safe, one should always swallow medication in the upright position and wash it down with lots of water.
Other factors
Being overweight can promote reflux. Excess abdominal fat puts pressure on the stomach and the loss of even a moderate amount of weight makes many people feel better.
Proton pump inhibitors (PPIs)
Proton pump inhibitors (PPIs) limit acid secretion in the stomach. They allow rapid resolution of symptoms and healing of the esophagus in 80-90% of patients. The drug is also useful in managing stricture, one of the more serious complications of GERD.
Even after symptoms are brought under control, the underlying disease remains present. It is possible that a person may need to take a medication for the rest of their life to manage GERD. Long-term use of medication – whether prescription or nonprescription – should be under the direction and supervision of a physician. Side effects are rare; nonetheless, any drug can potentially have adverse effects.
