When you swallow, food goes from your throat, down your esophagus, through the lower esophageal sphincter (LES), and into your stomach. When the LES does not close properly, the stomach contents leak back, or reflux, into the esophagus. This backflow of acid from the stomach can irritate and sometimes damage the lining of the inside of the esophagus, causing an uncomfortable burning sensation, commonly called heartburn. Occasional heartburn is common, but heartburn that occurs more than two times per week may be considered GERD.

Symptoms of GERD:

• Heartburn
• Regurgitation of stomach acid into the mouth
• Difficulty and/or pain when swallowing
• Chest pain
• Excessive clearing of the throat
• The feeling that food is stuck in your throat
• Burning sensation in the mouth

Factors that may contribute to GERD:

• Pregnancy
• Overweight
• Alcohol use
• Smoking
• Medications that delay emptying of the stomach or that increase the back-up of acid into the esophagus
• Foods that may be associated with reflux events:
• Citrus fruits – orange, grapefruit, lemon, lime
• Spicy foods
• Chocolate
• Caffeinated beverages – tea, coffee, cola
• High fat foods – oil, butter, desserts, fried foods
• Raw garlic and onions
• Mint flavorings – peppermint and spearmint oils
• Tomato-based foods - spaghetti sauce, pizza, chili

Lifestyle changes that may help manage GERD:

• Raise the head of your bed by 6-8 inches by placing blocks of wood under the bedposts (not extra pillows)
• Eat a low fat diet
• Avoid alcohol
• Stop smoking
• Maintain a healthy body weight – lose weight if necessary
• Eat smaller meals
• Wear loose-fitting clothing
• Do not lie down for at least 3 hours after a meal
• Drink liquids between meals instead of with meals
• Avoid lying down, bending over or straining after eating
• Chew gum after meals to help neutralize stomach acid
• Work with your registered dietitian to develop an eating plan that’s right for you!

Other sources of information:

The American Gastroenterological Association (AGA) www.gastro.org

The American College of Gastroenterology (ACG) www.acg.gi.org

Nutritional Information

• Nutritional Counseling
• Probiotics

References:

Balog Catalgo C, Whitney EN. Nutrition and Diet Therapy: Principles and Practice. 6th Ed. Wadsworth Publishing, 2003.

The GERD FAQs. GERD Information Resource Center, sponsored by AstraZeneca LP. Accessed 9/5/2006: http://www.gerd.com/home.htm

National Digestive Diseases Information Clearinghouse (NDDIC): Heartburn, Hiatal Hernia, and Gastroesophageal Reflux Disease (GERD). Accessed 9/5/2006: http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/

The Cleveland Clinic Health: http://my.clevelandclinic.org/health/diseases_conditions/hic_gastroesophogeal_reflux_disease_GERD/ts_diagnosis