Hi friends! Today we are going to talk about GERD, also known as Gastroesophageal reflux disease, and/or known colloquially as “acid reflux” and/or “heartburn.” Specifically, we are going to discuss what GERD is, and how to manage it, including what to eat and avoid when you have GERD. This is an issue that impacts a lot of people (up to one in ten adults!), so if you experience GERD, I hope you find this post useful!
GERD is something I’ve had since undergrad. It can be super distracting and inconvenient at times, so if you suffer from it, know that I see you, I feel you, and I want to help provide you with up-to-date information on how to manage your symptoms and avoid any potential long-term or dangerous complications!
Read on for more about what to eat and avoid when you have GERD!
*Disclaimer: As always, this is general information intended for healthy adults. Your needs may vary based on medical status, lifestyle, or life-stage. Please never replace generalized health information you’ve read online with individualized clinical care.
What is GERD? What causes GERD?
GERD stands for Gastroesophageal reflux disease. GERD occurs when acid and other contents from your stomach are not properly contained in the stomach; rather, they creep up into the esophagus, causing ‘reflux,’ or irritation to the esophagus.
In most individuals, a muscle called the lower esophageal sphincter, found at the bottom of the esophagus/entrance of the stomach, is able to tightly contain acid and other stomach contents by opening to allow food to enter the stomach from the esophagus, and keeping closed most of the rest of the time.
However, the lower esophageal sphincter can become loose or open from time to time, allowing stomach contents to reflux into the esophagus and cause irritation, or GERD.
GERD can happen in people of all ages. Certain conditions can increase risk or symptoms of GERD, including being pregnant, having COPD, being overweight or obese, smoking, and being on certain medications including painkillers, antihistamines, antidepressants, and sedatives.
Hiatal hernias, which occur when part of the stomach pushes up through an opening in the diaphragm, are another common cause of GERD.
Frequent use of Non-steroidal Anti-Inflammatory Drugs, also known as NSAIDs (like aspirin and ibuprofen) can also lead to exacerbation of GERD.
What are the symptoms of GERD?
The most common symptoms of GERD include belching (dry or with stomach contents), heartburn (or the sensation of pain or burning in the chest area), nausea, vomiting, bad breath, respiratory problems, and sometimes worn down tooth enamel, from the acid contents.
So, if you’ve ever burped up some food and had that lovely stomach acid taste arise into your mouth, and/or felt weird pain by your heart after eating, you may be experiencing GERD.
Can GERD be dangerous?
Yes. I feel like very often people sort of shrug off acid reflux and heartburn. But chronic GERD can lead to serious health complications, including inflammation and/or bleeding and hemorrhaging of the esophageal throat lining.
Another condition, known as Barrett’s esophagus, make occur as a result of GERD. In Barrett’s esophagus, the tissue lining of the esophagus changes to resemble the tissue of the intestines, and increases the risk of esophageal adenocarcinoma (cancer).
To avoid the discomfort and potentially serious complications of GERD, proper management is important!
What is best to eat and avoid when you have GERD?
There are lots of commonly suggested actions for individuals to take if they experience GERD. It may be interesting to know that few of them are based off of substantial evidence.
Many people assume avoiding acidic foods or spicy foods, like citrus fruits and hot sauces, is the key to managing GERD. But there is actually little data to support this assumption. While acidic foods may be irritating or triggering to certain individuals, they are actually far less acidic than the stomach, and avoiding them may not be necessary to manage acid reflux.
Alcohol and peppermint may relax the lower esophageal sphincter and make GERD worse, and greasy or fatty foods may sit in the stomach for longer periods of time, potentially triggering GERD. Caffeine and carbonation may also trigger GERD in some individuals, but the data is still shaky.
The best way to decide what to eat and avoid when you have GERD is to make a mini diet/symptom diary, and try to identify which foods or drinks you find triggering for symptoms.
So what are proven ways to manage GERD?
Not eating 2-3 hours before bedtime is a proven, effective way to manage GERD symptoms, especially if you experience nocturnal (night time) GERD. Using an inclined pillow for sleeping may also help.
Staying away from heavy, greasy meals, which are more difficult to digest and sit in the stomach longer, allowing for more time to be refluxed into the esophagus, may also be helpful.
Eating smaller, more frequent meals, rather than a couple large meals, can also prevent large quantities of food from sitting in the stomach and exacerbating GERD symptoms.
Furthermore, quitting smoking can help decrease GERD symptoms, as can avoiding secondhand smoke.
Oh, and if you’re looking for a reason to ditch tight clothing, here’s a great one: tight clothing that presses on the abdomen may make GERD symptoms worse. So replace your fancy pants with sittin’ pants, especially while eating.
GERD Medications:
There are several medications commonly taken in individuals who experience GERD, including antiacids, H2 blockers (Pepcid AC, Axid AR, Zantac75, Tagamet HB), and protein pump inhibitors, also known as PPIs, which include Nexium, Prevacid, Prolisec, Protonix, AcipHex.
Although individual results vary, many people experience symptom relief from taking these medications. That said, they typically shouldn’t be taken long-term. Because…
Important things to Know if You Take Medications for GERD:
If you take H2 receptor or PPI medications long-term, you may be at risk for certain micronutrient deficiencies. Because these medications decrease the acid in your stomach, which is necessary for digestion of certain micronutrients, including iron and B12 (and possibly calcium and magnesium), it’s important to monitor your nutritional status if you take them for more than a couple months.
If you have signs or symptoms of anemia or are worried you may have a micronutrient deficiency, talk to your health care provider about getting a blood test done to make sure you are not experiencing a micronutrient deficiency!
Take home:
GERD, or Gastroesophageal reflux disease, impacts many individuals. While it’s easy to shrug off, it can actually lead to some serious complications and should be carefully managed if it goes on for long periods of time.
Avoiding eating a couple hours before bed, enjoying smaller more frequent meals rather than large meals, sleeping on an incline, and avoiding foods that trigger your symptoms, which may include fatty foods, alcohol and peppermint, are the best ways to manage GERD.
Individual diet triggers or irritants vary from person to person, and the best way to figure out what irritates your GERD is to take careful record of your diet and associated symptoms to identify triggers.
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