HEARTBURN PART II: G.E.R.D. AND LIFESTYLE

Before discussing how to decrease or even prevent the symptoms of G.E.R.D. (Gatroesophageal Reflux Disease) there are a few concepts that I wrote about last blog that I want to review:

1. G.E.R.D.  and the symptoms of heartburn occur when the acidic and/or bile-like contents of the stomach are pushed up into the esophagus.
2. The Lower Esophageal Sphincter and the diaphragm separate the stomach from the esophagus.  If either of these is not functioning correctly it is more likely that normal meals will cause G.E.R.D.
3. Food stimulates your stomach to make acid and your liver to make bile.
4. A ‘hiatal hernia’ occurs when part of your stomach is above the diaphragm.  This means that the diaphragm no longer helps keep acid and bile in the stomach, making G.E.R.D. much more likely.

If you are born with a hiatal hernia or develop it later in life there are surgical ways to deal with it, but that should be the your last alternative.  Most hiatal hernias can be dealt with by making certain lifestyle adjustments.    Here are a few adjustments that might help:

1. Do not be overweight.   Being heavy means that there is more fat in the abdomen.   Believe it or not, this causes an increase in pressure on the stomach and actually makes it more likely for stomach acid to be pushed up into the esophagus.
2. Do not lie down within two hours of eating. Once you eat, your stomach starts producing acid to digest the food you just ate.   Maximum acid production occurs an hour to two after a meal.  If you are like many people and either lie down on the sofa or go to bed after a meal, you are very likely to have symptoms of G.E.R.D.    After a meal is a great time to go for a short stroll or walk the dog.   Let gravity be your friend and help the meal and the acid go down through your intestine, not up to the esophagus.
3. Eat Small Meals.  The larger the meal, the more the stomach is stretched.   The more the stomach is stretched the more the L.E.S. is stretched.   The more the L.E.S. is stretched, the more likely stomach contents will reflux into the esophagus.  In this case less really is more.
4. Avoid foods that open the L.E.S. Certain substances cause the lower esophageal sphincter to open, thus making reflux more likely to occur.  Many of these substances are stimulants, like caffeine (that includes coffee, tea and sodas) and nicotine.   Fatty substances also affect the L.E.S;  for example, fatty meats, chocolate and fried food.   Some foods like peppermint and raw onions are notorious for causing reflux but how they do so is unknown.

Not all of these recommendations work for everyone, but most of them work for most people.   Try them out and see which ones work for you.   On my next blog I will get specific about which foods are the most notorious for causing G.E.R.D.   Stay tuned for HEARTBURN PART III:   You Mean I Have to Give  Up Tomatoes?

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