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Diet Changes for GERD

Proper treatment of gastroesophageal reflux disease (GERD) always begins with a visit to a healthcare professional to obtain an accurate diagnosis. It is important to recognize that chronic reflux does not get better on its own. Over-the-counter remedies may provide short-term symptom relief, but can mask an underlying disease if used long-term.

Symptoms of GERD

Just about everyone has had heartburn – that uncomfortable burning feeling in the chest after eating a heavy meal – at some point in their life. But, while occasional heartburn is nothing to worry about, heartburn that occurs more than once a week, becomes more severe, or occurs at night and wakes you from sleep may indicate gastroesophageal reflux disease (GERD). And, a visit to the doctor is advised.

Treatment for GERD may include medications advised by your doctor and certain diet and lifestyle changes. A combination of approaches, and some trial and error, may be necessary.

Diet and lifestyle changes often begin with what to avoid. These include things that can trigger or worsen symptoms.

Examples of things to reduce or steer clear of in your diet include:

High fat foods
Caffeine
Chocolate
Onions
Peppermint
Carbonated beverages
Alcohol
Citrus and tomato products

Coming up with the appropriate diet and lifestyle changes involves discovering what works best for you. Not all triggers and treatments will affect all people in the same way. Bear in mind that when you eat may be just as important as what you eat. A particular food that causes reflux when eaten 3–4 hours before bedtime may be harmless earlier in the day.

Changes to Diet

Eating right for GERD does not have to mean cutting out all of your favorite foods. Making just a few, simple modifications to your current diet is often enough…

While no proven “GERD diet” exists, the following foods may help you ease or avoid symptoms.

Fruits and Vegetables

Fruits. While most likely avoiding citrus fruits and juices, like oranges and lemons, choose from a variety of non-citrus fruits such as bananas, melons, apples, and pears among others.

Vegetables. Select from the wide variety of vegetables. Avoid or reduce sauces or toppings that are high in fat or other irritants like tomatoes or onions.

Lean Proteins

Eggs. These are high in protein. However, if eggs are a problem for you, stick to the whites and stay clear of the higher fat yolks, which are more likely to cause symptoms.

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Lean meat. High fat meals and fried foods tend to decrease lower esophageal sphincter (LES) pressure and delay stomach emptying, increasing the risk of reflux. Choose lean meats that are grilled, poached, broiled, or baked.

Complex Carbohydrates

Oatmeal, whole grain bread, rice, and couscous. All of these are good sources of healthy complex carbs. Whole grains and brown rice add fiber to your diet.

Potatoes and other root vegetables. These are great sources of healthy carbs and digestible fiber, but make sure to avoid adding onion and garlic during preparation, as these are common irritants.

Healthier Fats

Fat is a type of nutrient – high in calories but a necessary part of your diet. Not all fats are created equal. Generally avoid or reduce saturated fats (usually from meat and dairy) and trans fat (in processed foods, margarines, and shortenings). Try replacing them, in moderation, with unsaturated fats from plants or fish. Here are some examples:

Monounsaturated fats. Examples include oils such as olive, sesame, canola, and sunflower; avocados; peanuts and peanut butter; and many nuts and seeds.

Polyunsaturated fats. Examples include oils such as safflower, soybean, corn, flaxseed, and walnut; soybeans and tofu; and fatty fish such as salmon and trout.

Other Helpful Tips

Chew gum. Chewing gum (not spearmint or peppermint, which can relax the LES) increases saliva production and reduces the amount of acid in the esophagus.

Avoid alcohol. Alcohol is a known irritant that can weaken the LES and trigger reflux symptoms. However, while some people may experience a spike in symptoms after just one drink, others can tolerate moderate amounts. Experiment to see what works for you.

Keep good posture during and after a meal. It’s a good idea to sit up while eating and avoid lying flat for a minimum of two hours after eating a meal. Standing up and walking around after a meal helps encourage gastric juices to flow in the right direction.

Avoid eating immediately before bed. Digestion increases the amount of gastric acid present in the stomach. When you lay down, the ability of the LES to prevent stomach contents from traveling up the esophagus decreases. Occurring together, lots of stomach acid and a reclined position are a recipe for reflux. Timing can vary from individual to individual, but generally, eating a full meal less than three or four hours before bed is not advisable for GERD sufferers.

Eating right for GERD does not have to mean cutting out all of your favorite foods. Making just a few, simple modifications to your current diet is often enough to help reduce the discomforts of GERD. The goal is to create a diet based on a healthy variety of foods that include fruits and vegetables, lean sources of protein, complex carbohydrates, and healthy fats.

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If you suspect that foods may trigger or worsen your symptoms of GERD, try keeping a one week daily diary.

The Acid – Alkaline Conundrum

For good health, the body needs to maintain a certain acid-alkaline balance. Keeping this balance is crucial to remaining healthy and slowing the ageing process. Cells function more efficiently when they are alkaline. In an ideal world, the body should be 70% alkaline and 30% acid. In the western world the average person is about 80% acid and 20% alkaline. Excess acid in the body leads to disease.

A number of factors affect the acid-alkaline balance in the body. Foods are a big factor, as is stress and anxiety. Accordingly, a combination of poor diet and a stressful life style will make the body very acidic. This acidity leads to anything from simple problems such as poor absorption of foods to more sinister degenerative diseases such as arthritis and even cancer.

FOODS TO AVOID

Not all acid forming foods are bad for you. Protein, for instance, is acid forming; but we need it to build tissue and stay healthy. We do, however, tend to eat far more protein than is necessary. So try and cut down on meat and replace it with fish and pulses which are also rich in protein. The biggest animals on earth, lest we forget are herbivores….

All animal produce including eggs is acid forming, but red meat has a much higher uric acid content. So stick to fish,turkey and chicken.
Dairy produce such as milk or yogurt is alkaline on the way in but becomes acidic once digested. So it still has a negative affect on the body.
All nuts are acid forming except for almonds, fresh coconut and chestnuts.
Most grains are acid forming, but very healthy, so it’s all about balance. Millet, buckwheat and quinoa are alkaline.
Refined sugar, chocolate, alcohol, coffee, tea and fizzy drinks are very acid forming.
All drugs, prescription or recreational are very acid forming.

FRIENDLY FOODS

All vegetables are alkalising. Especially: Cabbage, broccoli, spring greens, green beans, carrots, kale and asparagus. These are high in magnesium which is highly alkalising. Seaweed, kelp, wheat grass and alfalfa are also great.
All fruits are very alkalising and a great source of vitamins and minerals. Plums and all berries are acidic, but still very healthy as part of a balanced diet. The most alkalising fruits are melon, mango, papaya and dates.
Citric fruit such as grapefruit, pineapple, and kiwi are acidic on the way in but turn alkaline after digestion, so good for your alkaline balance but not so good if you suffer from stomach acidity.
Sea salt is very alkalising as is apple cider vinegar, so use these when preparing salads or cooking.
Lemons and limes are very alkaline, orange juice is the devil … Its a long story.

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USEFUL REMEDIES

UltraClear PLus PH: This alkalising metabolic clearing program is a great way to detoxify the liver and gastro intestinal tract and re alkalise the body. (3 scoops in water first thing in the morning)

Spirulina Pacifica: This is an excellent vitalising blend of very absorbingly blue-green algae and a true alkalising super food.(2 tablets 3 times daily with water).

(Available through NUTRI: 0800 212 742)

Most health shops will carry an array of green powders which are all alkalising.

HELPFUL HINTS

Have a cup of warm water with lemon, apple cider vinegar and a little honey in the morning. This will help to re-alkalise the body that is often acidic when we wake up.
Drink at least 2 litres of water a day, dehydration leads to acidity.
Deep slow breathing will fill the lung bases with oxygen and flush out the stale acidic carbon dioxide.
Exercise, and take up some relaxation technique like meditation. Stress makes us very acidic and needs to be managed properly.
Drink diluted fresh juice in the morning. Add ginger which will keep you alkaline.
Cut down on your meats and eat your greens and you are half way there.

GERD Diet: Foods That Help with Acid Reflux (Heartburn)

Getting a case of acid reflux (heartburn) once in a while isn’t unusual, but some people suffer from burning discomfort, bloating and belching almost every time they eat. About 20% of the population has gastroesophageal reflux disease (GERD), a chronic acid reflux condition that’s diagnosed by a doctor.

Normally, the esophageal sphincter (a muscular tube that lets food pass into the stomach and then cinches shut to block it from coming back up) protects the esophagus from stomach acid. However, if the sphincter relaxes, food can push upward through the loosened opening and cause acid reflux.

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«Diet plays a major role in controlling acid reflux symptoms and is the first line of therapy used for people with GERD,» says Ekta Gupta, M.B.B.S., M.D., gastroenterologist with Johns Hopkins Medicine.

Foods That May Cause Heartburn

Foods commonly known to be heartburn triggers cause the esophageal sphincter to relax and delay the digestive process, letting food sit in the stomach longer, says Gupta. The worst culprits? Foods that are high in fat, salt or spice such as:

Fried food
Fast food
Pizza
Potato chips and other processed snacks
Chili powder and pepper (white, black, cayenne)
Fatty meats such as bacon and sausage
Cheese

Other foods that can cause the same problem include:

Tomato-based sauces
Citrus fruits
Chocolate
Peppermint
Carbonated beverages

«Moderation is key since many people may not be able to or want to completely eliminate these foods,» says Gupta. «But try to avoid eating problem foods late in the evening closer to bedtime, so they’re not sitting in your stomach and then coming up your esophagus when you lay down at night. It’s also a good idea to eat small frequent meals instead of bigger, heavier meals and avoid late-night dinners and bedtime snacks.»

Foods That Help Prevent Acid Reflux

Good news: There are plenty of things you can eat to help prevent acid reflux. Stock your kitchen with foods from these three categories:

High-fiber foods

Fibrous foods make you feel full so you’re less likely to overeat, which may contribute to heartburn. So, load up on healthy fiber from these foods:

Whole grains such as oatmeal, couscous and brown rice.
Root vegetables such as sweet potatoes, carrots and beets.
Green vegetables such as asparagus, broccoli and green beans.

Alkaline foods

Foods fall somewhere along the pH scale (an indicator of acid levels). Those that have a low pH are acidic and more likely to cause reflux. Those with higher pH are alkaline and can help offset strong stomach acid. Alkaline foods include:

Watery foods

Eating foods that contain a lot of water can dilute and weaken stomach acid. Choose foods such as:

Celery
Cucumber
Lettuce
Watermelon
Broth-based soups
Herbal tea

Heartburn Home Remedies

People with heartburn commonly reach for antacids, over-the-counter medications that neutralize stomach acid. But eating certain foods may also offer relief from symptoms. Consider trying the following:

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Milk

Does milk help with heartburn? «Milk is often thought to relieve heartburn,» says Gupta. «But you have to keep in mind that milk comes in different varieties — whole milk with the full amount of fat, 2% fat, and skim or nonfat milk. The fat in milk can aggravate acid reflux. But nonfat milk can act as a temporary buffer between the stomach lining and acidic stomach contents and provide immediate relief of heartburn symptoms.» Low-fat yogurt has the same soothing qualities along with a healthy dose of probiotics (good bacteria that enhance digestion).

Ginger

Ginger is one of the best digestive aids because of its medicinal properties. It’s alkaline in nature and anti-inflammatory, which eases irritation in the digestive tract. Try sipping ginger tea when you feel heartburn coming on.

Apple cider vinegar

While there isn’t enough research to prove that drinking apple cider vinegar works for acid reflux, many people swear that it helps. However, you should never drink it at full concentration because it’s a strong acid that can irritate the esophagus. Instead, put a small amount in warm water and drink it with meals.

Lemon water

Lemon juice is generally considered very acidic, but a small amount of lemon juice mixed with warm water and honey has an alkalizing effect that neutralizes stomach acid. Also, honey has natural antioxidants, which protect the health of cells.

How a Doctor Can Help

If you have heartburn two or more times a week and changes to your diet or eating pattern haven’t helped, consult a doctor. A gastroenterologist (a doctor who specializes in the digestive system) can perform tests to measure the acidity in your stomach and see if frequent acid reflux has damaged your esophagus.

GERD is often treatable through a combination of lifestyle changes and medication. But persistent symptoms of reflux need thorough evaluation by a gastroenterologist who can find the underlying cause and discuss available treatment options.

The Johns Hopkins Heartburn Center

GERD is an ongoing condition that often requires more attention than over-the-counter treatments can offer. The Heartburn Center at Johns Hopkins Medicine provides personalized care to help patients find relief.

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