Dietary and Behavioral Modifications Recommended in GERD patients.
GERD occurs when gastric acid backs up into the esophagus. This occurs when the lower esophageal sphincter (LES) has been weakened or when gastric emptying is delayed.
Many things can weaken the LES including:
- Eating foods that trigger GERD, such as acidic foods (for example, tomatoes and citrus fruits), spicy foods, or chocolate
- Alcohol or caffeine consumption.
- Nicotine use (e.g. from smoking)
- Medical conditions e.g. asthma. GERD worsens asthma symptoms. Asthma and some asthma medications, in turn, worsen GERD symptoms.
- Increased abdominal pressure (e.g. from obesity, pregnancy, or tight waistbands).
Other things can delay gastric emptying such as:
- Diabetes
- Fatty meals
- Large meals (prolong gastric emptying, increasing chances of reflux).
Lifestyle modifications, such as the following, are the first line of treatment for GERD.
- Lose weight.
- Raise the head of the bed about 4 to 8 inches.
- Wait for 3hrs after a meal before lying down.
- Sleep in the left lateral position.
- Avoid alcohol, caffeinated drinks, garlic, onions, etc.
- Stop smoking.
- Avoid large meals.
- Decrease dietary fat intake.
- Avoid trigger foods.
- Avoid acidic foods (citrus- and tomato-based products).
- Don’t wear clothes that are tight around the waist.
- Avoid medications that may promote GERD symptoms, e.g. theophylline, CCB beta agonists, alpha-adrenergic agonists, nitrates, some sedatives, etc.
**Avoid foods that lower the LES or delay gastric emptying. E.g. onions, garlic, peppermint, chocolate, carbonated drinks, citrus drinks, tomatoes, large meals, fatty meals.
LES = lower esophageal sphincter