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Dr.Chirag Thakkar

GERD/Acid reflux/Heartburn: Diet and Lifestyle

Acid reflux (GERD- Gastro-Esophageal Reflux Disease) is one of the most common lifestyle diseases affecting today’s society. Although not a life-threatening condition, this problem is a huge burden on individual GERD patients and on society. Although patients may need medications or surgery for treatment, a healthy lifestyle and diet is very important for treatment to be effective.

GERD/Acid reflux: a lifestyle disease

GERD a lifestyle disease

Acid reflux is a lifestyle disease, and due to today’s stressful and hectic lifestyle, the burden of this problem is increasing significantly. Thus, lifestyle change and correcting the way we eat is not just necessary to get a good solution to the problem of acid reflux and heartburn, it is also needed to prevent GERD.

Mechanical factors like hiatus hernia and your body’s general tendency to the weakness of muscles are contributory factors for heartburn and acid reflux. But the major reason for the increase in the occurrence of Acid reflux (GERD) is the changing lifestyle. Even with the above factors which cause GERD, a healthy lifestyle and diet pattern can prevent as well as decrease the severity of acid reflux.

Irregular meal timings, inadequate sleep, the habit of doing work along with meals, eating fast, eating fast food with the intent to manage work schedules are all the components of today’s lifestyle that contribute to the problem of GERD. Not to ignore the highly processed foods, sugar, chocolates, food prepared in animal fat, carbonated drinks are all equal culprits. Increasing social acceptability of alcohol and smoking, and increasing socialization also has some role.

Lifestyle changes for persons suffering from Acid reflux or GERD (Heartburn)

Stop smoking, tobacco in any form and alcohol

GERD treatment: Stop smoking and alcohol

Smoking and alcohol cause heartburn due to multiple reasons. First, both alcohol, tobacco and smoke can cause direct damage to the inner lining of your food pipe and stomach. This can lead to ulcers. Second, they also cause an increase in the production of acid from your stomach. Third, they relax the valve at the lower end of the food pipe. This leads to the reflux of food and acid back to the food pipe causing damage and ulcers there.

Hence, if you are suffering from heartburn i:e Acid reflux or GERD, and you have the habit to smoke or consume alcohol, then stopping it is the first thing you need to do. Then only we can achieve lasting relief from this problem.

Get good sleep

Good sleep: an important part of heartburn treatment

Good sleep is important for your body and mind to function properly. Inadequate sleep or poor quality of sleep affects your digestive system, your metabolism, immunity as well as your mental health. Hence, just as it affects your health in general, it can lead to heartburn and acid reflux. It also leads to a lot of functional digestive problems like bloating, abdominal cramps, constipation, and tummy upset. Though, these functional problems are not diseases it affects your quality of life and is difficult to treat.

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If you are obese or overweight, lose weight

Weight loss: Part of GERD treatment if you are overweight

Excess weight put pressure on your stomach causing acid to back up into your food pipe. Hence, those who are overweight are more likely to need long term medications for GERD. They are also more likely to have incomplete relief with medications and a poor quality of life due to acid reflux problems. Obesity and severe GERD both together is more likely to lead to breathing problems.

So, if your weight is healthy, work to maintain it. If you are overweight or obese, work to slowly lose weight — no more than 1 or 2 pounds (0.5 to 1 kilogram) a week. Ask your doctor for help in devising a weight-loss strategy that will work for you. You must understand that weight loss is very much the part of your acid reflux treatment.

Incorporate physical activity in your lifestyle

Physical activity: Important part of healthy lifestyle

Some form of physical activity is a part of a healthy lifestyle. It is very much needed to maintain overall physical as well as mental health. Not just to reduce weight, but it is needed to keep your metabolism healthy. It also helps in reducing anxiety and stress, which is a common cause of GERD and functional digestive problems like constipation and IBS.

Heavy gym exercise or running a marathon is not always needed. Even having half to one hour of walk or cycling or swimming or playing any sport of your choice should suffice. But you should make sure you are mentally switched off from your work and other day to day issues during this time.

De-stress yourself: Meditate

Increased tension, anxiety and stress lead to increased acid production by the stomach which in turn causes more reflux and heartburn. The functional problems like bloating, cramps and burping also increase in times of stress. By stress and anxiety, I am not talking about depression and major psychological problem that needs psychiatrist opinion. Even small stressful events like work pressure, missing a bus, verbal fight at a traffic signal are adequate enough to caused stress.

De-stress yourself: GERD/Heartburn

Many times the long-standing problem of heartburn and tummy upset is the cause of stress and anxiety. If that is the case, it leads to a vicious cycle where stress and heartburn eventually increase the severity of each other. In such a situation aggressive treatment for both heartburn and stress are needed togather.

In all the above situation meditation for even 10 minutes a day would help significantly. You need to learn and practice the art of calming yourself down. It can easily be learned if you do it regularly for a longer period of time. It also brings a lot many other health benefits along with improvement in your tummy problems.

Avoid tight-fitting clothes

Clothes that fit tightly around your tummy and waist put pressure on your stomach and the lower oesophagal sphincter (LES) valve. This makes it easy for the food to reflux back into your food pipe, especially after meals and when you bend or lie down. Hence, those suffering from severe GERD should avoid compressing clothes and belts.

Raise the head end of your bed

GERD/Acid reflux/Heartburn: Head end elevation

If you regularly experience heartburn at night during sleep, then put gravity to work for you. However, laparoscopic surgery is the best solution for such patients, after which there is no need to sleep with a head up. But, until you decide to have surgery, it will give lots of relief. Place wood or cement blocks under the feet of your bed so that the head end is raised by 6 to 9 inches. If it’s not possible to elevate your bed, you can insert a wedge between your mattress and bed to elevate your body from the waist up. Wedges are available at drugstores, medical supply stores or you can get them custom made at a mattress shop. Raising your head with additional pillows is not effective.

Dietary advice for patients suffering from GERD/Acid reflux (Heartburn)

How you eat is more important than what you eat

A large meal will empty slowly from the stomach and exert pressure on the LES valve. A snack at bedtime is well-positioned to reflux when you lie down. Avoid large meals, especially late in the day. Avoid overeating by eating smaller meals more frequently. Regularise your meal and sleep time.

Regular timings: five meals a day

Regular meal timings. Small and more frequent meals

You might try having the main meal at noon and a lighter one at dinner time. It is best to eat early in the evening so that the meal is digested at bedtime. Wait at least 1 to 2 hours after eating before lying down or going to bed. Increase the number of meals by adding a snack between your breakfast and lunch, lunch and dinner. Then you won’t be too hungry to pounce upon the food at lunch and dinner. Smaller meals and an upright, relaxed posture should help minimize reflux.

Relaxed and mindful eating

All meals should be eaten in relaxed stress-free surroundings. Trips to the kitchen to fetch food or the performance of other tasks such as minding children should be suspended during, and for a time after, eating. Make a habit to eat more mindfully. Take small bites, relish the taste, reflect to figure out the ingredients. Eat slowly, chew properly and try to understand when you start feeling full. Eat a bit less than what makes you full. These simple eating habits will help solve half of your tummy and diet-related problems.

Foods that should be avoided

Certain foods and beverages increase the chances of reflux, either by delaying emptying of the stomach or by increasing acid production. The foods which cause symptoms of heartburn may vary from person to person. It is best that you watch your diet carefully for a few weeks and maintain a symptom diary so you can identify which of these foods do not suit you and modify your diet accordingly.

Common GERD Trigger foods to be avoided

 

 

  • Tea
  • Coffe
  • Cold drinks and carbonated drinks
  • Sugar
  • Refined wheat flour
  • Some of the vegetables like onion, garlic, tomatoes
  • Full-fat milk and milk products. It means you should consume low-fat milk, curd and paneer
  • Citrus fruits like orange, pineapple, lemon

Regarding sour fruits, I would like to clarify one thing, these fruits are not the reason for acid reflux. Due to the presence of citric acid in it, the severity of the symptoms of GERD patients increases. If acid reflux is under control with medication or surgery, you can have all these fruits.

As such these fruits are an important part of a balanced diet and to be healthy one should consume them in proper amounts regularly. Even with treatment, if consumption of these fruits is causing any discomforts to you, you should discuss this with your doctor, and under his guidance changes in the treatment are required.

GERD Triggering Foods

Everyone has specific triggers. Common triggers such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine may make heartburn worse. Avoid foods you know will trigger your heartburn. Citrus fruits are in general a part of a healthy diet. So if you have heartburn due to it, then you need more aggressive treatment, so that you can have a healthy and balanced diet. If this is the case with regular medications, then GERD/Acid reflux surgery is the right option for you.

Healthy diet

Foods that do not cause GERD

Apart from your food triggers, you should follow a healthy diet. As part of a healthy diet, you should reduce the intake of fried, spicy and fatty food as much as possible. Both the frequency and amount should be reduced. You should learn the habit of enjoying each bite so that you can enjoy food even with restricting unhealthy food. The intake of healthy food options like vegetables, fruits, whole grains, millets (ragi, bajara, jowar), nuts, fish and lots of non-caloric and non-carbonated drinks should be increased.

All the above diet and lifestyle talk is for everyone, not just those troubled by heartburn. It is part of a normal healthy lifestyle. It will not only prevent the problem of GERD but many other lifestyle diseases like obesity, diabetes, cardiac, liver and kidney problems.

Watch our video on Diet and Lifestyle change for GERD/Acid reflux/Heartburn

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