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Your Best Lifestyle & Dietary Choices for Acid Reflux

What is Acid Reflux?

Acid reflux disease is a condition when the lower esophageal sphincter, the valve that separates the non-acidic esophagus from the acidic stomach, fails to work properly so that acid from the stomach travels up into the esophagus, irritating the esophageal tissue, resulting in heartburn.

Heartburn involves having a burning pain in the chest, a sense of acid in the back of the throat, and sometimes wheezing or a sore throat from excess acid where it doesn’t belong. Another name for acid reflux is gastroesophageal reflux disease or GERD.

Common Causes and Risk Factors

  • Eating a big meal or lying down shortly after eating – This causes stomach contents, which are acidic, to travel by gravity into the esophagus.
  • Being obese or overweight – This increases the pressure in the abdominal cavity so that the acid can rise upwards more readily.
  • Bending over at the waist after eating – This results in an increase in intra-abdominal pressure and causes the food you ate to enter the esophagus.
  • Eating too close to bedtime – When you eat too close to bedtime, you lie down, resulting in gravity allowing acid to enter the esophagus.
  • Eating certain foods – These include citrus fruits, chocolate, tomatoes, mint, onions, fatty foods, garlic, or spicy foods.
  • Drinking certain beverages – This includes carbonated soft drinks, alcohol, tea, or coffee.
  • Smoking – Smoking relaxes the lower esophageal sphincter so acid can leave the stomach.
  • Being pregnant – This increases the pressure within the abdomen so acid rises up above the stomach.
  • Taking certain medications – This includes aspirin, some muscle relaxants, ibuprofen, and some medications for high blood pressure.
  • Hiatal hernia – This means that there is a larger than normal hole in the diaphragm separating the chest from the abdomen and the stomach rides up into the chest cavity. The diaphragm also helps keep acid from leaving the stomach and, when it isn’t part of the equation, acid can back up into the esophagus, leading to GERD.

Symptoms

Some of the more common symptoms of acid reflux disease include the following:

  • Heartburn – This is a sensation of discomfort or burning pain that starts in the stomach and travels up the chest to the throat.
  • Regurgitation – This involves a sour taste or bitter taste in the back of your throat from acid traveling all of the way up to the mouth.
  • Feeling bloated – This is usually because the intra-abdominal pressure is elevated.
  • Bloody or black stools – This happens when the esophagus bleeds from irritation. The blood passes through your gastrointestinal tract, forming black, tarry stools.
  • Burping – This is from excess gas rising from the stomach.
  • Dysphagia – This is because your esophagus narrows when exposed to acid (it spasms) and you get the sense that food is being stuck in your throat.
  • Hiccups – This is from spasm of the diaphragm muscles.
  • Nausea – This is from irritation of the esophagus that makes you feel as though you might vomit.
  • Weight loss for an unknown reason
  • Wheezing or a dry cough – This from acid irritating the bronchial tree.
  • Sore throat. This from acid irritating the back of the throat.

Diagnosis

If you are experiencing acid reflux disease symptoms more than twice per week or if the medication used for the treatment of acid reflux doesn’t work, you need to think about being evaluated for the condition.

If you have tried all of the necessary lifestyle changes, including changing your diet, raising the head of your bed at night, and taking antacids, more treatment might be necessary.

Some of the tests used to diagnose acid reflux disease include the following:

  • Barium Swallow – This involves having you drink some barium contrast material so the doctor can see if it washes back up inside the esophagus or if it stays in the stomach when it is supposed to. An x-ray is used to identify the location of the contrast material.
  • Esophageal manometry – This is a test that measures the pressure inside the esophagus and the pressure of the lower esophageal sphincter. It can tell if acid is likely to come up inside your esophagus or not.
  • PH Monitoring – This checks for the level of acidity in the esophagus. If you have acid reflux, the pH inside of the esophagus will be too low, representing the presence of acid in the esophagus.
  • Upper GI Endoscopy – This involves using a flexible tube with a camera attached to the end of it. The camera can see areas of inflammation inside the esophagus and biopsies can be taken that will show damaging changes to the esophagus.
  • Biopsy – A biopsy can be taken of the lower esophagus, looking for Barrett’s esophagus, which is a pre-cancerous condition of the esophagus that is caused by excessive acid inside the esophagus over a long period of time.

Lifestyle and Dietary Changes that Can Affect Acid Reflux Disease

You can change your lifestyle somewhat so that your symptoms can diminish. Some lifestyle changes you need to make in order to reduce your GERD symptoms include the following:

  • Eat meals that are smaller but eat more often during the day. Small meals are less likely to fill the stomach and cause acid to rise into the esophagus.
  • Stop smoking. This will allow your lower esophageal sphincter to tighten so it can prevent acid from entering the esophagus from the stomach.
  • Raise the head of your bed. You can do this by putting wooden blocks under the posts at the head of the bed so that it is raised 4 to 6 inches above the foot of the bed.
  • Don’t eat any food within 2-3 hours before you lie down on the couch or lie in bed.
  • Sleep in a chair or lounge chair when taking naps during the day.
  • Avoid wearing tight clothing or tight belts around your waist.
  • Try to lose weight if you are overweight so that you can maintain a normal weight and can have a normal intra-abdominal pressure.
  • Talk to your doctor about the possibility that some of your medications may be contributing to acid reflux.

Foods that Fight Flare-Ups

Just as there are foods you shouldn’t eat when you have acid reflux, there is food that can help control your symptoms. Some foods you should consider to fight flare-ups of the disease include the following:

  • Oatmeal – Oatmeal is not just for breakfast. It is a food that will fill you up without causing acid reflux. You can even have oatmeal with raisins because the oats will absorb the acidity coming from the raisins.
  • Ginger – Ginger is good in moderation for the management of acid reflux flare-ups. It has anti-inflammatory properties and is used to manage nausea and other GI symptoms. Try peeling it, slicing it, or dicing it. It can also be grated with a food grater. It can be used in cooking or added to smoothies.
  • Aloe vera – This plant is notorious for healing. It can be used to treat acid reflux. You use it in recipes that require the use of a thickener and to cause liquids to congeal.
  • Salad – Salad is a great meal for those who have acid reflux. Avoid tomatoes and onions in the salad because they can make acid reflux worse. Also, avoid dressings that contain too much acid in them.
  • Banana – Bananas are good for the vast majority of people who have acid reflux but about one percent of people will have their acid reflux made worse by eating bananas. You’ll have to check to see if they bother you.
  • Melon – Melon is also a good food for the vast majority of those who suffer from acid reflux. Like bananas, a small percentage of people who eat melon will have worsening of their symptoms. Besides cantaloupe, you can also choose honeydew melon or watermelon.
  • Fennel – Fennel not only improves acid reflux but it helps the stomach to function better. It can be sliced thin and placed into salads. Fennel also adds flavor to dishes containing chicken.
  • Turkey and Chicken – You can eat these meats baked, boiled or grilled but never fried, as the fat will cause an increase in acid reflux symptoms. Take off the skin in order to reduce the fat content in the meat.
  • Seafood and fish – These can also be baked, grilled or sautéed but shouldn’t be eaten fried. They decrease the amount of reflux symptoms you have. It is okay to have wild caught fish as well as shrimp, crab, lobster, and other shellfish.
  • Greens and roots – This includes foods such as broccoli, asparagus, cauliflower, green beans, and other beans, which help acid reflux. All kinds of roots and greens are good for an acid reflux diet.
  • Celery – Celery can suppress your appetite and is a good source of roughage in the diet. It has a high water content and doesn’t cause acid reflux symptoms.
  • Parsley – Parsley is well known to help the stomach settle and will help digestion. Parsley can be used for food instead of just a garnish.
  • Rice and couscous – These are good foods for acid reflux. Try eating brown rice instead of white rice.
  • Baked Sweet Potatoes
  • Toast
  • Cottage Cheese
  • Foods that promote saliva production: According to Dr. Daniel Mausner, head of gastroenterology at Mercy Medical Center in Rockville Center preventing heartburn may sometimes be as easy eating something that promotes saliva production, such as a sour food because saliva helps to neutralize stomach acids.

Foods to Avoid

Acidic foods cause heartburn, and should be avoided and especially o an empty stomach. Experts recommend keeping a log and note which foods trigger heartburn in you, as everybody is different and may have different reactions.

Tangy Citrus Fruits
  • Oranges
  • orange juice
  • grapefruits
  • Tomatoes
Caffeine

All drinks with caffeine are major heartburn triggers.

  • Coffee
  • Soda
  • Tea
High Fat Foods

While fatty foods are not as acid inducing as acidic foods are, they can still be major triggers because fat slows the emptying of the stomach, providing increased opportunity for distended stomach that places undue pressure on the esophageal sphincter increasing the likelihood for heartburn to occur.

  • Cheese
  • Nuts
  • Avocadoes
  • Steaks
Alcohol

Beer, wine, and cocktails can trigger heartburn, especially when they are taken with a fatty meal.

Garlic and Onion
  • Spicy Foods
  • Pepper
  • Mexican food
  • Chili
  • Indian spices
Peppermint

Peppermint reduces risks of getting heartburn because it relaxes the sphincter muscle located between the stomach and esophagus, which supports stomach acids to flow back into the esophagus.

Chocolate

Not only does chocolate contain caffeine, it also relaxes the sphincter, which allows stomach acids to flow back into the esophagus.

Carbonated Beverages

That fizzy drink you love so much causes gastric distension and when the stomach is distended, it increases pressure on the esophageal sphincter causing reflux and heartburn.

Medications for Acid Reflux

If food changes and lifestyle changes don’t work for the management of acid reflux, you can try one of the many choices of medication for the disorder. These include the following:

  • Antacids – These include things like Maalox, Mylanta, Rolaids Alka-Seltzer, and TUMS. These directly lower the pH of the stomach contents and lessens the acidity of the contents that rises up inside the esophagus.
  • Foaming agents – This includes medications like Gaviscon that coat the inside of your stomach, lessening the pH and reducing acid reflux symptoms.
  • Histamine 2 blockers – These include medications like Tagamet, Zantac, and Pepcid, which act on the histamine 2 receptors of the stomach, lowering the stomach pH.
  • Proton pump inhibitors – These include medications like Prevacid, Prilosec, Protonix, Aciphex, and Nexium. The act on the proton pump in the stomach, reducing the amount of acidity in the stomach.
  • Prokinetic medications –These include medications such as Urecholine and Reglan. They strengthen the lower esophageal sphincter and help the stomach empty its contents faster so that acid reflux is reduced.

Surgery to Correct Acid Reflux

If you have tried everything and still have acid reflux, surgery might be indicated. There are a couple of kinds of surgery that might be considered.

LINX

There is a surgery that involves placing a ring called a LINX around the lower part of the esophagus.

The ring is made of magnetic titanium beads that are connected by wires made of titanium. It helps your reflux symptoms by preventing the contents of the stomach from rising up into the esophagus. It can result in a reduction of the amount of medications you need to take for your acid reflux.

Nissen Fundoplication

Another type of surgery is called a Nissen fundoplication. This is a surgery that makes an artificial valve by wrapping the stomach around the esophagus, effectively making a sphincter. The hiatal hernia, if present, can be repaired at the same time.

It is usually done using a laparoscope, which is a type of surgery involving small incisions in the abdomen and a camera that locates the stomach in order to do the surgery.

Acid reflux can be a very annoying disease to have and it increases the risk of developing esophageal cancer. Fortunately, there are lifestyle changes you can take part in as well as foods you can eat that can reduce your symptoms. Medications and surgery for the condition are used as a last resort whenever lifestyle and dietary changes fail to control the symptoms.