Diet and Acid Reflux (July 8, 2014)
If you’ve ever been diagnosed with GERD (gastroesophageal reflux disease – aka acid reflux), whoever diagnosed you probably handed you a list of foods that you were told to avoid because they would worsen your symptoms. And if you were a very good patient, you dutifully eliminated those foods from your diet – for a while. Then you probably went back to eating them, still thinking you probably shouldn't and feeling guilty about the whole thing.
Well, here’s a little relief from the guilt part of that, anyway. Last year a couple of researchers screened more than 2,000 published studies, looking for actual evidence that the consumption of certain foods worsened the symptoms of acid reflux. And found nothing. There’s no evidence that consumption of ANY food worsens the symptoms of GERD. Their work was convincing enough that the American College of Gastroenterology now advises acid reflux patients to avoid foods only if doing so causes them to have fewer symptoms.
So if you have reflux symptoms, that means that now you have to pay attention to what you are eating and note what foods increase symptoms FOR YOU PERSONALLY. Nothing else counts. If every time you eat chocolate your acid reflux increases, that’s a trigger food for you. If eating chocolate doesn't bother you, you don’t need to avoid it.
Where did that list come from in the first place? Well – “logic”. GERD comes from backflow of stomach acid into the esophagus. Coffee and tea, chocolate, and fat all relax the sphincter between the esophagus and the stomach. So these foods were automatically placed on a Don’t Eat list – even though there was no actual evidence that eating those foods worsened symptoms. I can't find a reason why spicy food and carbonated beverages were ever on the list in the first place, except for Logic. And you know what they say about what happens when you AssUMe... Human logic isn't always the body's logic.
If you suspect a particular food, or need to find your trigger foods, you can do so with an elimination diet. Eliminate the Suspect Food entirely from your diet for at least a couple of weeks, and note whether your symptoms improve. Then eat a large quantity of it at one sitting and see what happens. If your reflux re-appears or gets worse, you’ve found an offender. If it doesn’t, you can eat your happy food with a clear conscience.
What else is helpful with GERD besides eliminating trigger foods? Losing weight is very likely to help; symptoms disappeared in 40% of those who lost 10-15 pounds, and 65% in those who lost an average of 29 lbs. If you are of normal weight but smoking, quitting smoking will help. Don't go to bed with a full stomach, and raise the head of the bed about six inches (but don't prop yourself up on pillows -- that can increase abdominal pressure and actually worsen the reflux). And please, if you are using PPIs or other medications to relieve reflux symptoms, don't consider them anything but a temporary stopgap -- like all medications there can be problems with them, especially with long-term usage, so do try some of these other solutions.
--dr. diane holmes
Copyright © 2014
If you’ve ever been diagnosed with GERD (gastroesophageal reflux disease – aka acid reflux), whoever diagnosed you probably handed you a list of foods that you were told to avoid because they would worsen your symptoms. And if you were a very good patient, you dutifully eliminated those foods from your diet – for a while. Then you probably went back to eating them, still thinking you probably shouldn't and feeling guilty about the whole thing.
Well, here’s a little relief from the guilt part of that, anyway. Last year a couple of researchers screened more than 2,000 published studies, looking for actual evidence that the consumption of certain foods worsened the symptoms of acid reflux. And found nothing. There’s no evidence that consumption of ANY food worsens the symptoms of GERD. Their work was convincing enough that the American College of Gastroenterology now advises acid reflux patients to avoid foods only if doing so causes them to have fewer symptoms.
So if you have reflux symptoms, that means that now you have to pay attention to what you are eating and note what foods increase symptoms FOR YOU PERSONALLY. Nothing else counts. If every time you eat chocolate your acid reflux increases, that’s a trigger food for you. If eating chocolate doesn't bother you, you don’t need to avoid it.
Where did that list come from in the first place? Well – “logic”. GERD comes from backflow of stomach acid into the esophagus. Coffee and tea, chocolate, and fat all relax the sphincter between the esophagus and the stomach. So these foods were automatically placed on a Don’t Eat list – even though there was no actual evidence that eating those foods worsened symptoms. I can't find a reason why spicy food and carbonated beverages were ever on the list in the first place, except for Logic. And you know what they say about what happens when you AssUMe... Human logic isn't always the body's logic.
If you suspect a particular food, or need to find your trigger foods, you can do so with an elimination diet. Eliminate the Suspect Food entirely from your diet for at least a couple of weeks, and note whether your symptoms improve. Then eat a large quantity of it at one sitting and see what happens. If your reflux re-appears or gets worse, you’ve found an offender. If it doesn’t, you can eat your happy food with a clear conscience.
What else is helpful with GERD besides eliminating trigger foods? Losing weight is very likely to help; symptoms disappeared in 40% of those who lost 10-15 pounds, and 65% in those who lost an average of 29 lbs. If you are of normal weight but smoking, quitting smoking will help. Don't go to bed with a full stomach, and raise the head of the bed about six inches (but don't prop yourself up on pillows -- that can increase abdominal pressure and actually worsen the reflux). And please, if you are using PPIs or other medications to relieve reflux symptoms, don't consider them anything but a temporary stopgap -- like all medications there can be problems with them, especially with long-term usage, so do try some of these other solutions.
--dr. diane holmes
Copyright © 2014