GERD (Gastro Oesophageal Reflux Disease) A Stressful lifestyle problem.

Recent studies suggest that the prevalence of GERD in India itself may range between 8-20% and could be much more .

GERD, a severe and chronic form of ‘acid reflux’ is on the rise. Earlier it was thought to be a disease of the West but now Asia is not far behind. Recent studies suggest that the prevalence in India itself may range between 8-20% and could be much more with greater number of adolescents getting affected as well.

UNDERSTANDING GERD

It is a digestive disease in which there is a back flow of stomach acid and bile into the oesophagus (food pipe), resulting in a series of troublesome clinical symptoms – the most common being heartburn (burning pain in the lower chest area often after eating large meals or lying down right after eating) and acidity which may keep one awake at night especially after ‘partying’ till late and having some extra drinks; distension, bloating and a feeling of fullness. Other additional symptoms could be sour taste, frequent belching, hiccups, vomiting, occasional cough, sore throat. Several complications can arise like bleeding and ulcers in the food pipe. Normally, when food is eaten it enters the stomach and the ring of muscles ( lower oesophageal sphincter - LES) controlling the opening between the stomach and oesophagus closes to prevent the food from going back to the food pipe. Reflux occurs when the pressure inside the stomach is higher and ‘LES’ becomes week or damaged and is not able to prevent the backflow.

Causes GERD :

• Lying down right after a large meal.

• Obesity

• Sedentary habits

• Excessive use of painkillers, drugs for asthma, anti-histamines, sedatives, anti depressants.

• Stress

There are certain food and dietary habits that may be linked to acid reflux “

1. excessive caffeine and alcohol – Most people with acid reflux may observe their symptoms aggravating after a morning strong cup of tea or coffee.

2. increased intake of table salt

3. a diet low in dietary fiber and more in starches and refined carbs.

4. Eating large meals

5. Chocolates and carbonated drinks, acidic fruit juices.

6. Heavy fried and fatty meals especially late at night. These remain in the stomach for a long period of time and can cause the LES to relax, allowing more stomach acid to flow back in the food pipe.

7. tomato sauce, salsa and chillies, garlic, onion, spicy food

8. Tomatoes and citrus fruits like oranges, grapefruit, lemon, lime.

The following foods have a high fat content. Avoid or eat sparingly-

• Oily, greasy food like french fries, fatty desserts or snacks

• full fat dairy, processed cheese, cream, ice cream, butter

• Fatty fried cuts of beef, pork, lamb.

• Cream sauces and salad dressings ,gravies

MANAGING GERD

Various studies have shown that no single diet has been proven to prevent GERD. However,one can minimize and control symptoms. Food triggers are different for everyone. Learn to identify your individual triggers and keep a food diary (for at least a week) regarding –

• What foods you eat .

• Meal timings

• When and what symptoms do you experience.

This way you may be able to identify certain foods that may be causing reflux. Try avoiding or minimizing these and see if the symptoms disappear.

Certain foods may ease symptoms in some people.

• Research shows that increasing fiber in your diet not only reduces acid reflux, it will also reduce the risk of high cholesterol, high sugar, haemorrhoids and other bowel problems. A diet rich in whole grains, fruits and vegetables(3-4 servings) can help manage acid reflux.

• Colas, acidic juices like pineapple, grape fruit, tomato, orange, tangerine and coffee to be strictly avoided. Prefer mint and caffeine free herbal teas.

• Almond/soya milk ,low fat or skimmed milk are preferable as they have an alkaline impact and neutralize the stomach acidity. Try smoothies made with low acid fruits like apples, bananas, green grapes, water melon.

• Other good options are carrot juice, aloe vera juice, a mix juice of beet, water melon, spinach, cucumber, avocado, water melon.

• Unsweetened coconut water is a good option as it is rich in potassium and regulates the acid base balance

• Water – Drinking enough water (6-8 glasses) may sometimes be a very effective solution as the pH of water is neutral or 7. This can help raise the pH of an acidic meal. But remember that too much water can disturb the mineral and acid base balance of the body and increase acid reflux.

Some additional valuable tips and life style measures that you may want to keep in mind :

• Avoid skipping meals especially breakfast. Do not leave the stomach empty for long periods of time allowing acid to act on the stomach lining and also increasing the reflux. Skipping meals may make you ravenous leading to binging and over drinking later in the night.

• Avoid late night snacks (fast food like chips, burgers etc) and beverages (carbonated and caffeinated drinks) that may cause reflux.

• Do not recline while eating or drinking. Maintain an upright position.

• Moderate alcohol consumption especially at night and reduce oily, spicy food.

• Maintain movement till atleast 2 hours after dinner before getting into bed.

• Chewing a slice of ginger or having a spoonful of ginger juice 2-3 times a day is a grandma’s old remedy for acid reflux.

• Avoid over stuffing yourself at every meal. Space it out.

• May use antacids to reduce acid flow. But don’t make it a habit.

• People with an acid reflux problem should use a high pillow (sleep on an incline) so that gravity can prevent back flow of acid.

• Wear loose fitting clothes especially while sleeping.

• Avoid bending below waist after meals.

• Maintain a healthy weight. Lose weight if overweight or obese.

• Avoid increased pressure on your abdomen such as by wearing tight belts.

• Maintain a straight posture.

• Quit smoking.

GERD is a chronic problem and may not be progressive. Faulty lifestyle and eating habits are the biggest culprits in creating acid reflux. These need to be modified as suggested or else complications like bleeding or ulceration in the oesophagus can occur.