What is GERD/acid reflux?

Gastroesophageal reflux disease, or GERD (also called chronic acid reflux) is a condition that occurs when the acid-containing contents in your stomach leak backward up into your esophagus, throat and mouth. Your stomach’s acid then forms a backwash up through your esophagus into your throat and mouth. This backwash can burn your esophagus and throat and cause a sour taste in your mouth.

Everyone experiences acid reflux and heartburn sometimes, but if you have acid reflux more than two times per week over several weeks, are always taking antacids or heartburn medications and you still have heartburn, you may have progressed to GERD. Though many prior prescription medications for GERD are now available over-the-counter, GERD should be managed in conjunction with your healthcare provider because the condition can lead to serious health problems, including cancer, and may require a medical intervention.

Digestive Anatomy and GERD

Your stomach contains gastric juice composed of digestive enzymes, hydrochloric acid and other substances to absorb nutrients. to break down food. The hydrochloric acid breaks down food and the digestive enzymes break up proteins. The acidic gastric juice also kills harmful bacteria that can be present in your food or drink. Mucus covers the stomach wall with a protective coating that works with bicarbonate to protect the stomach wall itself from the hydrochloric acid.

Your esophagus is the tube from your throat to your stomach. When GERD occurs, a valve at the end of your esophagus called the lower esophageal sphincter (LES) does not close tightly as it should or stays relaxed once your food enters your stomach. This can happen for many different reasons, including your diet.

Foods Most Likely to Trigger GERD

Although there is no dedicated GERD diet or acid reflux diet, certain foods can trigger heartburn and those that can help counteract heartburn or do not cause it. These foods cause acid reflux because they cause a delay in the digestive process, which lets food sit in the stomach longer. The worst foods for GERD are spicy foods and those high in fat and salt. Certain drinks may also trigger heartburn. Foods to avoid with GERD include:

  • Alcohol
  • Caffeine
  • Carbonated beverages
  • Cheese
  • Chili powder and pepper (white, black, cayenne)
  • Chocolate
  • Citrus fruits and drinks, like orange juice
  • Coffee
  • Fried food
  • Fast food
  • Fatty meats such as bacon and sausage pizza
  • Onions
  • Peppermint
  • Potato chips and other processed snacks
  • Tomato-based sauces

Foods that Can Calm Stomach Acid

There are many foods that help acid reflux go away. Foods to eat with GERD include:

High-fiber foods usually make you feel full and therefore less likely to overeat. Some examples include:

  • Whole grains such as oatmeal, quinoa, barley, whole wheat products and brown rice.
  • Root vegetables such as ginger, carrots, beets and sweet potatoes.
  • Green vegetables such as lettuce, asparagus, cucumber, broccoli and green beans.

Alkaline foods are those that have a low pH (those with a high pH are more acidic) can help offset extra stomach acid, including:

  • Bananas
  • Cauliflower
  • Fennel
  • Melons
  • Nuts

High water-content foods dilute stomach acid, weakening it. Some watery foods that neutralize acid reflux include:

  • Broth-based soups (not tomato)
  • Celery
  • Cucumber
  • Herbal tea (non-caffeinated)
  • Watermelon

The Importance of Keeping a Food Diary

The foods, spices and beverages that trigger heartburn are different for everyone. Keeping a food diary will help you determine which foods cause symptoms, which don’t, and which actually help. This information will also help your doctor determine the cause of your GERD and make suggestions for your particular diet.

Other Causes of GERD

Overeating or big, heavy meals is a common heartburn trigger, as well as eating too close to bedtime. Other non-food related causes of GERD include:

  • Medications, including those for allergies, asthma and high blood pressure, and certain painkillers, sedatives and antidepressants
  • Obesity due to increased pressure on the abdomen
  • Pregnancy due to increased pressure on the abdomen
  • A hiatal hernia, where the upper part of the stomach pushes up into the diaphragm
  • Sleeping flat on your back, allowing the acid to easily wash up into your esophagus
  • Smoking or being exposed to second-hand smoke

Managing GERD During COVID-19

Managing GERD during the COVID-19 pandemic remains the same as any other time. The only difference for you is upping your willpower, as you may have more difficulty modifying your food choices when staying and working from home. Also, stress eating is likely to be more prominent and can add to acid reflux, both from stress itself and the emotional eating that may come with it.

Lifestyle changes and medication are often enough to manage GERD. However, if you do not want to give up such a delicious array of foods and your morning cup of joe, moderation is key. Eat small frequent meals during the day as well, instead of bigger, heavier meals. Try to work in foods that help counteract acid reflux and look for recipes to help add flavor. Substitutions may work as well. For example, swap out apple or pear juice for orange juice and herbal tea for black tea. Also try to avoid eating the problematic foods later in the evening, so they’re not sitting in your stomach and then coming back up when you sleep. You don’t have to make all the changes at once.

Surgical Treatment for GERD

If the above modifications and medications are not working and you are still suffering persistent symptoms of acid reflux, you need a thorough evaluation. An exam and diagnostic testing can help find the underlying cause and determine available treatment options.

Advanced Laparoscopic Associates offers surgery options for the treatment of GERD. The LINX is a quarter-sized ring of magnetic titanium beads that wraps the esophagus and reinforces the LES. It is implanted laparoscopically, has a short hospital stay and low rate of complications. Most importantly, its short recovery time means an almost immediate improvement in symptoms and a very brief interruption of your daily life.

Another surgical option is fundoplication, which is an established surgical procedure to strengthen the LES. In the most popular form, known as Nissen fundoplication, surgeons wrap the top part of the stomach—called the fundus—around the bottom of the esophagus and suture it in place. This reinforces the LES and prevents stomach acid from creeping up the esophagus.

Most Nissen fundoplication procedures are now performed laparoscopically, with small incisions, small tools and a flexible camera called a laparoscope attached to a video monitor. As with LINX, hospital stays are brief, recovery time is short and pain levels are low.

If you have tried medication and lifestyle changes to control your GERD and still have frequent symptoms, request an appointment with one of our surgeons today. We will discuss the options available to treat your GERD and come up with a treatment plan that’s right for you.

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