Kathy Kolasa: Lifestyle changes address reflux
Wednesday, August 21, 2019
Q I recently was diagnosed with GERD (gastroesophageal reflux disease) and given medication. Are there any lifestyle changes I can make that will be helpful? I hate taking medicine. — GW, Greenville
A I asked Derek Schaap, a Brody medical student to answer your question. Here is what he wants you to know:
Absolutely! GERD is a condition with several risk factors you can change. Diet and lifestyle changes should be an important part of a good treatment plan. That being said, medications play a crucial role, too. The gold standard for managing this disease is lifestyle together with medications.
Before giving you the details, it’s important to understand what this disease is so you understand why and how it disease is managed. It is a deceptively common disease worldwide. About 1 in 4 Americans suffers from this condition with more people developing it over the past 10 years. GERD occurs when the lower esophageal sphincter, a muscle that acts like a valve between your stomach and esophagus, doesn’t close properly.
This lets acidic stomach contents go the wrong direction and back into your esophagus or the muscular tube connecting the throat with the stomach. This can cause the burning sensation we like to call heart burn that some people get in their chest after eating. Depending on the severity of the reflux, GERD can also cause nausea, difficulty swallowing, regurgitation of food or sour liquids, sore throat, disrupted sleep, and even new or worsening asthma.
What makes GERD particularly tricky is the number of different risk factors involved that can all play a roll simultaneously. Obesity, pregnancy, smoking, overeating, fatty and fried foods, beverages such as alcohol or coffee, and certain medications can all contribute to reflux. Aside from the immediate symptoms and discomfort, doctors care about GERD because if your esophagus stays inflamed, scar tissue can form leading to more serious problems with swallowing, bleeding ulcers, and changes to the tissue lining of the esophagus. These problems put a person at a higher risk for cancer.
Step one to manage GERD is identifying the risk factors that apply to you and learn to minimize their impact. Weight management and head-of-bed elevation — especially if you are having more symptoms around bedtime and lying down — are two important factors. Avoiding meals 2 to 3 hours prior to bedtime also may help.
If you are overweight, weight loss is indicated, and we have great local registered dietitian nutritionists as well as community programs you can access. Ask your doctor what weight loss method is best for you. And by you, I mean you! Weight loss is a balancing act. You don’t have to go to the gym seven days per week, nor do you have to cut out every food you enjoy or frantically count calories or carbs. You can start by cutting back on fatty and fried foods or alcohol, which I mentioned are triggers for reflux.
Your doctor also may want you to quit using tobacco. Besides all the negative health effects it can directly impact GERD. Due to nicotine exposure, tobacco use can decrease the ability of the lower esophageal sphincter to contract and increase how often you have reflux. Nicotine is in smoking and chewing tobacco, and in most e-cigarette or vaping solutions. Vaping is new so there is a lot to learn about any long-term health effects of it. Your doctor knows quitting is not a small task and doesn’t happen overnight. Ask your doctor to find what will work for you.
Symptoms from GERD don’t go away overnight either. If you relied on lifestyle the symptoms may persist for some time before getting better. While the proper treatment of GERD should be preventive rather than responsive, medications are often prescribed that work by decreasing the amount of acid your stomach produces for more rapid relief. Although it may seem like it’s easier to take a medication and not worry changing your lifestyle, all medications come with some risk of unwanted side-effects.
Using medicine treatment for GERD remains a potentially temporary but strongly recommended supplement rather than a replacement for weight loss and lifestyle modification. This is by no means an exhaustive list of everything that goes into diagnosing and treating GERD. If these symptoms are familiar to you, ask your doctor so he or she can evaluate your concerns and treat them appropriately.