You are just settling into your recliner after dinner and...oh no...that familiar heartburn sensation is rearing its ugly head.
Acid reflux is among the most commonly seen digestive complaints. While occasional reflux is normal (these are brief episodes that happen shortly after a meal) and can happen to anyone, when symptoms of reflux affect your quality of life and/or cause damage to the lining of the esophagus, it is described as Gastroesophageal Reflux Disease (GERD).
What is GERD?
What we commonly refer to as heartburn or acid reflux is actually the condition known as Gastroesophageal Reflux Disease (GERD).
This is when stomach acid frequently flows back up into your esophagus due to the lower esophageal sphincter (LES) relaxing at the wrong times. The LES acts as a valve between your esophagus and your stomach. It’s estimated that GERD affects 10 - 20% of the Western population.
What are the symptoms of acid reflux (GERD)?
The most common symptoms of GERD include:
Burning sensation in the center of your chest (heartburn), which sometimes spreads to the throat. This usually happens after eating, and may be worse at night
Regurgitation of food or sour liquid - when acid and undigested food flow back into your throat or mouth
Other symptoms you may experience include:
Stomach pain (pain in the upper abdomen)
Difficulty or pain with swallowing
Persistent raspy/hoarse voice (due to acid irritating the vocal cords)
Persistent sore throat or cough
Sense of a lump in the throat
Nausea and/or vomiting
What lifestyle changes can help with acid reflux (GERD) symptoms?
If you are experiencing symptoms of acid reflux, start by making a few changes to your daily routine:
Avoid lying down soon after eating
If possible, aim to wait at least 2- 3 hours after eating before lying down or going to bed.
Try to plan dinner for at least 2-3 hours before your usual bedtime.
Saliva helps to neutralize refluxed acid. Smoking reduces the amount of saliva in the mouth and throat.
Smoking also lowers the pressure in the lower esophageal sphincter allowing more frequent episodes of acid reflux in the esophagus.
Raise the head of your bed if you suffer from GERD symptoms while sleeping
You can do this by using a foam wedge under the mattress or putting a block of wood or rubber under 2 legs of the bed.
The idea is to raise your head and shoulders above your stomach to allow gravity to prevent acid from backing up into your esophagus.
Wear loose, comfortable clothing
Some people find they feel better if they avoid tight fitting clothing that puts pressure on the abdomen
What foods should be avoided with acid reflux (GERD)?
While some foods have been found to cause more relaxation of the LES, food triggers for acid reflux can differ from person to person.
You don’t need to limit or avoid a food unless it triggers or worsens reflux symptoms for you.
Common food triggers include:
fatty or fried foods
acidic foods (e.g. tomato sauce, orange juice)
Beyond WHAT to eat, it's also important to consider HOW to eat. You may find it helpful to eat food slowly and chew thoroughly. Being mindful of portion size at meals may also help to improve symptoms as some people find a large meal in one sitting can worsen symptoms.
How is acid reflux (GERD) treated?
For most people with GERD symptoms, medications are needed alongside dietary and lifestyle changes to provide symptom relief. Medications that are used to help with symptoms of acid reflux typically work by reducing or blocking stomach acid.
Medications commonly used for mild symptoms:
Antacids (e.g. TUMS, Maalox, Rolaids)
Works by neutralizing stomach acid
Histamine blockers (e.g. Pepcid, Zantac)
Works by reducing production of acid in the stomach
For frequent and more severe symptoms
Proton pump inhibitors (PPIs) (e.g. pantoprazole (Tecta, Pantoloc), omeprazole (Losec), lansoprazole (Prevacid)
Works by reducing production of stomach acid.
If you are dealing with symptoms of reflux, give the dietary and lifestyle recommendations a try to see if you experience any improvements. If symptoms continue, be sure to speak with your healthcare team about other options that may help.
Katz PO, Gerson LB, & Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. The American Journal of Gastroenterology. 2013;108(3): 308–328. https://doi.org/10.1038/ajg.2012.444
David A, John KM, Naoki C, et al. Canadian Consensus Conference on the Management of Gastroesophageal Reflux Disease in Adults – Update 2004. Canadian Journal of Gastroenterology. 2005;19(1): 15–35. https://doi.org/10.1155/2005/836030
Enhanced Primary Care Pathway: Gastroesphageal Reflux Disease. Alberta Health Services. https://www.cag-acg.org/images/publications/GERD_Enhanced_Primary_Care_Pathway_July_2016.pdf. Accessed Aug 31, 2021.