Caring for People With Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease (GERD) is becoming an increasing problem for people of all ages in the United States. This is probably due in part to an increase in the consumption of fast food, which tends to be greasy and fatty, as well as the escalating rate of obesity.

If you're suffering from acid reflux, it's important that you see a doctor to determine if a diagnosis of GERD is appropriate and exclude all other disorders with similar symptoms. The severity of your GERD symptoms will determine the best treatment options.

In the meantime, here are ways you can help lessen the severity of heartburn symptoms at home.

Son helping to serve salad for mother at the family dinner table
Image Source / Getty Images

Food Choices

The lower esophageal sphincter (LES), the valve between the esophagus and stomach, normally closes tightly to keep food and stomach acid where it belongs.

If the lower esophageal sphincter relaxes when it shouldn't, food and stomach acid can back up into the esophagus and cause heartburn.

Heartburn is often triggered by certain foods that relax the LES. These may include:

  • Fried (greasy) foods
  • High-fat meats
  • Butter and margarine
  • Mayonnaise
  • Creamy sauces
  • Alcohol
  • Whole-milk dairy products
  • Chocolate
  • Peppermint
  • Caffeinated beverages (e.g., soft drinks, coffee, tea, cocoa)

Heartburn may also occur when the stomach produces too much acid, and this backs up into the esophagus.

Foods that may stimulate acid production and increase heartburn should also be avoided.

Foods That Stimulate Acid Production

  • Caffeinated beverages
  • Carbonated beverages
  • Alcohol
  • Spicy foods
  • Black pepper
  • Citrus fruit and juices (e.g., orange, grapefruit)
  • Tomato juice

When you eat out, inquire as to how different dishes are prepared. You can ask that meat is grilled rather than fried, for example. Many dishes include high-fat gravy and sauces that you can ask to have switched to a low-fat substitute or served on the side.

2:04

Avoid These Things If You Have GERD

Mealtime

Large meals expand the stomach and can increase upward pressure against the lower esophageal sphincter (LES), which causes heartburn. Eating less, but more frequently may help (think snacks, rather than full courses).

Using smaller dishes at home, preparing less food, and serving meals from the stove—rather than the table, where it's easy to reach for seconds—may be helpful strategies.

Late night snacking may be your bedtime ritual, but if you suffer from GERD, it can make for a painful, uncomfortable night's sleep. Try to avoid eating during the two- to three-hour window before you go to bed.

Gravity helps keep the stomach juices from backing up into the esophagus and assists the flow of food and digestive juices from the stomach to the intestines. So, while after dinner snacking isn't advised, staying up for a while after the meal can help give the body time to take advantage of gravity's forces while food is being digested.

Bedtime

Nighttime heartburn can be the most dangerous. If frequent nighttime heartburn occurs, the risk of complications increases.

At night, refluxed acid tends to remain in the esophagus for longer periods, allowing it to cause more damage to the esophagus.

There are, however, ways to prevent nighttime heartburn.

  • Elevate the head of your bed about 6 to 8 inches by placing bricks or wooden blocks under that end of the bed. Raising your bed to a slight slant helps to reduce pressure against your lower esophageal sphincter (LES), which decreases acid exposure. Your doctor may also suggest using an acid reflux bed or a wedge pillow to elevate your head while sleeping.
  • Try a body pillow to keep you lying on your left side with your head elevated. Lying on your left side helps stomach acid pass through the LES into the stomach.

Clothing Choices

Clothing that's tight around the abdomen squeezes the stomach, forcing food up against the LES, causing food to shoot back up into the esophagus.

Avoiding tight-fitting belts, tight-waisted jeans, and slenderizing garments can help prevent irritation to the LES.

Symptom Tracking

Buy a journal and record when you experience heartburn symptoms, what foods were consumed, and what activity you were doing before the heartburn occurred. The severity of each heartburn episode and what gave you relief should also be noted.

You can rank your discomfort on a scale of 1 to 10 with 10 being the most discomfort you can imagine and 1 being pain that is barely there.

You can bring this information to your doctor, who can then help you make modifications to your diet, activity, or medications if needed.

GERD Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Woman

Exercise

If you are overweight or obese, even losing 5 or 10 pounds can help alleviate heartburn symptoms and exercise, in general, is beneficial for a host of reasons. Go on walks, ride your bike, or jump on the treadmill while you're watching TV. Try fun family activities like bowling, hiking, gardening, or swimming. Getting active with friends or family can keep you more motivated.

Medications

Antacids like Tums, Rolaids, and Mylanta neutralize stomach acid. It's helpful to keep them handy in case you need them.

If you need to use antacids for more than a week or if an antacid doesn't quickly resolve symptoms, a visit to the doctor is recommended. 

Using an antacid for more than one to two weeks should only be done with the guidance of a physician.

If you have made dietary and lifestyle changes that reduce heartburn without success, it may be time to use one of the stronger medications. Beyond antacids, there are two primary categories of heartburn medications:

  • H2 blockers, such as Tagamet (cimetidine), Pepcid (famotidine), and Axid (nizatidine)
  • Proton pump inhibitors (PPIs), such as Prilosec (omeprazole), Prevacid (lansoprazole), Nexium (esomeprazole), Aciphex (rabeprazole), and Protonix (pantoprazole)

Long-term use of PPIs has been associated with kidney disease, heart attack, and bone fractures. Potential side effects should be discussed with a physician. Long-term acid reflux can also result in complications, so your doctor can help you weigh the risks and benefits of treatment.

Support

The best treatment for acid reflux is prevention, and making changes to your diet, sleeping position, and activity is the best way to begin. These changes, however, can sometimes be hard to make, so let your family and friends know so they can help provide encouragement.

Involving your doctor can be helpful, not only in learning more about how to help control symptoms but in giving guidance and support for the lifestyle changes you have made.

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