GERD: Gastroesophageal Reflux Disease

What is GERD?

When we eat, food passes from the throat and into the stomach through a tube. This tube is the esophagus (ee-SOFF-uh-gus). Sometimes it’s called the food pipe. At the bottom is a ring of muscles that acts as a valve between the esophagus and stomach. This is the lower esophageal (ee-soff-uh-GEE-ol) sphincter (ss-FINK-ter).

These muscles in the lower esophagus can become weak. Food, smoking, and alcohol may weaken the sphincter, so it may stop closing properly. The contents in the stomach then may leak back, or “reflux,” into the esophagus. This problem is called “GERD.” GERD is short for gastroesophageal (GAS-trow-ee-soff-uh-GEE-ol) reflux disease.

GERD’s Most Common Symptom

Heartburn is the most common symptom of GERD. When acid in the stomach refluxes, it touches the lining of the esophagus. This can cause a burning feeling in your chest or throat. We call this sensation heartburn or acid indigestion. You can have heartburn once in a while without having GERD. But if you have heartburn more than twice a week, it’s likely you have GERD.

Other Symptoms of GERD

If you don’t have heartburn, you can still have GERD. Some other symptoms of GERD are clearing your throat often, trouble swallowing, feeling like food is stuck in your throat, burning in your mouth, and pain in your chest.

When to See a Doctor

GERD can lead to more serious health problems over time. If you have any symptoms listed above, or if you use antacids more than 2 weeks, call your primary doctor or internal medicine specialist.

How GERD is Treated

Treatments for GERD include lifestyle changes, medicine, and surgery. Your doctor will prescribe the treatment plan that is best for you.

Lifestyle Changes to Reduce GERD

For relief from GERD, follow the guidelines below:

  • Avoid all foods that cause you physical distress.
  • Stop using tobacco in any form. The nicotine in tobacco weakens the esophageal sphincter.
  • Do not drink alcohol, which relaxes the sphincter.
  • Avoid hard candy, chewing gum, and soda drinks. When you chew gum or suck on hard candy, you swallow more air. Soda drinks, which are carbonated, contain air. Using these products can cause belching and reflux.
  • Eat 5 or 6 small meals during the day, not 3 large ones.
  • Eat slowly — take small mouthfuls and chew well.
  • Avoid the foods listed below, which increase reflux:
      • Food that is very hot or very cold
      • Fatty or fried foods
      • Peppermint or spearmint, including flavoring
      • Coffee, tea, and soft drinks that contain caffeine
      • Spicy, highly seasoned foods
      • Tomato-based dishes, such as spaghetti with sauce, chili, and pizza
      • Citrus fruits and juices, especially in the morning
      • Chocolate and sweets, if they cause symptoms
  •  Do not lie down right after you eat. Remain upright for at least 2 hours.
  • Avoid late evening snacks.
  • Avoid bending over or stooping after you eat.
  • Avoid lifting heavy objects.
  • Avoid wearing tight clothes across your waist, stomach, or abdomen.
  • Lose weight if you are overweight. Obesity can increase reflux.
  • Raise the head of your bed 6 to 8 inches.
  • Try sleeping on your right side.
  • Take your medicines exactly as your doctor prescribes.
  • Tell any doctor examining you that you are being treated for GERD.
  • Keep a relaxed atmosphere during meals.

Suggested Diet for GERD

Beverages

 Choose

Avoid

  • Skim or 1% milk
  • Decaf, non-mint, and herbal teas
  • Juices, except those to avoid
  • Soft drink mixes, such as Crystal Lite
  • Caffeine- free beverages
  • Whole, 2%, and chocolate milk
  • Alcohol
  • Regular or decaf coffee
  • Tea that has caffeine
  • Mint tea
  • Soda, pop, or carbonated beverages
  • Citrus juices and drinks, such as orange, grapefuit, lemon, lime, pineapple

Breads and grains

 Choose

Avoid

  • All breads and grains prepared with low-fat content
  • Any prepared with whole milk or high-fat content, such as sweet rolls, muffins, biscuits, croissants
 

Vegetables

 Choose Avoid
  •  All vegetables, except those to avoid
  • Fried or cream-style vegetables
  • Tomatoes and tomato sauce
 

Fruits

 Choose Avoid
  • Any fresh, canned, or cooked fruits, excpet those to avoid
  • Citrus fruits, such as oranges, grapefruit, lemons, limes, pineapples
 

Soups and seasonings

 Choose

Avoid

  • All herbs and spices, except those to avoid
  • Fat-free broths
  • Home-made soups with lean meat, allowed vegetables (no tomatoes), and skim milk
  • Cream, cheese, or tomato-based soups
  • Herbs and spices found in tomato sauces, such as basil, oregano, garlic
  • Chili and jalapeno peppers
  • Vinegar

 

Meats and substitutes

 Choose

Avoid

  • Baked, boiled, or broiled beef, pork, lamb, veal, skinless poultry, fish
  • Low-fat lunch meats
  • Cooked dried beans and peas
  • Peanut butter, if tolerated
  • Eggs
  • Low-fat cheeses
  • Fatty or fried beef, pork, lamb, veal, poultry, fish
  • Fried eggs
  • Bacon, sausage, pepperoni, lunch meats, hot dogs

 

Fats and Oils: Limit to 3 servings per day

 Choose Avoid
  • Butter and margarine
  • Vegetable oils
  • Mayonnaise
  • Mildly seasoned salad dressings
  • Plain cream cheese
  • Fried foods
  • Cream sauces and gravies
  • Highly seasoned salad dressings
  • Bacon fat, ham fat, lard, salt pork
  • Nuts

 

Sweets and Desserts

 Choose Avoid
  • Sugar, honey, jelly, jam, syrup, marshmallows
  • Angel food cake
  • Non-fat or low-fat pudding, custard, ice cream, frozen yogurt, sherbet
  • Low-fat cookies
  • Gelatin made from allowed foods
  • Sweets and desserts with chocolate, pepperming, or spearmint
  • High-fat pastries
  • Nuts
  • Hard or cream-filled candy
  • Chewing gum

 

Sample Menu

 

 Breakfast

  •  3/4 cup cereal
  • 1 cup skim or 1% milk
  • 1 egg, poached
  • 1 slice toast or bread
  • 1 teaspon margarine
  • caffeine-free drink
 Mid-Morning Snack
  •  1/2 cup canned fruit (non-cirus) or 1 small, fresh fruit (non-citrus)
 Lunch
  •  3 oz. chicken
  • 1/2 cup rice
  • 1/2 cup spinach
  • 1 teaspoon margarine
  • 1/2 cup fruit juice (non-citrus)
 Mid-Afternoon Snack
  •  5 saltine crackers
  • 1/4 cup low-fat cottage cheese
 Dinner
  •  3 oz. baked fish
  • 1 medium potato
  • 1/2 cup carrots
  • 1 teaspon margarine
  • 1 cup skim or 1% milk
  • water
  

Reviewed April 2011

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