Management with Life Style Modifications (Healthy Aging Learning Series) Health Coaching Session July, 2019
Gastroesophageal reflux disease, or GERD, is a digestive disorder that affects the lower esophageal sphincter (LES), the ring of muscle between the esophagus and stomach. Gastroesophageal reflux disease (GERD) happens when the lower esophageal sphincter does not close correctly. Stomach contents back up into the esophagus and cause burning.
Gastroesophageal reflux disease (GERD) is the most common upper gastrointestinal disorder seen in the elderly. The most common cause of reflux episodes is transient LES relaxations, the drop in the lower esophageal sphincter (LES) pressure not accompanied by swallowing. Incompetence of the LES was shown to be more prevalent in the elderly. The most common symptoms of GERD are heartburn and acid regurgitation. Other common symptoms may include water brash, belching, chest pain, nausea, chronic sore throat and cough, hoarseness (scratchy-sounding voice), bitter taste in mouth.
In addition to medical treatment (i.e., antacids, H2 receptor blockers, proton pump inhibitors), diet and life style modifications are important preventive measures. Avoiding the following foods may help with reducing acid production:
Caffeine (regular coffee, regular tea, chocolate)
Mints (peppermint, spearmint)
Fried, greasy foods
Garlic and onions
Coming up with the appropriate diet involves discovering what works best for you. Not all triggers and treatments will affect all people in the same way. Taking note of foods and beverages that seem to trigger reflux is useful.
Fiber intake is a dilemma in GERD diet. Adequate fiber consumption is essential for health. Dietary fiber is one of many aspects to consider in successfully managing reflux symptoms. Fiber intake was significantly associated with improved perception of reflux symptoms. However, too much fiber (more than 10 gram daily) may further aggravate the problem, as reported from studies. Fiber overload can cause stomach distention, increased stomach pressure and prolonged stomach emptying -- all of which can lead to worsened acid reflux.
Managing GERD with life style modifications:
Follow the general guidance below may help you to ease or prevent GERD symptoms.
Achieve and maintain a healthy weight.
Eat small, frequent meals. Large meals may increase stomach pressure, and therefore reflux.
Fat takes the longest time to leave the stomach; therefore, reduce the total amount of fat that you eat at a meal by decreasing the amount of margarine, butter, oils, salad dressings, gravy, fatty meats, and full-fat dairy/milk products such as sour cream, cheese, and whole milk.
Maintain an upright posture while eating and for 45-60 minutes afterward. Avoid bending over or reaching below your waist after meals to do things like loading the dishwasher, tying your shoes, or picking up items from the ground.
Avoid eating before bedtime. It takes the stomach four to five hours to fully empty a meal, so wait at least three hours after eating to go to bed.
Avoid clothing that is tight in the abdominal area.
When sleeping, raise the head of the bed 6-8 inches, using wooden blocks under the bedposts. Extra pillows will not work.
Stop smoking or chewing Tabaco.
Reflux triggers vary from person to person. Try eliminating possible trigger foods for two weeks, then reintroduce one food at a time to determine your tolerance and evaluate severity of symptoms.
Your doctor may prescribe acid-reducing medications, such as proton pump inhibitors (PPIs). Discuss with your physician when new or worsening symptoms occur.