BURNING, aching or pain in the stomach or esophagus; reflux of stomach contents that is often worse at night in bed; burping or a sense of heat or mild acid in the throat occurring several times a month – all are symptoms of gastroesophageal reflux disease (GERD).
GERD is not a condition to be ignored. Erosion and irritation of the esophagus over time can alter the makeup of the cells lining the esophagus, leading to an inflammatory condition called Barrett’s esophagus. This condition is only identifiable with an endoscopic exam, which involves placing a tube with optical and biopsy capabilities down the throat and into the stomach for visual inspection and tissue sampling. Barrett’s esophagus is a concern because it can be a precursor to cancer.
When symptoms are relatively mild, it is reasonable to try a one- to two-week therapeutic trial of the lifestyle changes mentioned below to see if the condition readily resolves itself. If resolution is not apparent within 12 days, tests to consider are an endoscopy, a blood test for unwanted bacteria (Helicobacter pylori) in the stomach, and a barium swallow with Xray, to identify hiatal hernia. A hiatal hernia may compromise the integrity of the sphincter where the esophagus enters the stomach, resulting in stomach acid coming up the esophagus, irritating unprotected tissue and causing discomfort.
Obesity and a Western high-octane diet rich in sugar, fat, alcohol, tobacco, coffee and large, late evening meals is the perfect recipe for GERD. The abdominal fat of obese individuals puts added pressure on the stomach, thus promoting reflux. I have found the following lifestyle interventions to be quite effective in my practice:
–With regard to diet, avoid coffee, caffeine, black tea, green tea, alcohol, salsa-type products, tomato sauce, citrus or apple juice, peppermint in any form (tea, Altoids, etc.), nicotine, chocolate, soda or carbonated drinks, sugary food, deep-fried food or heavy, oily meals, large meals and chewing gum. These all can lead to overproduction of stomach acids and cause the sphincter leading into the stomach to relax, resulting in reflux of stomach contents.
–Try not to consume more than four ounces of liquid at mealtimes. –If taking vitamin supplements, try a 10-day trial without them and see if this takes care of the problem.
–Consuming high-fiber foods, including a variety of vegetables and whole fruits (not citrus), is one of the best ways to reduce the incidence of GERD.
–When you eat, relax, chew your food well and stop stressing.
If your condition does not completely resolve after one or two weeks of following these suggestions, consult your physician. Lab tests may be indicated, and a more comprehensive treatment regimen may be required.
Jon Dunn is a naturopathic physician living in Nosara, on the northern Pacific coast. E-mail him at firstname.lastname@example.org or visit www.drjondunn.com.