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In medicine, the phenomenon of gastric juices upsurging from the stomach to the esophagus, reaching even the most severe cases even in the throat, is referred to as gastroesophageal reflux or gastric reflux. Gastroesophageal reflux affects a lot of people sporadically and can, in certain circumstances, become a chronic disorder; When it assumes a chronic character, represents a true disease, whose specific name is gastroesophageal reflux disease, but that, in the common jargon, is simply (and again) gastroesophageal reflux. In industrialized countries, gastroesophageal reflux disease is considered a common condition since, according to some statistics, affects between 20 and 40% of people aged between 45 and 64 years.
When it is chronic, the gastroesophageal reflux is due to a malfunction of low esophageal sphincter, LES, i.e. the valve, which is placed between the esophagus and the stomach, prevents the rise of the food from the latter. Among factors that may affect LES function include conditions such as obesity, cigarette smoking, hysterectomy, asthma, constant intake of certain medications, pregnancy, stress and poor nutrition habits.
Acid reflux conditions and lifestyle
When we speak about acid reflux, or as it commonly called, heartburn, it can be either a sporadic appearance or a chronic condition. In the event of the latter, certain steps should be taken to change the patient’s lifestyle habits. While diseases that have acid reflux as one of their major symptoms are very numerous (you can learn all about them from these two articles: [A Complete Guide To Esophageal Health: Acid Reflux, Hiatal Hernia, GERD And More] and [Possible Causes Of Acid Reflux (Heartburn)]), the most common condition characterized by frequent heartburns is gastroesophageal reflux disease (GERD).
Gastroesophageal reflux and diet are closely linked to each other, at the level of causes, therapy and prevention. It is essentially important, when diagnosed with GERD, to prevent possible complications with a timely change in eating habits. The present piece is entirely devoted to dietary advice and lifestyle tips for individuals suffering from frequent acid regurgitation. You will learn about foods to avoid, products to add on your diet to help you fight excessive stomach acidity, and new healthier habits to adopt.
GERD is a disturbance related to the rise of gastric contents in the esophagus which, due to lack of adequate proteins for a pH that is so acidic, can be damaged in the long term by causing a symptom characterized by: Diet Reflux Gastroesophageal reflex pyroxia -sternal, regurgitated with gastric (at night not always noticeable) and epigastric pain; NB. Gastro-oesophageal reflux disease is often linked to anatomic alteration called hystatic hernia.
Gastroesophageal reflux is a physiological manifestation (about 50 episodes per day), but what determines GERD is the alteration of the balance between aggressive agents (acidic gastric contents) and preventive-defensive ones of the esophagus; The latter are: the anti-reflux barrier (consisting mainly of the lower esophageal sphincter – LES – whose activity in the GERD is partially compromised) and mucosal trophism (layered epithelium that blocks the passage of acidic ions to GERD submucosal tissues, remarkably worn out by the chemical stress of gastric contents).
The diagnostic criteria of gastroesophageal reflux disease are predominantly related to symptoms: reflux episodes that last for at least 3-5 minutes and are associated with pyrosis, regurgitation and pain. However, especially at the initial stage, gastroesophageal reflux disease is almost completely asymptomatic and diagnosis is needed: a pH-metric assessment associated with, and possibly, an esophagogastroduodenoscopy. GERD manifests more frequently in obese than in normal subjects.
Certainly, for a gastroesophageal reflux sufferer, the most important aspect is the diet as therapy; Such a diet includes: the exclusion of certain foods (too fat foods, coffee, chocolate, spices, carbonated drinks, etc.), preference for certain types of foods (lean protein foods, citric acid-free fruit, Whole grains, non-fat, vegetables, etc.), the use of healthy methods of cooking and food preparation, and the slow and serene eating of meals.
To cope with chronic gastroesophageal reflux, you will need:
- Drug-based drug therapy such as antacids, alginates, anti-H2 and proton pump inhibitors, which buffer gastric acidity and / or reduce the production of acid digestive juices from the stomach;
- Appropriate diet therapy, which increases the cardiac tone rather than overheating it, keeping the intraddominal pressure at low levels instead of increasing it and leading to acid secretion by the stomach.
The first rule: eat slowly
The first digestion, as is known, occurs in the mouth and this is true not only because the saliva contains a chemical with digestive properties, but also because the shredding of the food during chewing eases gastric activity. Eating a sandwich hastily by swallowing whole snacks encourages reflux as it extends the time to stay food in the stomach. For this reason it is essential that the chewing is very slow and that the diet involves taking four or five small meals instead of one or two big daily meals overloading the stomach.
One of the first thoughts that a person’s complaining about heartburn has in the mind is the type of food ingested during the last meal. In this regard, two different types of foods should be distinguished, which, if present in the diet, can favor gastroesophageal reflux:
Foods that delay stomach emptying by increasing the likelihood of a rise in acid juices. As we have seen in order to avoid reflux, it is important that the stomach is quickly emptied. Consequently, in the presence of such a disease, the diet will have to be poor in all those foods that increase the time during which the meals stay in the stomach (e.g. fatty foods such as seasoned cheese, chocolate, sausages and fries). On the other hand, the carbonated drinks and the chewing gum increase directly or indirectly the amount of air present in the gastric sac. The presence of these gases increases the pressure inside the stomach by favoring the upward elevation of gastric contents.
Foods that have intrinsic irritating properties (white wine, vinegar, alcohol, spirits, tomato or citrus juice). Such foods, which also include coffee, cocoa and the foods or drinks containing it, promote acid production in the stomach
The ambivalence of milk
Milk, being an alkaline food, has an immediate positive effect since its basicity is to counteract (buffer) the acidity of the reflux. But milk, especially the whole, is also rich in fats and proteins that increase gastric acidity and slow down stomach emptying. Milk therefore has a beneficial effect in the immediate but, especially if you exaggerate with the amounts, after initial relief it can cause a quick recurrence of the symptoms.
The increase in intra-abdominal pressure, by pressing against the stomach walls, favors the uptake of gastric contents. Such pressure can increase in absolutely physiological situations such as pregnancy or obesity and overweight.
Species in recent years, a bit like the mother of all the ills, when talking about digestive tract disorders, stress is always called into question. In the presence of gastroesophageal reflux, this hypothesis should not be excluded since anxiety and retarded anger can, for example, exacerbate the typical symptoms of the disease. On the other hand, it is very unlikely that stress is the direct cause of the reflux.
Acid reflux at night
Night stomach burns is particularly annoying as it tends to last for a long time. Such burning is often caused by a cardiac valve incontinence that favors the ascension of acids in the esophagus where they remain for a long time irritating the mucous membranes. In addition to dieting, it may be useful in these cases to place a raise underneath the mattress so that the force of gravity prevents the ascension of the acids.
The following information is for exclusively informative purposes and does not intend to replace the opinion of professional figures such as a physician, nutritionist or dietician whose intervention is necessary for the prescription and composition of personalized food therapies.
Diet for excessive stomach acidity
The diet for gastroesophageal reflux disease is aimed at:
- If necessary, lose extra weight
- Re-schedule your meals by reducing the volume
- Avoid foods that promote gastric secretion (nerve: coffee, tea, alcohol)
- Remove spices and carbonated beverages
- Avoid / minimize very fatty meals
- Avoid / minimize unprotected, raw or prolonged protein foods
- Avoid / minimize very cold or very hot foods
- Avoid / minimize chocolate, onion and garlic.
Gastroesophageal reflux disease must also be associated with certain well-defined habits; For example: abolition of cigarette smoke, removal of too tight clothes, maintenance of erect posture during and after meals, prolonged chewing, sleep at least 3 hours after the meal and failure to perform physical exercise immediately after the meal.
Staying away from these 12 foods (and drinks) will spare you the heartburn discomfort
Among the sworn enemies of those suffering from gastroesophageal reflux include the intingules and especially fat-rich foods (e.g. fried, red meat, fatty cheeses, too much oil, etc.); these, in fact, remain in the stomach for a long time (because they take a long time for digestion), they induce an inadequate production of gastric juices (always for digestion reasons) and ultimately reduce cardiac muscle tone.
Skimming through the acid reflux blacklist below, one cannot help noticing the unlikely alliance of superfoods and great sources of beneficial nutrition elements with junk food family representatives. The rationale behind this vicinity is in the chemistry involved in stomach acidity equations. We included some tips on how to override the ban, accruing the benefits of healthy foods while preventing them from triggering acid regurgitations.
In the list of foods and drinks to be avoided in the presence of gastroesophageal reflux disease, the following should be singled out:
- Foods containing caffeine (including coffee and tea). Chocolate may aggravate the symptoms of gastritis and stomach ulcers, all because of the presence of caffeine and high fat content that both provoke stomach acidity symptoms. Here’s another bad news: it contains a significant amount of oxalate that disrupts the absorption process of calcium; it can therefore contribute to the development of osteoporosis.
- Mint is a source of menthol, which can irritate the mucous lining of the stomach and cause the onset of increased acidity, thus leading to acid reflux. It is, however, recommended in other conditions associated with acid upsurge, in particular, common heartburn. Before you decide in favour of adding this herb into your meals or drinks, it is worthwhile asking your GP on its suitability in your individual case.
- Those are rich in citric and other dietary acids, which is no good when your goal in planning the meals is to minimize acidity. Be careful with raw tomatoes as well as salsas, ketchups and canned foods. It is best to totally eliminate them.
- Ethanol is a major irritant of the stomach mucosa, and thereafter it should be banned from a healthy diet plan of anyone who suffers from excessive stomach acidity. Whenever your stomach feels like it will take extra juices to digest a meal or a drink, it will go to the extremes in order to protect its lining from the irritating agent. The results you will feel up your esophagus and throat.
- Soft drinks. Soft carbonated drinks increase the volume of food you’ve ingested, expanding the walls of the stomach with the gases contained therein. This will be followed by a massive upsurge of stomach acid.
- Spices like pepper, chili pepper, curry, nutmeg etc. Those are extremely irritating for the stomach mucosa due to the presence of formic and butyric acids and capsaicinoids, the chemicals that prompt stomach to produce even more gastric juices in order to face the digestion challenge.
- Fatty cheeses. Due to their having high percentage of fat, ripened and fresh cheeses (unless they are made of skimmed milk) should be discarded from a diet of a gastroesophageal reflux sufferer.
- Fatty desserts. For the same reason as above, desserts with fat percent above 3% do not make it into the list of foods allowed for acid reflux patients. Cheesecakes, creams, parfaits should be abstained from, as in order to digest them your stomach will respond with increased juice production which will inevitably lead to heartburn.
- Rye bread. Due to the presence of irritating acids and being generally a heavy food to digest, rye bread should be avoided when you suffer from acid reflux on a regular basis. It is also true that in certain individuals heartburn is provoked by wheat bread and pasta, as well as other foods containing gluten, but those are second to bread made of rye flour.
- Fatty fish. This one is tough to include in this list, because the irreplaceable omega-3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) found exclusively in fatty kinds of fish and crustaceous. However, fat is still fat, and its ingestion will backfire with the same results as we have seen in the above examples. The good news is that omega-3 fatty acids can be supplemented with high quality capsules. The tip for a really good omega-3 supplement is to choose the one with a denser EPA content.
- Citrus fruit. Grapefruits, oranges, lemons and limes are loaded with health benefits, but there is no denying the fact that their tanginess has a lot of acidity behind it. Consume citrus fruit mixed in a fruit salad where they are proportionally minimal. To source vitamin C elsewhere, look for kiwis and broccoli.
- Sad as we are to include garlic in the acid reflux blacklist, there is no overriding the fact that garlic is a major heartburn trigger due to the presence of agents irritating the mucosa lining of the stomach and causing it to respond with increased acid production. The health-benefitting compromise in this case, as we have already seen in the case with fatty fish, would be to ingest garlic in capsules, since this product has serious superfood qualities that cannot be replaced in their totality.
General dietary advice for acid reflux
Gastroesophageal reflux and diet are, respectively, a condition and a daily life behavior that, as has been seen in the introduction, is an inseparable bond, not only at the causal but also above all therapeutic level. The next sections of this article will deal with the very important role of a proper dietary plan, in the treatment of chronic gastroesophageal reflux; the purpose is to provide readers with a guide that collects information on how to feed, such as eating foods, such as food supplements, how to cook food, etc., in the presence of gastroesophageal reflux.
Small and frequent meals
A binge-size meal to curb hunger pangs, due to prolonged fasting, represent, for people with gastroesophageal reflux, one of the main reasons for the onset of symptoms. This inconsistency between binge eating and the gastric reflux phenomenon explains why doctors strongly advise on the consumption of small, frequent meals: in fact, taking on a small amount of food and with a certain daily rate prevents excessive overload of the stomach, falling into a situation Fasting and taking more calories than those that really serve the body. Therefore, you should never skip a meal; avoid overloading the stomach during the digestive process.
Eat far away from night time
For those suffering from gastroesophageal reflux, a very common mistake that can trigger the symptoms is to go to bed shortly after the meal, with the so-called ‘full belly’. The horizontal position, taken in bed, favors the ascension to the esophagus of the acid content of the stomach.
On this subject, the wise advice from doctors and experts is to wait at least two hours before bedtime and to lie with your head lifted from the bed of 7 to 8 inches.
At least two hours of waiting serve the stomach to digest ingested food and empty some of the gastric juices while the raised head position ensures that the remaining stomach juices do not go back into the esophagus.
Keep erect posture during and immediately after meals. If the horizontal position after meals favors the rise of gastric juices in the esophagus, the erect position (hence vertical) is instead an obstacle to the aforementioned elevation, for physical reasons. All this is why physicians recommend eating while maintaining a upright position and staying in that position for at least 45-60 minutes, even after eating.
Body weight control and intra-abdominal pressure. Excessive abdominal fat presence results in a higher intra-abdominal pressure than normal. The presence of intraddominal pressure higher than normal tends to affect the structure and functioning of the stomach, particularly the cardias; The latter, in fact, weakens muscularly, becoming less effective in containing gastric juices in the stomach, which at this point are more likely to regurgitate from the esophagus. In the light of this, it is easily perceived the importance of a change in diet in the context of gastroesophageal reflux and obesity, which must first aim at achieving and then maintaining the weight form (hence weight loss and consolidation of new body weight are advised).
What to eat
Listed foods to be avoided in case of gastroesophageal reflux, remains to clarify what the subject can eat without thought with the problem.
Among the recommended foods allowed in the presence of gastroesophageal reflux disease, are reported:
- Lean and protein-rich foods (such as white meat, eggs, most of the fish, seafood etc.), because unlike fatty foods, are easier to digest, involve less production of gastric juices and increase muscular tone of LES.
- Fresh vegetables, low in fat and sugar, whose digestion requires considerable production of gastric juices.
- Low-fat whole grains. The large amount of whole grain fibers absorbs stomach gastric juices, making the phenomenon of gastroesophageal reflux less likely.
- Fruits with low content of citric acid, such as melons, pears, apples, bananas, and berries, because they keep the acidity of the stomach within acceptable values.
It should also be pointed out that the above foods are good foods for those who suffer from gastroesophageal reflux, provided that their cooking and / or preparation is in compliance with certain rules (see the next section).
Use low temperature when cooking
If cooked or prepared inadequately, the foods indicated for those suffering from gastroesophageal reflux can also be harmful and may lead to the esophagus rising to the acid content of the stomach.
For example, it is counterproductive to eat:
- Fried eggs or vegetables;
- White meat excessively seasoned with oil, spices and / or spices;
- White meat cooked at very high temperatures;
- Sugared fruit;
- Extremely toasted wholewheat bread.
Therefore, in the presence of gastroesophageal reflux, not only the types of food consumed but also the methods of cooking and preparation are important, which should be healthy.
For example, the following foods represent a winning choice:
- Baking fish or lean meats;
- Steaming for vegetables;
- White meat on the plate, cooked at low temperatures (will then care for the consumer avoid eating any burnt parts);
- Raw and low-consumption of seasonal vegetables;
- Consumption natural fruit, without the addition of sugars;
- Dressing of the pasta with vegetable sauces cooked with steam and with a drop of oil, rather than with flavors rich in fats and aromas.
Chew well and without haste
To complete a framework that already includes balanced nutrition, the choice of right foods, and the use of healthy baking methods, also contributes to the serenity of eating meals. In fact, eating well (‘good’ in the sense of healthy) is not enough, you also need to chew slowly and swallow with caution. Surely, helping to take such a approach to food comes from attending, at meal time, in serene and relaxing environments.
A diet such as that described above, initiated at the earliest symptoms of gastroesophageal reflux (acidity, acid regurgitation, gastric pain, etc.), may prevent the latter from presenting with a certain constancy and taking the contours of a chronic disorder. Avoiding chronic inflammation of gastroesophageal reflux is important because it can result in major complications such as esophageal ulcer, esophageal stenosis and Barrett’s esophagus.
So, in the light of this and what has been said in the previous sections of this article, in a context of gastroesophageal reflux, diet is a pivotal point of both therapy and prevention.
THE LIST OF RIGHT AND WRONG FOODS FOR ACID REFLUX
Type of food
|Milk and derived products||Skimmed milk with up to 2% fat.
|Whole milk and milk with a fat percentage ≥ 4%.
|Vegetables||Most of the vegetables
|All fried or seasoned vegetables.|
|Fruit||Fruits with low citric acid (e.g. apples, melons, pears, berries, bananas, peaches, etc.).||Citrus fruits (e.g.: oranges, grapefruit, lemon etc.).
|Bread and cereals||All low-fat preparations.||Preparations combined with milk and milk derivatives.
Prepared with too much fat.
|Meat and meat substitutes||Lean meats, eggs, fish (preferably the meager one) and seafood.
Cuts of cold meat.
|Fat meats (e.g. sausage, bacon, chicken skin etc.).|
|Fats and oils||Small doses, better than plant origin.||Large doses, regardless of whether it is of animal or vegetable origin.|
|Sweets and desserts||All desserts without or low in fat (less than 3 grams).||Chocolate.
Desserts prepared with oil and / or fat (e.g. butter).
|Drinks||Water, decaffeinated drinks and non-acid fruit juices.||Drinks with caffeine, mint, alcohol, mint tea and carbonated drinks.|
|Soups||All preparations without or low in fat.||Soups with added fat, milk, oil etc.|