Gastro Oesophageal Reflux Disease and Diet

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Could you be suffering from gastro oesophageal reflux disease, otherwise known as GERD?

There are many different possible symptoms of gastric reflux. These include:

Symptoms in kids or adults can include difficulty swallowing, burping, bloating, nausea, hiccups, a feeling of over full stomach or even chest pain

Not just limited to adults though, even babies can suffer reflux. It can present as difficulty feeding, pulling off the breast early, arching their back, excessive crying, difficulty falling asleep and then not staying asleep for more than one sleep cycle or even waking as soon as you put them down. Read this blog for more info about babies and reflux.

Gastro Oesphogeal Reflux is defined as the overflow of the acidic contents of the stomach, back up into the food pipe (oesophagus). If mild this may only happen twice a week.  Moderate is referred to as at least once per day.  Normally, the sphincter muscle at the top of the stomach, stops the contents being regurgitated, but sometimes this muscle is weak, or not functioning properly and the muscle is not effective enough.

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GERD can happen to anyone, but there are several key risk factors

- being overweight (stomach is more likely to be squashed)

- pregnancy (stomach is pushed up and squashed so that it is harder for food to stay in the stomach)

- smoking (triggers the stomach to product more acid and prevents the sphincter muscles from working effectively)

- eating large meals or eating right before bed (lying down causes the sphincter that normally prevents food from going back up the food pipe, to relax, making it easier for the stomach contents to be released back into the oesophagus.

- alcohol (alcohol is processed first in preference to other nutrients, so the food will sit in the stomach a lot longer than normal and therefore make reflux more likely.

- eating high fat foods (sit in the stomach for longer)

- coffee

- taking medications such as aspirin

- food intolerances /(read more below)

- spicy foods (slow stomach emptying and also irritate the already inflamed lining of the food pipe)

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What foods make reflux worse?

Whilst there are a number of factors listed above that contribute to gastric reflux, one major factor that is often underestimated is food intolerance.

It is not fully understood what the mechanism is in all cases, but reflux is a major symptom of food intolerance.  Food intolerance usually does cause a host of other symptoms besides gastric reflux and this can help you work out whether food is the issue or something else.

If you regularly experience unexplained fatigue, headaches, foggy thinking, persistent runny nose or blocked sinuses, bloating, constipation or diarrhoea, you may be reacting to something you are eating. Being easily triggered, having OCD type behaviours, lack of judgement and behavioural problems are also symptoms. Some people have gut symptoms, some have symptoms that affect their thinking and others develop skin rashes, eczema or respiratory symptoms like asthma.

On their own, these symptoms may not be related to food intolerance, but the more symptoms you have, with no other identified cause, the more likely it is related to the foods you eat.  Most of these symptoms can be a normal part of life, but if you feel like they are more severe and more often than they should be, then it is definitely worth exploring further.

Food sensitivities are also very often a cause of reflux in babies.  Some Dr’s will tell you it’s the result of an under developed digestive system, which may well be correct. However, reflux in babies is not commonly understood to be related to food sensitivities and should always be considered, especially before medications are used.

So what types of foods cause reflux?

Sometimes people attribute individual foods to their reflux:

For example, garlic, onion, tomatoes, chocolate, mint, spicy foods, carbonated drinks, processed meat or citrus fruits.

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Sometimes it is not just one food but certain food groups. The fact is, that everyone is different and you need to do some detective work to figure it out.  Common food groups  that often cause problems include dairy, wheat/gluten, FODMAP foods, salicylates, amines and glutamates (natural chemicals found in most fruits and vegetables)

These cause a build up of gas that puts pressure on the stomach and push the stomach contents upwards.

The most effective way to determine which food or foods impact is to keep a food diary and work with a dietitian experienced in food intolerance to help you make sense of symptoms and food groups that may be causing problems.

Depending on the cause of the issue and your motivation or capacity to make changes, there are several possible treatment options. These include

Medications to block the production of stomach acid

Antacids to decrease the pH of your stomach to lower the acid and help you feel better.

But treating the cause is usually the best way to manage it and often dietary change and exercise can be enough.. 

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  • Jenny Trezise
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