Definition & Overview
A reflux or heartburn diet is a meeting between a patient and a nutritionist with the goal to manage the symptoms of the condition by creating a nutritional plan and identifying lifestyle changes that need to be adapted. The process of digestion follows the path of food from the mouth down to the esophagus and stomach. When, for whatever reason, gastric acid, food and fluids from the stomach flow back into the esophagus, this causes a common symptom called heartburn, which is known medically as an acid reflux. If it occurs more than twice a week, it is considered chronic and referred to as gastroesophageal reflux disease (GERD). This condition requires medical treatment. To understand better, under normal conditions, food, fluids and gastric juices do not flow back into the esophagus. The lower esophageal sphincter (LES), a muscular valve at the end of the esophagus, opens when food passes from the esophagus into the stomach and closes to keep everything from coming back up. When the LES relaxes too frequently or for too long, it can remain open and the acid “refluxes” back into the esophagus. Heartburn is what people experience when the acids from the stomach come into contact with the lining of the esophagus. The acids that are used to digest food cause the burning sensation within the esophagus and it can be felt behind the breastbone and upwards near the neck and throat. Some people can even taste the acid at the back of their throat. This burning sensation can last between one to several hours and worsen after eating food, especially when lying down or bending over.
Who Should Undergo & Expected Results
Heartburn may be described as the most common symptom of acid reflux. It can be mild or severe depending on the chronic nature of the patient’s acid reflux. Other symptoms that may be experienced include regurgitation (when vomit contents enter your mouth), sore throat, nausea after eating, bloating, coughing and upper abdomen discomfort.
People who are overweight or those who regularly overeat are more prone to getting heartburn or acid reflux. While the consumption of caffeine and alcohol and smoking of cigarettes can exacerbate the condition. Eating of citrus, spicy, fatty, and fried foods also contribute to heartburn.
When taken altogether, these triggers and symptoms point to a predisposition to acid reflux and GERD. Those who suspect that they may be candidates for acid reflux may benefit from a diet consultation to prevent the condition from getting worse. Those who have been diagnosed with acid reflux may also find it helpful to identify the foods to eat and avoid to manage their acid reflux.
How Does the Procedure Work?
The doctor will have a better handle on the patient’s needs if a full diagnosis is presented. Together with a medical history and a physical examination, acid reflux or GERD may be diagnosed through the following procedures:
* Upper gastrointestinal series (Barium swallow) – A fluid called barium is swallowed to coat the esophagus, stomach, and duodenum. The metallic, chalky liquid shows up on the x-ray enabling the doctor to check the said organs for any abnormalities.
* Esophagogastroduodenoscopy (EGD) – An endoscope (a small camera fitted into a thin tube) is guided into the mouth all the way into the upper digestive system. This allows the doctor to view the esophagus, stomach, and duodenum from the inside. * Esophageal manometry – this test determines how strong or weak the esophagus muscles are. It’s basically like an EGD except that there isn’t a camera at the end of a tube but a sensor that relays the results to a computer. The pressure produced by the esophageal muscles at rest is recorded. This will determine if the muscles are too relaxed that they allow food to flow back up. * pH monitoring – is another test that monitors the acidity in the esophagus. A thin plastic tube is inserted into the nostril and guided down into the esophagus. The other end is attached to a monitor that records the readings for a 24 to 48-hour period.
The results of these procedures are then presented to a nutritionist. Generally, acid reflux symptoms can be managed by living a healthy lifestyle. Even if the symptoms point to a worsening condition, a nutritionist’s diet program can alleviate the symptoms and put a halt to the condition. Here are some recommendations that a nutritionist may offer upon consultation: Eat more of the following food that can help improve acid reflux symptoms * Oatmeal * Ginger * Melons * Poultry * Seafood * Celery, parsley, broccoli, asparagus, green beans
As you eat more of the abovementioned food, avoid the following acid reflux-inducing food * High fat and fried foods (French fries, butter, whole milk, cheese, fatty red meat) * Spicy foods * Citrus fruits (oranges, lemons, pineapple, limes) * Tomatoes and tomato-based foods * Garlic * Onions * Coffee, tea, alcohol, carbonated beverages, citrus and tomato juices * Chocolate * Mint
Make the following lifestyle changes
- Stop smoking
- Avoid eating heavy meals, instead, eat frequent, small meals throughout the day
- Have an hour or two gap between dinner and going to bed
- Lose weight especially if overweight
- Stop drinking alcohol
- Monitor the medications you are taking
- If necessary, take medications such as H2 blockers and protein pump inhibitors
Possible Complications and Risks
The recommendations mentioned in this article are rather easy to accomplish if you are dedicated to recovering from acid reflux. However, continued ignorance of any symptoms or completely disregarding the recommendations of the nutritionist can become problematic in the long run. Also, some symptoms may be misunderstood or may be indications of other unrelated problems and must not be ignored.
For instance, heartburn may mimic pain caused by heart disease. Do not ignore if the heartburn pain comes with sweating, nausea and light-headedness. Severe heartburn may also be due to a more serious medical condition especially if it persists despite taking medication for it. If the acid reflux is left untreated and lifestyle changes are not undertaken, this can lead to a more serious condition like esophageal cancer.
Reference: * Petersen RP, Pellegrini CA Oelschlager BK.. Hiatal Hernia and Gastroesophageal Reflux Disease. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 44.