Diet and Lifestyle Factors
Reflux is the backward flow of stomach
contents into the oesophagus. This may
be accompanied by a rising, burning feeling in the chest; often referred to as
heartburn. Signs and symptoms may also
include an acidic taste in the mouth, increased burping, a hoarse throat or a
dry cough. Reflux, or gastro-oesophageal
reflux disease (GORD), is a very common disorder with 20-40% of adults
reporting symptoms at least once weekly. Hiatus hernia is a common contributor to reflux. When GORD is untreated and persistent the
prolonged acid exposure increases the risk of developing serious inflammation
and damage to the oesophagus, with a small risk of malignancy.
Diet and Lifestyle
Diet and lifestyle modifications are
often considered the first line of therapy for sufferers of reflux or
GORD. Modifications such as weight loss,
cessation of smoking, dietary changes and elevation of the head of the bed can
be effective. Obesity can
cause reflux due to increasing pressure from the abdomen onto the oesophagus. Pregnant women experience a high rate of
reflux symptoms for the same reason.
Diet can affect reflux in a number of
ways with an individual’s dietary habits, including specific foods and drinks,
playing a role. Dietary components can
alter the tone of the sphincter between the oesophagus and the stomach and also
affect the amount of acid that is produced in the stomach, thus exacerbating
the burning sensation and inflammation of the oesophagus.
The Effect of Food
Large, high fat meals are a common cause
of reflux as they increase the pressure exerted on the oesophageal sphincter,
slow down gastric emptying and increasing the acid produced in the stomach. Small,
frequent, lower fat meals may be of benefit.
Peppermint, spearmint and coffee reduce
the tone of the oesophageal sphincter allowing for more backward flow of
stomach contents. Caffeine containing
foods and drinks also stimulate acid secretion whilst beer, wine and other
fermented alcoholic beverages increase gastric acidity. Citrus fruits, tomatoes, soft drinks, and
spicy foods may irritate and cause pain when the oesophagus is inflamed. Diets low in
fruit and vegetables and wholegrain cereals have been implicated in increasing
the risk of oesophageal cancer. Ensure you consume adequate fruit and
vegetables daily, to reduce risk of reflux.
Elimination of Foods
Avoiding particular foods and types of
meals can be extremely beneficial to sufferers of GORD. It is important that
the elimination of foods does not lead to nutritional deficiencies. It is
highly recommended to seek the advice of an accredited practicing dietitian
(APD) who can provide individual expert advice on reflux management. Find an
APD through the Dietitians Association of Australia website.
Medications as a Cause
Many common medications can cause reflux
symptoms. If you suspect that your
medication may be causing or contributing to your reflux, discuss this with
your pharmacist or doctor to find an appropriate alternative or management
Symptomatic relief and healing of the
oesophagus is generally achieved with medications prescribed by your doctor or
obtained from your pharmacist. Proton
pump inhibitors, H2 antagonists or for mild, infrequent cases
antacids, can be extremely beneficial.
Nutritional Implications of Medical
Treatments for Reflux or GORD
Medications that are used to treat
reflux or GORD can have significant effects on the absorption of certain
nutrients. Antacids should ideally be
taken at least two hours apart from meals as they bind to minerals such as iron
and prevent absorption.
Other medications used to treat reflux,
specifically H2 antagonists and proton pump inhibitors, reduce the
acid production in the stomach for a significant period of time. Vitamin B12
requires an acidic environment for its absorption and people may become B12
deficient due to taking these medications.
The absorption of minerals such as calcium, zinc and iron, as well as folic acid
may also be decreased due to the change in pH in the stomach.
Guidelines for Minimising Your Symptoms of Reflux
Eat a healthy,
nutritionally balanced diet with adequate fibre
Eat plenty of fruit, vegetables
and wholegrain foods
Lose weight if overweight
Avoid eating for several
hours before bedtime & elevate the bed head
Choose smaller, more
Minimise alcohol and
Stay upright, wear loose
clothing and avoid vigorous activity after meals