Foods and GERD

[Mo__0]

  In trying to develop a diet my spouse can live with, I've
  read many articles and web sites about GERD (everything from
  "pop" sites to Medline). So far, the advice seems to look like
  this:
  Primary irritants -
  Caffeine, alcohol and carminatives (mints) lower LES tone.
  Acidic foods (orange juice, pineapple, tomato products) irritate
  mucosal membranes. High-fat foods are difficult to digest.
  Secondary irritants:
  Some sources list onions, garlic, carbonated beverages, red meat
  and "spicy" foods in general.  It seems to me that this list
  would be highly individual, and our best bet would be to stay
  on a fairly bland diet (lots of small meals, no food 3 hours
  before bed) and then as we're sure the esophagitis has healed,
  slowly add his favorite foods (tomatoes, onions, spicy things)
  in and watch for any reaction. The foods which lower LES tone
  would be permanently out (though he will miss that occasional
  beer!).
  His GI is not interested in discussing diets past giving us
  a badly copied handout, so I'm looking for general advice
  on this.
  Thanks, M
Dear M,
You basically have it right. Here is a summary of anti-reflux measures.
The lifestyle modifications that are considered helpful in patients with hiatal hernia and gastroesophageal reflux are called
anti-reflux measures. Foods that can decrease lower esophageal sphincter pressure should be avoided. Those foods include:
coffee, tea, cola beverages (with and without caffeine), citrus drinks, fatty foods, spicy foods, onions, peppermint and chocolate.
Medications such as aspirin or non-steroidal inflammatory agents (for example: ibuprofen, naproxen etc.) can be irritating to the
stomach or esophagus. Other medications that decrease lower esophageal sphincter pressure are theophylline and albuterol
(medicine for asthma) and calcium channel blockers (such as dilitiazem, nifedipine for high blood pressure and angina). It is
important for you to review the list of your medications with your doctor. Other helpful lifestyle changes include: elevating the
head of your bed on 4-6 inch cinderblocks or using a wedge under the mattress; not eating at least 3-4 hours before bedtime;
eating smaller, more frequent meals and avoiding smoking and alcohol. I hope you find this information helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or
consultation. Always check with your personal physician when you have a question pertaining to your health.
If you wish to be seen at our institution please call 1-800-653-6568, our Referring Physicians’ Office and make an appointment
to see Dr. Muszkat, one of our experts in Gastroenterology.
HFHSM.D.-ym
*Keywords:gastroesophageal reflux, anti-reflux measures