Did you know reflux disease is extremely common? As for its main symptom - heartburn - about 30% of Americans experience it monthly. 10% experience it daily. Symptoms appear day or night, sometimes both. So, not only is heartburn ruining a good night's sleep. It's interfering with performance at work. While only a fraction of Americans live with persistent reflux disease, almost all will experience its classic symptom - hearburn - at some point in their lives. The vicious cycle GERD creates can be seen from one study that went as far as to find a relationship between reflux disease and anxiety or depression. While anxiety or depression may increase the risk of GERD, often GERD's symptoms can contribute to anxiety or depression.
Tame the Flame of Heartburn
The best change someone living with reflux disease can make is losing weight if obese. This helps reduce some of the pressure that abdominal fat places on the stomach. What else can be done?
Well, does this routine sound familiar? It's been a long day at work. Because breakfast and lunch were skipped or skimped on, you're extremely hungry by dinner time and have a heavy meal. After dinner, it's time to kick back and relax in front of the TV.
The previous scenario highlights some classsic contributers to heartburn - overeating in one sitting and late night meals or lying down after a heavy meal. Therefore, prepare smaller meals that can be enjoyed more frequently. Also, plan to stay upright for at least two to three hours after eating.
The speed at which you eat may also affect whether or not heartburn will follow. Take your time to chew your food thoroughly.
Stress at any point - before, during, or after a meal - can also contribute to heartburn. Try your best to relax around meal times.
Almost any resource on GERD will tell you to avoid spicy foods, fatty foods, mint, tomato products, chocolate, citrus, caffeine and carbonated beverages. Do studies show that cutting these out improve GERD symptoms? Actually, results are conflicting.
The truth is we are all unique. Your best bet is to keep a food journal to keep track of potentially offending foods or sensitivities. Sometimes it is all about timing. Instead of cutting these foods out entirely, you may be able to still enjoy and tolerate them by eating them earlier in the day - not just before bedtime.
Why are these changes so important? While some symptoms of heartburn are caused by a real, legitimate issue with the esophagus or the valve between the esophagus and the stomach, many cases are simply caused by overindulgence. When it comes to overindulgence, some simple lifestyle modifications may help reduce or even lead your doctor to believe its time to discontinue the use of heartburn medication.One of the side effects of the main heartburn medication - PPIs (proton pump inhibitors) - is reduced calcium absorption. Why? Stomach acid is needed to absorb calcium. PPIs reduce stomach acid production and can, thus, reduce the amount of calcium you absorb from your food. It comes as no surprise then that long term users of PPIs are at greater risk of hip fractures, as some studies have pointed out.
Fight with Fiber
How can fiber help with fighting heartburn symptoms?
A 2018 study in the World Journal of Gastroenterology suggested that low fiber intake decreased emptying of the stomach and motility of stomach, thus adding fuel to the fire when it comes to GERD. Dietary fibers may not only improve stomach emptying but also levels of stomach acidity.
As a plus, high fiber foods can help keep blood sugar levels stable. Adequate levels of ifber are 25 grams per day for women and 38 grams per day for men. How can you meet that goal each day?
Consider a sample breakfast that starts the day off with 17 grams of fiber:
+ 1/2 cup of oatmeal (2 grams)
+ 1 cup strawberries (3 grams)
+ 1 oz almonds (4 grams)
+ 1 oz flaxseeds (8 grams)
A Green drink with the use of 1 scoop of Greenergy powder will add an extra 2 grams of fiber for a total of 19 grams for breakfast.
Add 1/2 cup of cooked beans to your lunch wrap or salad for an additional 7 grams of fiber. We are at 26 grams of fiber total so far. Include a piece of fresh fruit for lunch (such as a small banana) for 3 more grams of fiber. Combine it with a protein, such as 2 tablespoons of almond or peanut butter and you get 2 more grams of fiber. We are already at 28 grams of fiber and we still have dinner and snacks to go.
Bottom line: Including less processed foods and more whole, fresh, fiber-rich foods in each meal and snack will make meeting fiber goals a breeze.
References
Antunes C, Curtis SA. Gastroesophageal Reflux Disease. [Updated 2019 May 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441938/
J Gastroenterol Hepatol. 2017 Jun;32(6):1170-1177. doi: 10.1111/jgh.13650.
Yang, X. J., Jiang, H. M., Hou, X. H., & Song, J. (2015). Anxiety and depression in patients with gastroesophageal reflux disease and their effect on quality of life. World journal of gastroenterology, 21(14), 4302–4309. doi:10.3748/wjg.v21.i14.4302
JAMA. 2006 Dec 27;296(24):2947-53.
Song, E. M., Jung, H. K., & Jung, J. M. (2013). The association between reflux esophagitis and psychosocial stress. Digestive diseases and sciences, 58(2), 471–477. doi:10.1007/s10620-012-2377-z
Morozov, S., Isakov, V., & Konovalova, M. (2018). Fiber-enriched diet helps to control symptoms and improves esophageal motility in patients with non-erosive gastroesophageal reflux disease. World journal of gastroenterology, 24(21), 2291–2299. doi:10.3748/wjg.v24.i21.2291