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Ease heartburn and reflux without drugs: avoid certain foods, eat smaller meals, don't eat before bedtime, and lose weight to help prevent symptoms.

Treat frequent heartburn or gastroesophageal reflux disease (GERD) with dietary changes and lifestyle measures whenever possible; proton pump inhibitors--medications that treat reflux--can have unwanted side effects (see article on page 4). Fortunately, there are several strategies that can be effective.

Dietary do's and don'ts

"Avoid foods that trigger GERD, including spicy foods, fried foods, high-fat foods, carbonated beverages, and all artificial sweeteners (Splenda, Equal, Sweet 'N Low), which are found in diet sodas and sugar-free gum and candy," says Christine Frissora, MD, a gastroenterologist at Weill Cornell Medical Center. Other foods that can trigger heartburn include citrus fruits, tomatoes, alcohol, caffeine, peppermint, garlic, onions, and chocolate.

Not all foods produce symptoms in every patient, so keeping a log or journal can be very helpful. If you keep a written record of what you eat and drink, including the amount and time of day, and note when you have heartburn or other GERD symptoms, it will help you identify foods and patterns that cause you problems.

The good news is that Dr. Frissora recommends eating plenty of healthy foods that don't cause heartburn for most people.

"Good choices include foods high in soluble fiber, such as berries, beets, legumes (lentils, beans, and peas), carrots, yams, peaches, bananas, mangos, and kiwifruit," says Dr. Frissora.

Other foods that generally are easy on the digestive system include:

* Rice, pasta, couscous, noodles, and polenta

* Fish and shrimp

* Oatmeal, waffles, pancakes, and corn and rice cereals that have little or no added sugar

* Low-fat Greek yogurt

* Mashed potatoes

* Chamomile and herbal teas (avoid teas that contain peppermint if you have identified mint as one of your trigger foods)

GERD: A "weighty" issue

If you are overweight or obese, shedding excess pounds may be very effective in preventing heartburn. Research has shown that losing weight reduces and even eliminates GERD symptoms in some patients.

If you have excess weight, especially in your abdominal area, it presses on your stomach and limits its capacity, so there is less room in your stomach for acid and other contents. This causes the level of your stomachs contents, including acid, to rise and move closer to the lower end of your esophagus, where it can more easily reflux into the esophagus and produce heartburn. In addition, excess weight can cause your lower esophageal sphincter (a band of tissue that opens to allow food into the stomach and is supposed to remain closed at other times) to relax so it doesn't close properly, enabling reflux.

For patients who have been diagnosed with obesity, Medicare covers weight-loss services including counseling and education. If you need help losing weight, ask your doctor for a referral to a health professional who specializes in weight loss.

Other factors

Your eating habits--when, how much, and even how you eat--also can trigger heartburn and other GERD symptoms.

Eat at least three hours before going to bed or lying down. When you are lying down, it is much easier for the contents of your stomach to reflux into your esophagus because they are both at the same level. While you are sleeping, your stomach also empties more slowly and more digestive secretions, including acid, are produced. If you often experience nighttime heartburn, raise the head of your bed at least six to eight inches by placing a foam wedge under the top part of your mattress.

Eating smaller meals, especially at dinnertime, also can help prevent heartburn. Smaller meals can be supplemented with healthy snacks that will keep your hunger at bay so you don't overindulge at your next meal. Eating slowly and thoroughly chewing your food also places less of a burden on your stomach, since it takes less time and stomach acid to break down smaller pieces of food than larger ones.

The bottom line: If you have GERD or frequent heartburn, altering your diet, eating habits, and lifestyle can be very effective at preventing symptoms and reducing or eliminating your need for PPI medications.


Keep your nutrient intake high with these

GERD-friendly foods:

* Soups: Homemade chicken noodle, vegetable, or lentil

* Fruits: Nectarines, apricots, watermelon, honeydew, and cantaloupe

* Root vegetables: Cooked, mashed rutabagas, turnips, and parsnips

* Cruciferous vegetables: Cooked broccoli and cauliflower (these can be pureed in soups)

* Leafy greens: Baby lettuces and cooked baby spinach
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Title Annotation:TREATMENT
Publication:Women's Health Advisor
Date:Mar 1, 2016
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