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Got GERD or Frequent Heartburn? Ease Your Symptoms Without Drugs: Avoiding certain foods, changing when and how much you eat, and losing weight can help prevent heartburn.

If you have been diagnosed with gastroesophageal reflux disease (GERD), you may be taking proton pump inhibitors (PPI) such as omeprazole (Prilosec), lansoprazole (Prevacid), or esomeprazole (Nexium) to keep your heartburn and other symptoms under control. However, evidence is mounting that PPIs can have serious side effects (see What You Should Know). Fortunately, there are many strategies you can employ to ease your GERD symptoms without drugs.

Dietary Strategies

"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 Medicine. 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. 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 that cause you problems.

And, there are plenty of healthy foods that don't cause heartburn for most people.

"Good choices include foods high in soluble fiber, such as legumes (lentils, beans, and peas), carrots, berries, peaches, bananas, beets, mangoes, 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

> Nectarines, apricots, watermelon, honeydew, and cantaloupe

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

> Soups, such as homemade chicken noodle, vegetable, or lentil

> Mashed potatoes

> Baby lettuces and cooked baby spinach

> Low-fat Greek yogurt

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. 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. Your stomach isn't as full when you eat less, so the acid in your stomach remains farther away from your esophagus. Smaller meals can be supplemented with healthy snacks that will keep your hunger at bay. 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 Weight Factor

If you are overweight or obese, shedding some pounds may prevent 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 stomach's contents, including acid, to rise, so it can more easily reflux into the esophagus and produce heartburn. In addition, extra weight can cause your lower esophageal sphincter (LES, a band of tissue that opens to allow food into the stomach) to relax so it doesn't close properly.

For patients who have been diagnosed with obesity, Medicare covers weight-loss services. If you need help losing weight, ask your doctor for a referral to a registered dietitian nutritionist or other health professional who specializes in weight loss who can help you create a healthy eating plan that will meet your nutritional needs while whittling away pounds.

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

WHAT YOU SHOULD KNOW

Long-term PPI use has been associated with:

> Decreased absorption of some vitamins and minerals, including calcium, which raises the risk of osteoporosis and bone fractures

> Small intestinal bacterial overgrowth (SIBO), a condition that can cause bloating, gas, and diarrhea

> Higher risk of pneumonia

> Higher risk of Clostridium difficile infection of the colon

> Acute insterstitial nephritis (inflammation in the kidneys)

Caption: Eating smaller meals, avoiding alcohol, and losing weight can help prevent heartburn.
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Title Annotation:DIGESTIVE HEALTH
Publication:Women's Health Advisor
Date:Sep 1, 2018
Words:737
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