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GERD



Gastroesophageal reflux disease (GERD) is a condition in which stomach contents, including stomach acid, flows upward into your food pipe (esophagus) usually causing discomfort.

 
  • Overview
  • Action Plan
  • Ask The Doctor
  • Success Stories

Overview


Gastroesophageal reflux disease (GERD) is much more common now than even 25 years ago, especially in North America. Approximately 20% of North Americans experience frequent GERD symptoms,1 which may include:

  • Dry cough
  • Chest pain (burning)
  • Hoarseness or sore throat
  • Sour taste in mouth
  • Sensation of a lump in throat
  • Regurgitation of food/sour liquid

Risk factors for GERD include:

  • Obesity
  • Poor diet
  • Lack of physical activity
  • Tobacco use
  • Alcohol use
  • Overeating
  • Chronic intestinal bloating or constipation

Unfortunately, many end up taking antacid medications on a daily basis in order to control these symptoms. The most commonly used medications, proton pump inhibitors, are not meant to be used chronically, as they may be associated with increased risk of infections, bone loss, interstitial nephritis, and poor absorption of certain dietary nutrients. For the vast majority of those with GERD, there are lifestyle modifications which can prevent and effectively treat this disease. A Nutritarian lifestyle effectively addresses each of the major risk factors. Most who begin changing their diets to a Nutritarian pattern should notice improvements over a few weeks to a few months but may depend on other factors, such as how long it may take to reach a more favorable weight.

 
References
  1. Rubenstein JH, Chen JW. Epidemiology of gastroesophageal reflux disease. Gastroenterol Clin North Am 2014, 43:1-14.

Action Plan


Diet

A Nutritarian eating style is the appropriate method for reducing gastroesophageal reflux disease (GERD) symptoms over time.

Foods that need to be reduced or eliminated for best results include:

  • Refined grains (pastas, breads, cakes, etc.)
  • Refined sugars/concentrated sweeteners
  • Alcohol
  • Fatty meals (high oil, cheese, spreads)
  • Carbonated/caffeinated drinks
  • Animal products (meats, dairy, etc.)
  • Spicy foods

For some, following a temporary (1-2 months) lower-acid version of the Nutritarian diet may be helpful if the general changes in diet aren’t effectively reducing GERD symptoms. Reducing the following foods temporarily, followed by gradually re-introducing them in small amounts over time as tolerated may be helpful:

  • Tomato sauce
  • Vinegars
  • Berries, plums, cherries, and citrus fruit

Overeating on unhealthy and healthy food alike past the point of fullness may also bring on symptoms of GERD, so make sure to stop when you are satisfied and before you are overly full.

Reducing or eliminating animal product consumption can reduce acid secretion and increase transit time.

Reaching a more favorable weight

A Nutritarian lifestyle should automatically help you reach an ideal weight over time, which is associated with low risk of GERD. Even a moderate amount of weight loss in this direction is often sufficient to relieve symptoms. Weight reduction is important to have less internal fat around our abdomen, so there is less internal pressure on the stomach, which can lead to leakage of acid into the esophagus, among other reasons.

Medication

If on a proton pump inhibitor, stopping the medication suddenly can spike a rebound of excess acid, so work with your doctor to gradually wean down on the dose and/or switch to a H2 blocker, which is helpful.

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Ask The Doctor


The following are sample questions from the Ask the Doctor Community Platinum and higher members can post their health questions directly to Dr. Fuhrman. (All members can browse questions and answers.)

Q.

I have a severe case of GERD and will be having my second endoscopy shortly. I am taking 20mg of Asiphex twice a day, and I was instructed to be on a bland diet until the endoscopy to control the intense burning. I am just starting a Nutritarian diet. What should I do to modify it to a "bland diet"?

A.

Eating a "bland" diet will just perpetuate the problem, as GERD is promoted by lack of micronutrients on the typical low nutrient diet. I would postpone or cancel the endoscopy now, and use the next three months to revamp your body chemistry with a totally different nutritional approach. The health and the ability of the lining of the esophagus and stomach to resist inflammation is enhanced by the consumption of raw cruciferous vegetables and their juices, so take a proactive approach.

Your diet should include green juices, blended salads, steamed greens, and soups, but everything should be chewed to a liquid before swallowing. You also should be taking extra Vitamin D. The most important thing, of course, is no oil, sweets, baked goods or animal products. Let this be the start of a new you. Keep me posted how you are doing every few weeks and record everything you eat.

 
Q.

As I work to relieve my GERD condition, I have realized that it may stem from other digestive issues. I have a lot of gas and bloating, and it feels like food just sits in my stomach.

What can I do to naturally promote gastric emptying? I am trying to eat small meals so my stomach doesn’t have as much to handle.

A.

Of course, GERD is best treated with the right diet, chewing well, and not overeating, so I hope you are already following my dietary advice. Animal products, because of their high levels of protein, delay gastric emptying, as does oil, so stick to a mostly vegan-style Nutritarian diet.

Continue to eat small meals, avoiding refined foods, tea, coffee, chocolate, soda, alcohol, and dairy. Do not eat three hours before bed. Raise the head of your bed eight inches so your chest is elevated, not just your head.