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Do you suffer from heartburn or have you been diagnosed with GORD? The right diet may help ease your discomfort.
Although most people suffer from reflux of acid stomach contents (heartburn) at some time or another, particularly when overindulging in rich foods and too much alcohol, some people are constantly plagued by acid from the stomach pushing up into the oesophagus.
This is caused by a defect in a valve or sphincter at the bottom end of the oesophagus that normally closes to prevent acid from the stomach pushing up into the oesophagus. If such a valve defect exists, the acid contents of the stomach will come into contact with the delicate lining of the oesophagus, causing damage.
In some cases, bile acids from the gall bladder may also enter the oesophagus (an alkaline part of the digestive tract), and cause corrosion of the sensitive tissues.
This refers to a spectrum of clinical conditions, called gastro-oesophageal reflux disease, or GORD.
Symptoms of GORD
Heartburn is the most typical symptom of GORD, which can manifest as severe pain in the upper and other parts of the abdomen.
Episodes of heartburn tend to occur after meals, especially if the meal has been rich or too large. Body movements such as bending over, lying down or lifting heavy objects that cause strain may make the symptoms worse.
Some people may experience reflux during sleep. This is potentially dangerous as "regurgitated" material may be breathed into the lungs.
Approximately 20% of people with GORD may have such severe and constant inflammation of the sensitive tissues of the oesophagus that it can lead to cancerous changes and bleeding, also known as Barrett’s oesophagus. Swallowing can be extremely painful and the affected person may stop eating, which may lead to malnutrition.
Treatment of GORD
If you suffer from persistent, recurrent and severe heartburn, you should have a medical examination to find out if you’re suffering from GORD.
Your doctor will prescribe the necessary medication, of which antacids are first on the list. Liquid antacids line the stomach and also protect the inside of the oesophagus from contact with abrasive acid material such as stomach contents or bile acids.
More severe, chronic GORD, which can lead to damage of the oesophagus, may be treated with medications called H2-antagonists and PPIs. If medical and dietary treatments don’t improve the condition, surgery may be indicated.
GORD sufferers are often also advised to raise the top or head end of their bed while sleeping to prevent reflux during the night.
Dietary treatment in GORD
If you have GORD, you shouldn’t eat large, heavy meals and are advised to have small, light meals at regular intervals.
Try splitting up your three standard daily meals into five smaller ones, for example:
Breakfast: Cereal with yoghurt and a milky drink or herb tea
Mid-morning snack: Sandwich with cottage cheese or a boiled egg and a milky drink
Lunch: 30g portion of lean meat or fish or egg with fruit and cooked vegetables
Mid-afternoon snack: 2 biscuits with milky herb tea
Supper: 50g lean meat or fish with rice and cooked vegetables
Dessert: Canned fruit with custard or yoghurt
Don’t eat anything in the 3 - 4 hours before going to bed (i.e. avoid late-night snacking).
Experiment to find out which foods to avoid. This is usually an individual reaction: one person can eat brown or whole-wheat bread without suffering any ill effects, while the next person can only eat white bread.
You may find that avoiding spicy foods and condiments, very acid foods (e.g. citrus fruits and orange juice), gassy cold drinks, excessive coffee, tea and caffeinated cold drinks, and all alcohol, will improve your condition a great deal.
Foods that cause build-up of gas that distends the stomach and forces acid up into the oesophagus may also cause distress.
Common gas-producing foods are:
• Raw onions, garlic, shallots, leeks
• The entire cabbage family – cabbage, broccoli, Brussels sprouts, cauliflower, Chinese cabbage and red cabbage
• Legumes (dry beans, peas, lentils, soya products)
If you’re struggling to work out what you can or can’t eat, ask your gastroenterologist to refer you to a clinical dietician.
The dietician will help you to select foods that you can eat without pain and discomfort, and also monitor if your diet is still balanced. As some foods cause so much pain and discomfort, you may have to eliminate them from your diet. This, however, can cause deficiencies if you don’t substitute other foods that also contain the missing nutrients.
GORD and overweight
People who are overweight or obese may be more susceptible to GORD.
A report in the Arbor Clinical Updates as early as 2006 cited two studies that investigated the link between body weight and GORD. In an American study of more than 10,000 female nurses, it was found that women who were overweight or obese were more likely to suffer from GORD and had more severe symptoms.
Another report indicated that overweight and obese people not only suffered more frequently and severely from GORD, but that they were exposed to a higher risk of cancer of the oesophagus.
The best step for any person with GORD, who is overweight or obese, is to try to lose weight. This will improve symptoms and outcomes. If you consult a clinical dietician, she or he will also help you to start losing weight.
References:
(Arbor Clinical Nutrition Updates (2006). Heartburn, coffee, chocolate & spices. Issue 260, 2006; Isselbacher KJ et al (1980). Harrison's Principles of Internal Medicine. 9th Edition. McGraw-Hill, New York; Mahan LK et al (2012). Krause’s Food and the Nutrition Care Process. 13thEdition. Elsevier, Missouri, USA).
Although most people suffer from reflux of acid stomach contents (heartburn) at some time or another, particularly when overindulging in rich foods and too much alcohol, some people are constantly plagued by acid from the stomach pushing up into the oesophagus.
This is caused by a defect in a valve or sphincter at the bottom end of the oesophagus that normally closes to prevent acid from the stomach pushing up into the oesophagus. If such a valve defect exists, the acid contents of the stomach will come into contact with the delicate lining of the oesophagus, causing damage.
In some cases, bile acids from the gall bladder may also enter the oesophagus (an alkaline part of the digestive tract), and cause corrosion of the sensitive tissues.
This refers to a spectrum of clinical conditions, called gastro-oesophageal reflux disease, or GORD.
Symptoms of GORD
Heartburn is the most typical symptom of GORD, which can manifest as severe pain in the upper and other parts of the abdomen.
Episodes of heartburn tend to occur after meals, especially if the meal has been rich or too large. Body movements such as bending over, lying down or lifting heavy objects that cause strain may make the symptoms worse.
Some people may experience reflux during sleep. This is potentially dangerous as "regurgitated" material may be breathed into the lungs.
Approximately 20% of people with GORD may have such severe and constant inflammation of the sensitive tissues of the oesophagus that it can lead to cancerous changes and bleeding, also known as Barrett’s oesophagus. Swallowing can be extremely painful and the affected person may stop eating, which may lead to malnutrition.
Treatment of GORD
If you suffer from persistent, recurrent and severe heartburn, you should have a medical examination to find out if you’re suffering from GORD.
Your doctor will prescribe the necessary medication, of which antacids are first on the list. Liquid antacids line the stomach and also protect the inside of the oesophagus from contact with abrasive acid material such as stomach contents or bile acids.
More severe, chronic GORD, which can lead to damage of the oesophagus, may be treated with medications called H2-antagonists and PPIs. If medical and dietary treatments don’t improve the condition, surgery may be indicated.
GORD sufferers are often also advised to raise the top or head end of their bed while sleeping to prevent reflux during the night.
Dietary treatment in GORD
If you have GORD, you shouldn’t eat large, heavy meals and are advised to have small, light meals at regular intervals.
Try splitting up your three standard daily meals into five smaller ones, for example:
Breakfast: Cereal with yoghurt and a milky drink or herb tea
Mid-morning snack: Sandwich with cottage cheese or a boiled egg and a milky drink
Lunch: 30g portion of lean meat or fish or egg with fruit and cooked vegetables
Mid-afternoon snack: 2 biscuits with milky herb tea
Supper: 50g lean meat or fish with rice and cooked vegetables
Dessert: Canned fruit with custard or yoghurt
Don’t eat anything in the 3 - 4 hours before going to bed (i.e. avoid late-night snacking).
Experiment to find out which foods to avoid. This is usually an individual reaction: one person can eat brown or whole-wheat bread without suffering any ill effects, while the next person can only eat white bread.
You may find that avoiding spicy foods and condiments, very acid foods (e.g. citrus fruits and orange juice), gassy cold drinks, excessive coffee, tea and caffeinated cold drinks, and all alcohol, will improve your condition a great deal.
Foods that cause build-up of gas that distends the stomach and forces acid up into the oesophagus may also cause distress.
Common gas-producing foods are:
• Raw onions, garlic, shallots, leeks
• The entire cabbage family – cabbage, broccoli, Brussels sprouts, cauliflower, Chinese cabbage and red cabbage
• Legumes (dry beans, peas, lentils, soya products)
If you’re struggling to work out what you can or can’t eat, ask your gastroenterologist to refer you to a clinical dietician.
The dietician will help you to select foods that you can eat without pain and discomfort, and also monitor if your diet is still balanced. As some foods cause so much pain and discomfort, you may have to eliminate them from your diet. This, however, can cause deficiencies if you don’t substitute other foods that also contain the missing nutrients.
GORD and overweight
People who are overweight or obese may be more susceptible to GORD.
A report in the Arbor Clinical Updates as early as 2006 cited two studies that investigated the link between body weight and GORD. In an American study of more than 10,000 female nurses, it was found that women who were overweight or obese were more likely to suffer from GORD and had more severe symptoms.
Another report indicated that overweight and obese people not only suffered more frequently and severely from GORD, but that they were exposed to a higher risk of cancer of the oesophagus.
The best step for any person with GORD, who is overweight or obese, is to try to lose weight. This will improve symptoms and outcomes. If you consult a clinical dietician, she or he will also help you to start losing weight.
References:
(Arbor Clinical Nutrition Updates (2006). Heartburn, coffee, chocolate & spices. Issue 260, 2006; Isselbacher KJ et al (1980). Harrison's Principles of Internal Medicine. 9th Edition. McGraw-Hill, New York; Mahan LK et al (2012). Krause’s Food and the Nutrition Care Process. 13thEdition. Elsevier, Missouri, USA).
