Esophageal Reflux (GERD) or Heartburn


Esophageal Reflux refers to the regurgitation of stomach acids into the esophagus. The most common symptom is heartburn. Esophageal reflux is usually a mild condition that can be managed medically or nutritionally. In chronic cases, however, it may lead to esophagitis, ulceration, or hemorrhage.

The esophagus is usually protected from reflux of stomach contents by the contraction of the LES, or lower esophageal sphincter. If the LES becomes stretched and weakened it no longer is able to efficiently protect the patient from reflux (regurgitation of stomach acids).

When the LES muscle loosens, it allows the stomach acids to move back into the esophagus, instead of doing its job and holding the stomach acids in the stomach. The feeling of heartburn comes from those stomach acids being in the wrong place!

Nutritional Changes:

• Achieve and maintain desirable body weight.

• Avoid large meals. If extra calories are needed, have mid-morning and mid-afternoon snacks. Small meals are preferable, since they digest more efficiently and will lessen the chance of reflux.

• Avoid eating meals or snacks for at least two hours before lying down. If you must eat late, prop yourself up with a few pillows before lying down.

• Take chewable digestive or papaya enzymes with each meal to help with your digestion.

Avoid or limit foods and beverages that relax the LES:

• Alcohol

• Peppermint or spearmint

• Garlic or onion

• Chocolate

• High-fat foods: fried foods, meats, cream sauces, gravies, margarine or butter, cream, oil, and high-fat salad dressings

Avoid or limit foods and beverages that can be irritating:

• Carbonated beverages

• Citrus fruit and juices

• Coffee (regular or decaf)

• Spices

• Tomato products

• Very hot or very cold foods

Increase foods that do not affect the LES:

• Low-fat protein foods (low-fat dairy products, lean meat, chicken, fish)

• Carbohydrate foods with a low-fat content (breads, cereals, crackers, fruit, noodles, potatoes, rice and vegetables prepared without added fat)

• Drink liquids between meals instead of with meals

• Wear loose fitting clothes, especially after meals

• Avoid or quit smoking

Addendum to article on GERD:

While making dietary changes to protect yourself from GERD (Gastroesophageal Reflux Disease) it is critical to understand that GERD places the person at higher risk for Esophageal Cancer. The survival rate of esophageal cancer is low: one in five people will survive less than five years.

The good news:

There are diagnostic tests to determine the extent of damage done by this reflux or (commonly known as) “heartburn”. The upper endoscopy is one test that is done under sedation. The other test is a Transnasal esophagoscopy (TNE) that is done with no sedation.

These tests are relatively simple and can determine if GERD has placed the person at risk of developing Esophageal Cancer. With or without symptoms, a scope using either diagnostic methods should be done since there are risks for cancer for those who have had GERD with or without continuing symptoms.

In addition to my dietary recommendations, eat at least 3 or more hours before going to bed and/or use pillows or an object to raise the head to reduce the stomach acid from reaching the esophagus. People may be unaware of the reflux occurring while sleeping so be prepared and safe. Further, symptoms of GERD to be aware of are persistent sore throat, a hoarse voice, chronic coughing or choking upon lying down. Remember, there may be no symptoms and still damage is being done.

For further information please contact ECAN (Esophageal Cancer Action Network) at