If you have ever had heartburn you know how painful and uncomfortable you can feel. Estimates suggest as many as 1 in 5 Canadians have persistent heartburn known as GERD (gastroesophageal reflux disease). The good news is that with a little lifestyle modification and in some cases medication, you can successfully manage your symptoms.

What is heartburn?

Heartburn occurs when the acidic liquid contents of the stomach regurgitate or reflux into the esophagus (the tube that runs between the lower throat and the stomach). This occurs occasionally in some people that have excess acid production or hiatal hernias but more commonly because of weak contractions or closings of the lower esophageal sphincter (LES), which is the ring of muscles that sits at the end of the esophagus where it joins the stomach.

If GERD is left untreated over time the lining of the esophagus gets inflamed and can cause narrowing, ulcers or a rare condition called Barrett’s esophagus which increase the risk of esophageal cancer.

What causes GERD?

What lifestyle factors can help prevent or manage GERD?

1. Mini meals – smaller meals are better than larger meals since there is less pressure on the stomach thereby reducing the risk of reflux.
2. No fluids with meals – to keep the volume of your stomach contents low to prevent too much pressure on the stomach, avoid drinking fluids at meal times.
3. Watch for trigger foods – while everyone is different the most common foods that can irritate an inflamed esophagus or increase heartburn are those that are acidic such as citrus fruit/juice and tomatoes/tomato sauces as well as garlic, onions, chili pepper, black pepper and carbonated beverages. Watch your intake of alcohol, coffee, decaffeinated coffee, chocolate, peppermint, spearmint and fatty foods since these can lower the pressure of the LES and increase reflux.
4. Stay upright after eating – avoid bending over or lying down for several hours after eating and consider raising the height of your bed 6-8 inches.
5. Stop smoking – smoking weakens the LES and increases reflux.
6. Prescription medications – in some cases your doctor will prescribe a prescription medication to help you manage your symptoms. If you are on an acid blocking medication speak to your doctor about vitamin B12 since absorption can be negatively affected. Also have your doctor monitor your iron levels regularly if you are on a proton pump inhibitor medication, which can impair iron absorption.
7.  Weight management – Many recommendations outline weight loss as a mode to reduce GERD, when it is more about health promoting behaviours. If someone is losing weight with appetite suppressants like smoking and caffeine, their GERD will not improve. Dieting to achieve weight loss can also increase stress responses and poor sleep, causing worse GERD as well. It is about creating a structure in place that allows for 4-6 small balanced meals to reduce back flow up the esophagus and reduce likelihood of over compensating with large meals.