The Basics of Acid Reflux

Posted on February 06, 2017   |   
13 Comments   |   
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This blog post was written by Katie Keating, RN, MS (patient advocate)

A brief education on diet and the basics of acid reflux is usually given to patients upon diagnosis. The management related to acid reflux correlates to the foods we eat and the activities that we are involved in. It is very challenging to be compliant with any diet and to change our habits; however, many of us desire to review, from time to time, and comply when we realize the impact foods and activities have on our daily lives and sleep patterns. I hope that you find this review helpful.

Gastric Reflux

Many patients with chronic lung disorders also have gastric reflux. Irritating acidic stomach juices leak out of the stomach and into the throat and esophagus, causing heartburn. The irritation results in muscle spasms in the throat. Common symptoms include frequent throat clearing, excessive mucous and soreness in the throat. Some patients have reflux with minimal symptoms.

The following are suggestions to assist in neutralizing the stomach acid, lessen the production of acid, and prevent acid from coming up into the esophagus. This information is not intended to be medical advice. Please consult with your doctor if you have specific questions regarding any of these suggestions.

Don’ts:

  • Avoid overeating; choose several small, bland meals to balance your intake throughout the day.  A full stomach will put extra pressure on the valve causing it to open and allow acid into the esophagus.

List of foods to avoid:

  • Caffeine, fatty foods, fried foods, spicy/acidic foods, foods that are very hot or cold, chocolate, garlic, heavy sauces, butter, whole milk, creamed foods and soups, citrus fruits and juices, peppermint and spearmint, margarine, and tomato-based products. Carbonated beverages
  • No more than 6 oz. of water per hour with food.
  • Caffeine, decaffeinated coffee can also increase stomach acid.  If you must drink coffee products, do stop by 2pm.
  • Alcohol/vino- if you desire a glass of wine, having it early with dinner will lessen reflux symptoms rather than drinking a glass before bedtime.

If you must eat any of the above-listed foods, it is best to eat them earlier in the day.

Activities:

  • No exercise 2 hours before sleep.
  • Do not bend from the waist to tie shoes.  Better to sit and extend legs, bending at the knees.
  • Be aware of body position when doing chores, such as loading washing machine, bend from the knees rather than bending from the waist.
  • No downward dog yoga poses 2 hours before bed.
  • Clothing that fits tightly across the midsection should be avoided.
  • Stress can worsen reflux symptoms; practice relaxation strategies such as meditation, exercise or yoga.

Evening:

  • No more than 10 oz. of fluids after 6pm. Avoid eating 2-3 hours before lying down.
  • This includes anything that can turn to liquid, such as ice cream or yogurt. The bacteria in the stomach can be aspirated to the lungs in a liquid consistency.
  • Head of bed raised 30-45 degrees, hips to shoulder level by purchasing plastic bed lifts. You can find them for, approximately $10.00 and they are easy to assemble
  • Or
  • Placing cinder blocks, wood or special cones under the bed. The desired elevation ranges from 4-11 inches, with 8 being the average.
  • Pile 2-3 pillows under head and shoulders. Place another pillow under the thighs so that the body is in a v position to prevent sliding to a flat position. Wedge pillows also help.
  • Sleeping on your back is the best, left side is second best, never on your stomach or right side.

Do’s:

  • Chew food properly
  • Low fat dairy products and lean meats
  • Whole grain breads and grains
  • Foods high in fiber to absorb liquids in the stomach
  • Non-citrus fruits
  • Low fat chicken, fish, turkey or meat
  • Low fat soups
  • Low fat milk and milk products
  • Low fat desserts
  • Decaffeinated non-mint teas

What works for you or what have you found that makes your symptoms worsen? Please comment, as we would love to hear from you!

For a more detailed explanation needed on acid reflux and how it affects our overall well being, visit:

www.aboutgerd.org/site/symptoms/diagnosis

http://www.webmd.com/heartburn-gerd/guide/laryngopharyngeal-reflux-silent-reflux#1

http://digestive.niddk.nih.gov

13 Comments



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  • This is a great post -- thank you! So are acid reflex and GERD the same thing? Thanks again!
    Reply
    • Thank you! :)
      Acid reflux and GERD are closely related, however, not the exact same condition. Acid reflux is the return of stomach acid into the esophagus, resulting in heartburn. Acid reflux may progress to GERD, which is the more serious form of reflux. Other signs of GERD, in addition to heartburn, may include coughing, wheezing, chest discomfort when you lie flat at night.

      Reply
    • That makes perfect sense. I had always thought the two were the same! Thanks for the clear explanation, K!
      Reply
    • Yes, very interesting. Thank you!
      Reply
  • You are most welcome!
    Yes, so many don't understand the difference, that one can lead to the other over time , if not careful.
    I didn't understand how extremely important dietary measures were until last year .
    Many patients, including myself, fear that their respiratory condition has worsened when they hear wheezing; however, the wheezing may be due to GERD which is more easily treated than some of the respiratory issues.
    I lived in fear for a few weeks , while awaiting an appointment/expertise from a GI, gastroenterologist .

    Reply
  • I am silent gerd and have just changed to a new one that is not to have as many side affects as prilosec and nexicum. There was a warning on these just last week about affecting kidney last year was the heart. I got protonix from my pulmo.
    Reply
    • You are very wise to switch, protect yourself.
      I am doing much better w/ reflux since I totally changed my diet and have been following the guideline. It is challenging to change, but it is worth it.
      Reply
  • Glad to see this post back in discussion again -- it is so helpful. Has anyone had success with wedge pillows in general? Wondering if they are comfortable for sleep -- definitely seems like they would help with the reflux issue at night.
    Reply
  • I have not been diagnosed with GERD, but do recognize some of the symptoms you mention. Do you not also think that some of the beverages you list as to be avoided could help one get rid of excess mucous? For instance, I intentionally use carbonated beverages to stimulate the coughing up of mucous after nebulizer use.

    Reply
    • Hello! I used to drink carbonated beverage a lot in the past for the same reason. My GI doc recommended me to stop drinking all carbonated beverages since it does aggravate reflux. Also, mints which everyone thinks help an upset stomach - can acutually worsen reflux symptoms. We cannot change old habits overnight; however little steps towards change can help us in the long run. I hope this helps.
      Reply
  • With Acid Reflux, exactly what does the suggestion of "no more than 6oz of water per hour with food" mean?

    Does it mean that in a 1 hour period in which you have food, drink no more than 6 oz of water?
    If my statement is correct, does this mean after consuming the food? Does it include before consuming the food?
    If the 1 hour does include before consuming the food, how long before?
    If I drink 6 oz of water at 7:45 am and eat at 8am, at what time may I drink more than 6oz of water?
    If I drink 10 oz of water at 7:45am, and eat at 8am, is that ok?
    Each day I drink 60oz of water, or more, and, eat 4 meals every 2 1/2 - 3 hours.
    I drink 1-2 glasses of water right when I wake up and then eat about 1 hour later.
    Also, what about other liquids. I drink 2 cups of almond milk with my morning oatmeal and with other meals. Is that ok?
    I may have other questions as I think about what I have read here.
    Thank you in advance for your replies.
    Reply
    • Tiik,
      Hello! Welcome to the site.
      The experts , Dr. Huitt, recommend 6oz per hour, they do not recommend that a patient with reflux gulp down a large bottle of fluids, especially soda within an hour.
      Personally, I feel that many of us can tolerate more than 6oz in the am, but should limit it to 6oz per hour in the pm. The reduction in the evening will lessen the reflux when you lie down to sleep at night
      All of our bodies are different, see what works the best for you. I will do whatever is possible to reduce the chance of sleep interruptions due to reflux or any gastrointestinal issue.

      Reply
    • Ksmiles123,

      Thank you for your reply. 6oz is such a small amount of water. It certainly won't quench my thirst.

      I drink 50-64oz of water per day.
      Currently I drink my first water usually around 7:30am and finish my lite 4th meal with beverage at 7:30pm. I don't eat past 7:30 unless necessary.
      This new information, and plan now, gives me 12 hours to get my 50-64oz of 6oz per hour water.
      12 x 6oz is 72oz, so this is very doable.
      I just need to remember my new schedule now. And I need a 6oz measure, which I know is 3/4 C. BTW, I don't drink fizzy liquids. :).
      Reply