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