Acid Reflux: Will It Change Your Lifestyle?

With a major improvement in the understanding, diagnosis, and management of acid reflux, family physicians and gastroenterologists have a greater variety of options for treating acid reflux.

Acid suppressant medications available today are extremely effective. Medications such as omeprazole and other proton pump inhibitors have become the mainstay of treatment. These drugs are now available without a prescription and are easy for patients to obtain. Therefore, it is very easy for doctors and patients to ignore the basic and simple ways of managing acid reflux disease.

A simple and effective part of treatment is lifestyle modification and reassurance. This includes changing the types of food eaten, avoiding certain medications, quitting smoking, losing weight, elevating the head of the bed, and the sensitive use of antacids and alginates. The most important foods to avoid are fatty foods. In this group are whole milk, butter, chocolate, and some fast foods. Over time, the patient will know what foods to eat and what to avoid. Peppermint oil relaxes the lower esophageal sphincter and can lead to reflux. If used for irritable bowel syndrome, be aware of this important side effect. When in doubt, see your GP or stop if you have reflux symptoms. Smoking has a similar effect on the lower esophageal sphincter. Stop smoking if you have acid reflux. It’s making it worse.

Certain foods should be taken in moderation. Decide for yourself whether citrus, spicy, or caffeine-containing foods are problematic. Avoid these foods if they aggravate acid reflux. Obesity causes an increase in abdominal pressure and, as a result, produces an increase in pressure on the lower esophageal sphincter. This pressure can result in acid reflux. Losing weight will reduce this pressure. It is very surprising how losing a small amount of weight can make a significant difference.

In nocturnal acid reflux, lying down at night causes the reflux to move up the esophagus. Raising the head of the bed will help reduce this. In addition, it reduces sensitization at night, which creates problems during the day. Evidence shows that extra pillows make no difference. Wearing tight clothing will increase intra-abdominal pressure and stimulate reflux. Wearing loose clothing will prevent this.

It is better to eat small regular meals than a few large meals. A large volume of food will dilate the stomach and affect the effectiveness of the sphincter. Similarly, do not lie down shortly after a meal. Make sure your last meal before bed is at least three hours before.

A review of the medical literature and the few placebo-controlled trials suggests that most patients with gastroesophageal disease (GERD) can be reasonably controlled by reassurance and lifestyle modification.

However, chronic and recurring acid reflux will take more than lifestyle changes and reassurance. Management should incorporate the use of effective doses of acid suppressing drugs to achieve satisfactory control of acid reflux symptoms.

If your symptoms persist despite the changes you make, see your GP. The thought of having an endoscopy can be overwhelming, but persistent acid reflux can cause long-term problems. Acid in the lower part of the esophagus can cause inflammation leading to esophagitis. Recurrent esophagitis can cause bleeding, stricture, and Barrett’s esophagus. Between 3 and 5% of Barrett’s esophagus develops adenocarcinoma. This condition is diagnosed by endoscopic biopsy. Keep these facts in mind if your symptoms persist.