Gastroesophageal Reflux Disease (GERD/GORD)

Gastroesophageal Reflux Disease, commonly known as GERD (or GORD in some countries), is a chronic condition where stomach acid flows back into the oesophagus, causing discomfort and potential damage to the oesophageal lining. This condition can significantly affect quality of life if not properly managed. As a clinical nutritionist, I want to provide you with a clear understanding of GERD/GORD, including its causes, symptoms, nutritional considerations, and how to manage it effectively.

What is GERD/GORD?

GERD (Gastroesophageal Reflux Disease) or GORD (Gastro-Oesophageal Reflux Disease) occurs when the lower esophageal sphincter (LES), a ring of muscle at the end of the esophagus, weakens or relaxes inappropriately. This allows stomach acid to flow back (reflux) into the esophagus, leading to symptoms like heartburn, chest pain, and regurgitation.

While occasional acid reflux is common, GERD/GORD is diagnosed when reflux occurs frequently—typically more than twice a week—and causes significant discomfort or damage to the esophagus.

Causes of GERD/GORD

Several factors can contribute to the development of GERD/GORD, including:

• Weakened LES: A weak or relaxed LES is the most common cause, allowing acid to escape from the stomach into the esophagus.

• Hiatal Hernia: A condition where part of the stomach pushes up through the diaphragm into the chest cavity, which can affect the function of the LES.

• Obesity: Excess body weight, especially around the abdomen, can increase pressure on the stomach, pushing acid into the esophagus.

• Pregnancy: Hormonal changes and increased abdominal pressure during pregnancy can lead to reflux.

• Dietary Choices: Certain foods and beverages, like fatty foods, chocolate, caffeine, alcohol, and spicy foods, can relax the LES or increase stomach acid, worsening symptoms.

• Smoking: Smoking can weaken the LES and impair the ability of the esophagus to clear acid.

Symptoms of GERD/GORD

GERD/GORD symptoms can vary in severity and may include:

• Heartburn: A burning sensation in the chest, often after eating, which may worsen when lying down.

• Regurgitation: The sensation of acid backing up into your throat or mouth, leading to a sour or bitter taste.

• Chest Pain: Pain or discomfort in the chest, sometimes mistaken for a heart attack.

• Difficulty Swallowing: Also known as dysphagia, this occurs when acid reflux leads to narrowing of the esophagus.

• Chronic Cough or Hoarseness: Acid reflux can irritate the throat and vocal cords, leading to persistent cough or hoarse voice.

• Sore Throat: Repeated exposure to acid can cause throat irritation.

Nutritional Considerations and Lifestyle Changes

Managing GERD/GORD often requires a combination of dietary changes, lifestyle adjustments, and, in some cases, medication. Here are some key strategies:

• Dietary Changes:

  • Avoid Trigger Foods: Identify and limit foods and beverages that trigger symptoms, such as fatty foods, spicy foods, chocolate, caffeine, and alcohol.

  • Eat Smaller Meals: Large meals can increase stomach pressure, so opt for smaller, more frequent meals.

  • Stay Upright After Eating: Avoid lying down immediately after meals; instead, wait at least 2-3 hours before reclining.

  • Incorporate Fiber: A diet rich in fiber from fruits, vegetables, and whole grains can promote healthy digestion and help manage symptoms.

  • Limit Acidic Foods: Citrus fruits, tomatoes, and vinegar-based foods can exacerbate symptoms.

• Lifestyle Changes:

  • Maintain a Healthy Weight: Losing excess weight can reduce pressure on the stomach and decrease reflux.

  • Quit Smoking: Smoking weakens the LES and increases reflux risk, so quitting can significantly improve symptoms.

  • Elevate the Head of the Bed: Raising the head of your bed by 6-8 inches can help prevent acid from rising while you sleep.

  • Wear Loose Clothing: Tight clothing around the abdomen can increase pressure on the stomach and worsen symptoms.

  • Manage Stress: Stress can exacerbate GERD/GORD symptoms, so incorporating stress-reduction techniques like meditation, yoga, or deep breathing exercises can be beneficial.

Medical Treatment Options

In some cases, lifestyle changes may not be enough to manage GERD/GORD symptoms, and medication may be necessary:

• Antacids: These can provide quick relief by neutralizing stomach acid.

• H2 Receptor Blockers: Medications like ranitidine reduce acid production in the stomach.

• Proton Pump Inhibitors (PPIs): Drugs like omeprazole are more potent acid reducers and can help heal the esophagus.

• Surgery: In severe cases where medications are not effective, surgical options like fundoplication may be considered.

Nutritional Deficiencies

Long-term use of acid-reducing medications, particularly PPIs, can lead to nutritional deficiencies, including:

• Vitamin B12: Acid is required for the absorption of vitamin B12, so reducing acid can lead to deficiency over time.

• Calcium: Reduced stomach acid can impair calcium absorption, increasing the risk of osteoporosis.

• Magnesium: PPIs can interfere with magnesium absorption, leading to low levels over time.

Monitoring these nutrients and supplementing as necessary under the guidance of a healthcare provider is essential for maintaining overall health.

Book a Consultation

If you struggle with GERD/GORD and need personalised guidance on managing your condition through diet and lifestyle changes, I can help. Book a consultation with me to develop a tailored plan that addresses your unique needs and improves your quality of life.

Understanding and managing GERD/GORD is crucial for preventing complications and improving your daily comfort. With the right approach, you can reduce symptoms and lead a healthier, more comfortable life.