Medications and Diet Plan for Treatment of GERD

March 09 05:36 2022 Print This Article

The digestive system is a well-designed mechanism. Food that is chewed and swallowed moves down the esophageal pipe (in the throat and upper chest) and enters the stomach where the process of digestion begins in full swing. The esophageal sphincter is a ring of muscles that relaxes to allow the food to enter the stomach and then contracts to prevent the food from going out of the stomach back into the esophagus (called a Reflux).

Sometimes, a reflux does happen after a meal. The condition is characterized by intense heartburn, burp that is spicy or pungent, and sometimes particles of food getting into the mouth. This condition is called acidity or acid reflux, depending on the exact condition. Everyone experiences this once or more in their lifetime, and is not cause for alarm.

However, when the above set of events happen chronically or repeatedly over a long period of time (3 weeks or more), the person could be suffering from what is called Gastro Esophageal Reflux Disease (GERD). GERD is a serious problem that will not heal with home-remedies, but requires treatment by a qualified Gastroenterologist.

Symptoms

• Burning feeling in the chest
• A sensation of food sticking in the chest
• Food regurgitation hiccups
• A sore throat burping
• Changes to the voice, including hoarseness
• Wheezing or weak coughing

Treatment

Treatment options are many, which include medication, minimally invasive procedures, lifestyle changes and diet changes. But for the purpose of this article, we will focus on Medication and Diet Plan.

Medication

OVER THE COUNTER (OTC) MEDICATIONS

• Antacids: As the name implies, these neutralize the stomach acid. These provide quick relief, but they are not enough to heal an inflamed esophagus that is damaged by stomach acids. Also, their overuse or prolonged use can cause side-effects such as kidney problems or diarrhea. Examples include Tums, Rolaids and Mylanta.
• H-2-receptor blockers: These drugs reduce acid production in the stomach for up to 12 hours or more depending on the dosage. However, they don’t act as quickly as antacids. Examples include nizatidine (Axid AR), cimetidine (Tagamet HB) and famotidine (Pepcid AC).
• Proton pump inhibitors: These drugs inhibit acid production and also heal the esophagus damaged by stomach acids by allowing time for damaged esophageal tissue to heal. They are stronger acid-blockers than H-2-receptor blockers. Examples include omeprazole (Prilosec OTC, Zegerid OTC) and lansoprazole (Prevacid 24 HR).

 PRESCRIPTION MEDICATIONS

• Prescription-strength H-2-receptor blockers: They generally do not cause any harm to the body, however long-term use may be associated with a slight increase in risk of vitamin B-12 deficiency, brittle bones and hence bone fractures. Examples include prescription-strength nizatidine and famotidine (Pepcid).
• Prescription-strength proton pump inhibitors: They generally do not cause any harm to the body, however long-term use may be associated with nausea, diarrhea, vitamin B-12 deficiency, headache and hip fracture. Examples include dexlansoprazole (Dexilant), lansoprazole (Prevacid), esomeprazole (Nexium), rabeprazole (Aciphex), omeprazole (Prilosec, Zegerid) and pantoprazole (Protonix).
• Drugs that strengthen the lower esophageal sphincter: These reduce the frequency in which the lower esophageal sphincter relaxes. Side effects for some people include fatigue or nausea. Baclofen is the most commonly prescribed drug in this category.

Diet Plan

It is good to know that there are no foods that actually cause GERD, however there are many foods that can either aggravate the symptoms, or minimize the symptoms, of GERD. Accordingly, doctors will advise you to avoid the first type and include more of the second type in your diet. This will become your Diet Plan till you or the doctors are convinced you are cured.

PROTEINS

• Foods to avoid: Saturated fats that come from red-meat, full-fat dairy products and egg-yolk can aggravate GERD and are best avoided. If you cannot avoid these foods totally, consume them in small proportions, or for lunch only so GERD symptoms will not keep you awake in the night.
• Foods to include: Chicken, turkey and fish which are broiled, baked, poached or grilled are healthy, and gut-friendly foods. So also, low-fat dairy and egg-whites are OK to consume and must be had as often as possible.

CARBOHYDRATES

• Foods to avoid: Refined grains such as maida must be avoided as they can irritate the digestive tract and can cause GERD symptoms.
• Foods to include: Brown rice, whole wheat, cuscous, millets, oats and barley are good to consume regularly. Tubers such as potatoes, sweet potatoes, yam, tapioca and cassava, are also OK as long as they are cooked plain and not with spices.

FATS

• Foods to avoid: Saturated fats that come from red-meat or full-fat dairy, hydrogenated fats (like dalda/vanaspathi) and trans-fats that come from processed foods, shortenings and margarines are best avoided.
• Foods to include: Mono-unsaturated and polyunsaturated fats are welcome and must be consumed often. These are found in the whole product or oils extracted from sunflower, olive, corn, sesame, canola, peanuts (and peanut butter), avocados, nuts and seeds, safflower, walnut, soybean (and tofu) and flaxseed. Fatty fish such as salmon and trout are also rich in such fats.

FIBER

• Foods to avoid: Citrus fruits such as orange and lemon, and vegetables such as tomato (including tomato ketchup/sauce), onion and garlic, in any form must be avoided when one is showing GERD symptoms.
• Foods to include: Fruits such as pears, bananas, apples and melons, and almost all other vegetables are good to consume. Root vegetables like carrot, beetroot and ginger and cruciferous vegetables like cauliflower, broccoli, cabbage, and asparagus are good to consume. Celery, lettuce, cucumber and watermelon are rich in water and these help dilute the stomach acids, so they are good to have.

SPICES

• Foods to avoid: Pepper or Chili in any form (white, black, red or green) aggravate GERD symptoms and must be avoided. Eat bland food without chili, while having GERD symptoms.
• Foods to include: Fennel seeds (saunf) are useful in reducing GERD symptoms, which is why they are a popular mouth-freshener after meals.

 OTHERS

• Foods to avoid: Fast food like pizzas and burgers that are loaded with saturated fats, fried foods such as potato chips, chocolate, peppermint, alcoholic beverages, caffeine, sodas and carbonated beverages.
• Foods to include: Broth-based soups are rich in water, so they help dilute the stomach acid. So also, herbal tea is alkaline by nature and help neutralize the stomach acid to a certain extent.

NOTE: Take medications only when prescribed by your doctors, self-medication must be avoided under any circumstances.

Reviewed by Dr Suresh S Venkita, Group Medical Director, Kauvery Hospitals

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

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