Acid Reflux - Will Lifestyle Changes Make a Difference?

Acid Reflux - Will Lifestyle Changes Make a Difference?

With a significant improvement in the understanding, diagnosis and management of acid reflux, primary care physicians and gastroenterologists have a greater choice of options for treating acid reflux.

The acid suppressants available today are extremely effective. Drugs such as omeprazole and other proton pump inhibitors have become the mainstay of treatment. These medications are now available over the counter and are easily available to patients. It is therefore so easy for practitioners and patients to ignore the simple basic methods of controlling acid reflux disease.

A simple and effective part of treatment is lifestyle modification and calming. This includes changing the types of foods consumed, avoiding certain medications, quitting smoking, losing weight, elevating the head of the bed, and judicious use of antacids and alginates. The most important foods to avoid are fatty foods. This group includes whole milk, butter, chocolate and some fast foods. Over time, a patient will know what foods to consume and what to avoid. Peppermint oil relaxes the lower esophageal sphincter and may cause reflux. If used for IBS, be aware of this important side effect. If in doubt, contact your GP or stop if you develop reflux symptoms. Smoking has a similar effect on the lower esophageal sphincter. Quit smoking if you have acid reflux. It makes it worse.

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

With nocturnal acid reflux, lying down at night causes reflux to travel up the esophagus. Raising the head of the bed helps reduce this. In addition, it reduces sensitization overnight, which causes problems during the day. There is evidence that additional pillows make no difference. Wearing tight clothing increases intra-abdominal pressure and stimulates reflux. Wearing loose clothing avoids this.

Small regular meals are better than a few large meals. Large amounts of food expand the stomach and reduce the efficiency of the sphincter. Likewise, do not lie down soon after eating. Make sure your last meal before retirement is at least three hours earlier.

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

However, chronic and recurrent acid reflux requires more than lifestyle changes and reassurance. Management should include the use of an effective dosage of acid suppressants to achieve satisfactory control of acid reflux symptoms.

If your symptoms persist despite the changes you have made, contact your primary care doctor. The thought of an endoscopy may be daunting, but persistent acid reflux can cause long-term problems. Acid in the lower esophagus can cause inflammation, leading to esophagitis. Recurrent esophagitis can cause bleeding, strictures, and Barrett's esophagus. 3 to 5% of Barrett's esophagus develop adenocarcinoma. This condition is diagnosed by biopsy during endoscopy. Remember these facts if your symptoms persist.

Inspired by Dr Phil Hariram