March is National Nutrition Month, when the Academy of Nutrition and Dietetics reminds everyone to return to the basics of healthy eating. It is also the time of year when the Academy celebrates expertise of registered dietitian nutritionists as the food and nutrition experts.
Many people have a passing case of indigestion from time to time. But when it occurs frequently, it could be indicative of a more serious condition called gastroesophageal reflux disease (GERD). Since this malady affects about 20 percent of Americans, it's important to know the facts.
What is GERD?
GERD is a digestive disorder in which stomach acids, food and fluids flow back into the esophagus. It can occur at any age and may be temporary or a long-term issue. The danger of untreated GERD is that it can cause health problems such as inflammation of the esophagus, which is a risk factor for esophageal cancer. It also may lead to respiratory problems such as asthma, fluid in the lungs, chest congestion, wheezing and pneumonia.
Recognizing the Symptoms
"Heartburn is the most common symptom, but not everyone experiences this," says Theresa Gustafson, MS, RD, LDN, CDE, a clinical dietitian at the Penn State Milton S. Hershey Medical Center. People with GERD also may notice they have bad breath, coughing, abdominal pain, nausea or vomiting. "Difficulty swallowing and erosion of your teeth are signs, but this may happen after you have had GERD for a while," says Gustafson.
Diagnosis and Treatment
Sometimes your doctor can diagnose GERD based on symptoms and medical history. Other times, further testing is necessary, and you will be referred to a gastroenterologist. You may need to have a chest X-ray to detect potential breathing problems and lung infections. An upper GI series is an X-ray examination of the digestive organs that can provide information about what is happening in your body. If needed, an endoscopy — a nonsurgical procedure during which a flexible tube passes through your GI tract to take pictures and tissue samples — may be ordered. An instrument called a pH probe can help track the flow of acid from your stomach.
"Medication may be necessary if you have tried everything and nothing works," says Gustafson. Lifestyle changes that may help alleviate the problem without medicine include quitting smoking, losing weight, wearing loose-fitting clothing, staying upright for a few hours after meals and sleeping with the head of the bed elevated.
Nutrition and Prevention
Knowing what and when to eat can go a long way in preventing bothersome GERD flare-ups. One significant culprit that can cause symptoms is fatty food. Try to choose lean meats, poultry, fish and beans as protein sources. Limit the amount of added butter and oil in your meals. Opt for baked dishes instead of fried foods. Pastries can be hidden sources of fat, so choose healthy whole grains instead. Low-fat dairy is a great source of calcium and vitamin D that also will help prevent GERD symptoms when substituted for full-fat options.
Certain foods and ingredients may worsen GERD symptoms. Try to avoid mint, chocolate, alcohol, caffeine, acidic foods and spicy foods, which may trigger a flare-up.
The timing and amount of food consumed also can make a difference in how you feel. Gustafson suggests avoiding large meals and opting instead for smaller, more frequent meals throughout the day.
Although we know the general triggers that can make GERD worse, customizing a lifestyle that works best for you can take some time. Try keeping a log of what you eat and drink throughout the day. Note when symptoms seem to flare up and review your log over time to identify patterns. Stay in contact with your doctor and a registered dietitian nutritionist so they can help guide you to the best prevention and treatment strategies.