If you have gastroesophageal reflux disease (GERD), you know how bothersome the symptoms can be. The discomfort from reflux can keep you awake at night, lead you to avoid your favorite foods and have you reaching for antacids to get your heartburn under control.
And GERD isn’t just uncomfortable. Severe or chronic GERD can put you at risk for conditions like Barrett's esophagus that can lead to cancer. Wahid Wassef, MD, a gastroenterologist with Banner – University Medicine, said, “Severe GERD can cause chronic inflammation of the esophagus. With it, the lining of the area changes from its normal tissue type to one that can develop into esophageal cancer.”
Keep in mind that Barrett’s esophagus is rare. “Not all people with GERD will develop severe GERD or Barrett's esophagus,” Dr. Wassef said. “If you manage your GERD closely, follow your diet and take medication as recommended, you can keep it from developing.”
If you have severe GERD, Dr. Wassef said you’ll need to take strong acid-control medications such as proton pump inhibitors (PPIs). Lifestyle changes can also help keep your stomach acid under control.
Your health care provider can recommend a personal treatment plan that can help keep your GERD under control, manage your symptoms and reduce your risk of complications. It’s important to see your doctor regularly if you have the condition. You will most likely need an endoscopy every two to three years to check for changes. Plus, newer endoscopic therapies can treat some forms of severe GERD.
Along with your medication, the following lifestyle changes may help. Different options work for different people, so talk to your provider to target those that are best for you.
1. Choose the right foods
When you eat some foods, you’re more likely to have stomach acid back up into your esophagus. “Avoiding caffeine, chocolate, citrus juice, red wine, tomatoes and tomato sauce would be a good start,” Dr. Wassef said. You may also want to limit fatty and fried foods. They can stay in your stomach longer and give stomach acid more time to leak into the esophagus.
If you have severe GERD, lean proteins, whole grains and non-citrus fruits are good options.
2. Build better eating habits
It’s not only what you eat that matters when you have GERD. When and how much you eat can make a difference, too.
Instead of eating two or three big meals in a day, try breaking them down into five or six smaller meals or snacks spread out over time. That gives your stomach time to empty in between, so it doesn’t get overloaded.
And don’t lie down right after you eat — let gravity help pull food away from your esophagus and into your stomach.
3. Make smart hydration choices
Carbonated, caffeinated, citrus and alcoholic beverages are more likely to trigger your reflux symptoms. Gentler choices for your digestive system are water, herbal teas, non-citrus juices, low-fat or skim milk, plant-based milk and coconut water.
4. Change your sleep position
When you lie flat, it’s easier for acid to enter the esophagus from the stomach. You may find that you have fewer reflux symptoms during the night if you raise the head of your bed. That can help acid stay in the stomach.
You can put bricks, books or bed risers under your upper bed posts or bed frame. Or you can get a wedge or pillow that goes either under your upper body or between your mattress and box spring.
The more you raise your upper body the better. Most people find that six to eight inches is enough to reduce symptoms and still sleep comfortably.
Be sure to raise your entire upper torso. That way, you’ll be sure to include the area where your stomach meets your esophagus, which is near the lower part of your shoulder blades. And you’ll be less likely to get back or neck pain.
5. Reduce stress
When you’re stressed or anxious, you may find that your GERD symptoms get worse. Relaxation or stress reduction techniques can help. Deep breathing, meditation or yoga may help you relax, lower stress and minimize GERD effects.
6. Manage your body weight
When you’re overweight or obese, the excess pounds can put pressure on your stomach and make it more likely that acid will get pushed into your esophagus. So losing weight may help lessen your GERD symptoms.
It’s not easy to lose weight. Working with your health care provider may help. Your provider can give you tips for choosing healthy foods that work with your preferences, managing your portion sizes and finding ways to increase your physical activity with things you enjoy doing.
They may also connect you with a nutritionist, weight-loss clinic or exercise professional. These experts can help you create a personal weight-loss program.
7. Look for the best ways to be active
Being physically active can help with GERD, but it’s important to choose the right exercises. Moderate and low-impact exercises like walking, yoga, swimming or riding a stationary bike often help.
Strenuous workouts and exercises that put pressure on your stomach (like crunches and exercises where you lay flat) can make GERD symptoms worse, so you may want to avoid them.
Try not to exercise right after you eat — it’s best to wait for an hour or two and give your stomach time to empty. Drink enough water to stay hydrated when you exercise but try not to drink too much — you don’t want a lot of water in your stomach.
8. Find what works for you
You might not like to walk on a treadmill, but you may discover you love riding a stationary bike. You may have to play around with the height of your raised bed to find your sweet spot. You could find that by mindfully walking, you both reduce your stress and increase your physical activity.
Try different lifestyle changes to find out what works best for your needs and keep in mind that small changes can make a big difference over time. By being proactive and making positive changes, you can help keep your symptoms under control.
The bottom line
Severe or chronic GERD happens when stomach acid regularly backs up into the esophagus and damages it. You’ll need medication to treat it, and lifestyle changes can also help keep symptoms at bay.
Your health care provider or an expert at Banner Health can help you both understand GERD and take the steps you need to keep symptoms under control and reduce your risk of complications.