Changing your diet can help with reflux disease

One of the more common medical conditions in the industrialized world is gastro-esophageal reflux disease (GERD).

Almost two in 10 people have symptoms of GERD. It is becoming one of the most common reasons for visits to a primary care physician.

GERD is not only painful, but can lead to a more serious medical condition known as Barrett's esophagus. Barrett's esophagus increases the risk of esophageal cancer.

Everyone has reflux to some degree, but often without clinical symptoms. Saliva production helps to keep the esophagus healthy. The lower esophageal sphincter (LES) between the esophagus and stomach greatly limits reflux of stomach contents. The diaphragm and other physical barriers to reflux also play important roles in preventing GERD.

GERD can happen when there is not enough saliva production. Weakness in the LES permits stomach contents to reflux into the esophagus. A hiatal hernia can increase reflux as can increased abdominal pressure as in obesity. Sometimes an illness or medications can slow the transit of food and stomach acid from the stomach to the intestines, and that increases the risk of reflux. Some illnesses and medications can reduce the production of acid-resistant mucus in the esophagus making GERD more likely.

The most common traditional medical approach to GERD is the use of specific medications that reduce the amount of acid the stomach can make. These medications are termed proton pump inhibitors (PPI). Less acid often leads to reduced symptoms of GERD.

However, since their introduction into the medical armamentarium they have been associated with a number of disturbing side effects. Side effects include a two-fold risk of a serious bowel bacteria, Clostridium difficile, increased risk of community acquired pneumonia, intestinal bacterial overgrowth syndrome, hip fracture and malabsorption of calcium, iron and vitamin B12, PPIs also increase the risk of a bacterial infection of the stomach and, surprisingly, heart attack.

Fortunately for most people, GERD is not a life-long disease but more like a life-style choice. In other words, you choose to have or not to have GERD.

In my experience one of the best approaches to GERD is to change the diet. A vegetable-based diet can be quite effective.

Losing weight to reduce the abdominal pressure is also effective and has many long-term health benefits. Smaller portion sizes may help some people, but not everyone.

Supplements such as marshmallow root and slippery elm coat the esophagus and protect it from acid.

Exercise is always good and specific breathing techniques like those found in Qigong or Tai Chi may help to strengthen the diaphragm and reduce GERD.

Some herbs like ginger stimulate the stomach to send its contents to the intestine rather than up the esophagus. Even chewing gum helps by increasing saliva production.

There are many supplements, herbs and therapies that can reduce or eliminate the need for PPI medications for GERD. Some people need PPIs, but the risk reduction for esophageal cancer is far from proven. I prefer a more natural way if possible.

• Dr. Patrick B. Massey, MD, PH.D., is president of ALT-MED Medical and Physical Therapy, 1544 Nerge Road, Elk Grove Village. His website is www.alt-med.org.