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Ugh, I have reflux. Is it because of what I’m eating?

The question: I have reflux and want to avoid taking medication. Are there certain foods I should avoid?

The answer: Many cases of reflux – gastrointestinal reflux disease or GERD – can be resolved by making dietary and lifestyle changes. If you do take medication to control symptoms such as heartburn, nausea and sore throat, you should still adjust your diet to help prevent these symptoms in the first place. Doing so may allow you to reduce or discontinue your medication.

GERD occurs when a muscle at the lower end of the esophagus – the esophageal sphincter – does not work properly. This muscle is meant to act like a one-way valve that closes off the esophagus. It should allow food to travel into the stomach and then contract to seal off the stomach, preventing partially digested food from refluxing into the esophagus.

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Hallmark symptoms of GERD include heartburn – a burning pain in the middle of the chest that can extend to the back – and acid regurgitation in the mouth. Some people experience nausea, dry cough, sore throat, difficulty swallowing and bad breath.

There are foods you should avoid if you have reflux. Chocolate, peppermint, spearmint, caffeinated beverages, alcohol and fatty foods can trigger symptoms because they lower the pressure of the esophageal sphincter and, as a result, promote reflux. You should also avoid alcohol and coffee (both caffeinated and decaf) since both stimulate stomach acid secretion.

Other foods that can worsen symptoms include citrus fruit and juices, tomatoes and tomato-based products, garlic, onions, carbonated beverages, chilli pepper and black pepper.

You can also prevent reflux symptoms by eating small, frequent meals rather than large ones. To help reduce stomach distension, you may find it helpful to drink fluids apart from meals.

Avoid lying down at least three hours after a meal. Some people benefit by raising the head of their bed about six to nine inches. Reflux also occurs less often when you sleep on your left side, rather than your right.

Weight control is important, too. It's thought that carrying extra weight around the abdomen creates pressure that can cause GERD. It's also possible that excess body fat releases chemicals that alter the normal function of the esophagus. Losing excess weight has helped many of my clients treat reflux and avoid the need for medication.

Leslie Beck, a registered dietitian, is the national director of nutrition at BodyScience Medical. She can be seen every Thursday at noon on CTV News Channel's Direct (www.bodysciencemedical.com).

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