A few lifestyle changes are worth trying before resorting to drugs for controlling gastro oesophageal reflux.
If you are sounding a little hoarse and have a sore throat, you may be bracing for a cold or a bout of the flu. But if you’ve had these symptoms for a while, they might be caused not by a virus but by a valve—your lower esophageal sphincter. That’s the muscle that controls the passage between the esophagus and stomach, and when it doesn’t close completely, stomach acid and food flow back into the esophagus. The medical term for this process is gastroesophageal reflux; the backward flow of acid is called acid reflux.
Acid reflux can cause sore throats and hoarseness and may literally leave a bad taste in your mouth. When acid reflux produces chronic symptoms, it is known as gastroesophageal reflux disorder, or GERD. The most common symptom of GERD is heartburn—pain in the upper abdomen and chest.
Three conditions—poor clearance of food or acid from the oesophagus, too much acid in the stomach, and delayed stomach emptying—contribute to acid reflux.
If you’ve been having repeated episodes of heartburn—or any other symptoms of acid reflux—you might try the following:
1. Eat sparingly and slowly. When the stomach is very full, there can be more reflux into the oesophagus. If it fits into your schedule, you may want to try what is sometimes called “grazing”—eating small meals more frequently rather than three large meals daily.
2. Avoid certain foods. People with acid reflux were once instructed to eliminate all but the blandest foods from their diets. But that’s no longer the case. There are still some foods that are more likely than others to trigger reflux, including mint, fatty foods, spicy foods, tomatoes, onions, garlic, coffee, tea, chocolate, and alcohol. If you eat any of these foods regularly, you might try eliminating them to see if doing so controls your reflux, and then try adding them back one by one.
3. Don’t drink carbonated beverages. They make you burp, which sends acid into the esophagus. Drink flat water instead of sparkling water.
4. Stay up after eating. When you’re standing, or even sitting, gravity alone helps keep acid in the stomach, where it belongs. Finish eating three hours before you go to bed. This means no naps after lunch, and no late suppers or midnight snacks.
5. Don’t move too fast. Avoid vigorous exercise for a couple of hours after eating. An after-dinner stroll is fine, but a more strenuous workout, especially if it involves bending over, can send acid into your esophagus.
6. Sleep on an incline. Ideally, your head should be 6 to 8 inches higher than your feet. Don’t try to create a wedge by stacking pillows. They won’t provide the uniform support you need.
7. Lose weight if it’s advised. Increased weight spreads the muscular structure that supports the lower oesophageal sphincter, decreasing the pressure that holds the sphincter closed. This leads to reflux and heartburn.
8. If you smoke, quit. Nicotine may relax the lower oesophageal sphincter.
9. Check your medications. Some, including postmenopausal oestrogen, tricyclic antidepressants, and anti-inflammatory painkillers, can relax the sphincter, while others which are taken to increase bone density, can irritate the oesophagus.
If these steps aren’t effective or if you have severe pain or difficulty swallowing, see your doctor to rule out other causes. You may also need medication to control reflux even as you pursue lifestyle changes.