According to the Montreal Consensus definition, GERD is a condition that develops when the backflow (reflux) of stomach contents into the esophagus causes certain clinical symptoms and complications. One of the main causes of gastric acid reflux is transient, i.e. temporary, relaxation of the lower esophageal sphincter. Various factors affecting the relaxation of the lower esophageal sphincter can increase or decrease reflux, i.e. affect the appearance or disappearance of heartburn and belching. Human body weight and pressure inside the abdominal cavity also play a huge role in the formation of this disease. Based on these data, American scientists have suggested, taking into account evidence-based medicine, that lifestyle in GERD needs correction (being in an elevated and vertical position, diet, body weight) and is useful for alleviating the symptoms of GERD. But with two caveats:

• firstly, it is necessary to change the lifestyle in GERD, taking into account the individuality of patients;
• secondly, these recommendations for lifestyle changes in GERD, individually and in combination, are in addition to medical treatment.

Can you smoke with GERD?

Chronic smokers (from 15 to 60 cigarettes per day) showed a decrease in pressure in the lower esophageal sphincter, which made them complain of heartburn, they also noted a lower gastric pH (i.e. more acidic environment), a decrease in bicarbonate in saliva, which neutralizes acid in reflux (which is why heartburn patients often swallow saliva). In addition, the esophagus is cleared of acid that has fallen during reflux with a cough and a deep breath, and clearance (the mechanism of increased peristalsis of the esophagus).

Many studies confirm the relief and disappearance of reflux symptoms after quitting tobacco smoking. This relationship is especially pronounced in individuals with normal body weight.

Can you gain weight with GERD?

Obesity is a well-known risk factor, including acid reflux. The intensity of symptoms is directly proportional to the increase in body weight.

Interesting data are provided by researchers regarding reflux in the surgical treatment of morbid obesity. It is noted that during bariatric operations (surgical treatment of excess weight) there is not always a decrease in the symptoms of reflux, as, for example, with vertical gastroplasty and gastric banding. And when applying a Roux -en-Y gastric bypass, a decrease in GERD symptoms was noted in all patients.

The recommendation to reduce body weight in patients with any degree of obesity in the presence of symptoms of reflux is the only one with high certainty for lifestyle changes in GERD.

According to research to date, weight loss is likely to improve GERD, leading to a reduction in symptoms in overweight and obese individuals, whether weight loss is achieved conservatively or through bariatric surgery.

Can you raise the head of the bed if you have GERD?

Lying down increases the effect of stomach acid on the esophageal mucosa, which is associated with worsening GERD symptoms.

Elevating the head of the bed with rollers or placing wedges or a 15-20 cm bed under the foot of the bed has been shown to reduce GERD symptoms by improving esophageal clearance (peristalsis). But this recommendation is considered by patients to be impractical and unacceptable in everyday life, or they are not observed.

Can you eat before bed if you have GERD?

Nocturnal reflux has a greater negative impact on patients’ quality of life. It is recommended to avoid eating 2-3 hours before bedtime. This is a very simple and easy to implement recommendation for patients. And efficient.

Is it possible to do breathing exercises with GERD?

Singers, especially opera singers, who practice the deep breathing technique may have the best defense against GERD symptoms. This is because during inhalation, the diaphragm contracts as the chest expands (abdominal breathing). At the same time, the legs of the diaphragm, which wrap around the esophagus in the diaphragmatic opening of the diaphragm, together with the lower esophageal sphincter, contribute to the activation of the protective mechanism against reflux. This is very clearly seen with retroversion gastroscopy , when the patient is asked to take a deep breath, then there is a tighter compression and clasping of the diaphragm of the esophagus by the legs.

Gymnastics is based on the transition from the usual chest type of respiratory movements to the abdominal. This is also the basis of treatment and eructations.

Is it possible to go on specialized diets with GERD?

Dietary restrictions do not have much effect on relieving GERD symptoms. In some cases, a number of dietary points may be recommended.

Some studies have shown that coffee causes the lower esophageal sphincter to relax, increasing the frequency of GERD symptoms. Drinking decaffeinated coffee significantly reduces the frequency of reflux. Fun fact: Drinking decaffeinated tea or adding caffeine to plain water had no effect on GERD symptoms. This supports the notion that some components of coffee other than caffeine may cause GERD symptoms. However, coffee does not increase the production of hydrochloric acid after a meal. But it was noted that drinking coffee on an empty stomach increased the frequency of reflux. This suggests that patients with GERD may benefit and should be advised not to drink coffee on an empty stomach.

Fried foods, heavily spiced foods, mint tea, carbonated drinks can also cause GERD symptoms and are reliable sources of heartburn at night…

Not only the nature and type of food, but also the time and volume of each meal can lead to the appearance of symptoms of GERD.

Can you drink alcohol with GERD?

The experience clearly demonstrated that alcohol directly suppresses the contractile function of the esophagus and leads to a decrease in pressure in the lower esophageal sphincter.

Here’s some interesting data: alcohol with an alcohol concentration of less than 5% can stimulate gastric acid secretion, while drinks with higher alcohol concentrations (5-40%) have no proven stimulatory effect and may actually suppress gastric acid production. With chronic alcohol use, this effect is already unpredictable.

In general, there are conflicting and inconsistent data on the role of alcohol in the progression of GERD symptoms and the effect of abstinence from drinking alcoholic beverages on disease relief. Excessive alcohol consumption by patients should be addressed, and then for reasons of general health, and not as a prevention or treatment of GERD.

What drugs should be limited for GERD?

The following drugs may cause or worsen GERD symptoms by relaxing the lower esophageal sphincter:

Calcium channel blockers

Nitrates

Beta blockers

Theophylline, eufillin

Benzodiazepines

Anticholinergic drugs ( scopolamine , ditropan , benztropine ) .