The displacement of stomach contents from the cardia to the esophagus is called gastroesophageal reflux (GER). It is a physiological event that is normally seen 8-10 times a day, usually after meals. If this event causes symptoms and signs in the patient and/or causes irritation and damage to the distal esophageal mucosa, it is called Gastroesophageal Reflux Disease (GERD).
Considering these situations, the diet management applied is also called reflux diet.
- Who should apply?
Obesity; GERD is an important risk factor for esophageal diseases such as Barrett’s esophagus and esophageal cancer. The relationship between obesity and esophageal cancer is stronger than the relationship between obesity and other types of cancer. Waist circumference and abdominal adiposity were associated with GERD rather than mass index (BMI), which is used as an indicator of obesity. Weight loss can improve GERD symptoms by reducing abdominal pressure. In addition to these, studies showing the relationship between BMI and esophageal cancer have shown that the risk of cancer may decrease with a decrease in body weight in GERD patients. For this reason, it is recommended that patients with gastroesophageal reflux (GER) reach their ideal body weight by reducing dietary energy. In a study examining the relationship between carbohydrate intake and GERD, it was shown that a low-carbohydrate diet (20 g/day) reduced esophageal acid exposure and GERD symptoms in obese and GERD individuals. In another study, it was stated that there was an inverse relationship between total carbohydrate intake and esophageal adenocarcinoma.
- Could you give information about diet and menu contents?
In experimental and clinical studies, it has been reported that fried foods, chocolate and soda reduce Lower Esophageal Sphincter (LES) pressure and increase the esophageal acid exposure time. There are very few and previous studies on the effects of these nutrients on LES pressure and esophageal pH. In these studies, it is stated that chocolate reduces the LES pressure and prolongs the exposure time of the esophagus to acid.
It is also stated that sweets such as confectionery may be associated with GERD due to their high fat content. It is recommended that GER patients should not consume these foods that reduce LES pressure.
Nutrition habits
Postprandial reflux is common in patients with gastroesophageal reflux. Excessive, large volume or hyperosmolar food intake causes gastric distension.
Postprandial-induced gastric distension may cause GERD by increasing the frequency of transient relaxation of LES and postprandial schema.
Eating late is associated with postprandial reflux. After eating late, gastric pH decreases and gastric acidity increases.
Eating fast is a factor that facilitates the formation of obesity. Since obesity is also an important factor in the formation of GERD, it is stated that there may be a positive relationship between GERD and eating fast. For these reasons, it is recommended that patients with GER not eat late and reduce the amount of food at meals by increasing the number of meals instead of eating large amounts of food.
- What are the things to pay attention to in the next meal after the person breaks the diet?
• There is not enough evidence in studies to confirm that various foods can trigger reflux.
• There are data showing that there may be a relationship between salt and salted foods, chocolate and fatty foods, carbonated drinks and the development of reflux.
• Low-volume, frequent and slow eating should be recommended.
• An increase in nocturnal reflux symptoms is observed in the supine position and the right lateral position.
• Lying in the left lateral position and raising the head in the supine position reduces the development of nocturnal reflux symptoms.
• In patients with reflux symptoms at night, the head of the bed should be elevated and the patient should lie on his left side.
• Smoking is a risk factor for the development of GOR symptoms in a quantity dependent manner.
• There are data showing that obesity, abdominal obesity and increased body adipose tissue are important risk factors for the development of GOR.
• Obesity is an important risk factor for GORH and it is recommended to lose weight in patients with GORH.
• Reflux symptoms are less common in individuals with mild to moderate physical activity.
