10 Things you should know about acid reflux

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Published on February 17, 2011 with No Comments

by Dr. Jamie Koufman, AARP

What is acid reflux?

It is a condition in which there is a backflow of stomach contents†ñ including acid and partially digested food ñ into the esophagus, the swallowing tube connecting the mouth and stomach.†

Could you be suffering from silent reflux?

Heartburn is just one symptom of this increasingly common condition, but because laryngopharyngeal reflux (LPR) typically does not involve heartburn, the condition has been dubbed ìSilent Reflux.

Silent Reflux symptoms include:

ï Hoarseness

ï Chronic cough

ï Choking bouts

ï Swallowing difficulties

ï Postnasal drip

ï Difficulty catching your breath

ï Constant feeling that you have a lump in your throat

Also known as gastroesophageal reflux disease, or GERD, it now affects about 40 percent of Americans, almost half of whom have a form of reflux known as silent reflux.

Here is what you need to know about managing ñ or even beating†ñ acid reflux.

1. Are you at risk? Acid reflux used to be diagnosed primarily in older adults and people who were overweight. But today plenty of thin people and young people are afflicted. While reflux is linked to obesity and genetics, its increasing prevalence, particularly among the young, is due to too much acid in the American diet.†

2. Reflux comes in different forms with different symptoms. The best-known type of reflux, GERD, is commonly associated with heartburn and indigestion. But people with silent reflux, or laryngopharyngeal reflux (LPR), may never have those telltale symptoms. Instead, they may have other symptoms as mentioned above. Indeed, reflux can worsen underlying asthma, making it more difficult to treat.

3. Medications are not a cure. As it turns out, acid reflux is not just due to acid. When you reflux, a stomach enzyme called pepsin also rises, and pepsin is not suppressed by the anti-reflux medicines currently on the market. That is why diet and lifestyle changes are important as they allow inflamed tissues to heal.

4. Eat the ìgood foods.î Whole-grain bread, oatmeal, salad, bananas, melons, chicken (without the skin), fish, turkey, celery, parsley, cauliflower, broccoli, asparagus, green beans, couscous and brown rice are all examples of great foods for people with GERD or LPR. These are foods with low acidity.

5. Avoid the ìbad foods.î Chocolate, carbonated beverages, alcohol, fatty meats, fried foods, high-fat dairy products, fast food, processed foods, caffeine, hot sauces, hot peppers, citrus fruits and juices all worsen acid reflux. Alcohol, chocolate and soda are especially problematic, not only because of their intrinsic acidity but because they weaken the bodyís defenses against stomach contents rising up.

6. Eat organic. Typically, organic foods do not have acid or other chemicals added. But check the labels. If you see citric acid, ascorbic acid or vitamin C listed in the ingredients, consider other products or foods.

Adding acid to foods (acidification) has long been used as a preservative. But the practice took off in the 1970s when Congress passed†Title 21, which mandates that the Food and Drug Administration regulate food manufacturing to prevent bacterial growth in packaged foods and beverages. Now, three decades later, we are seeing the public health consequences of a highly acidified diet: More than 100 million Americans, including young people, have acid reflux.

7. Do not eat after 8 p.m. When you eat can be just as important as what you eat. People with reflux should consider the kitchen closed after 8 p.m. That means no meals, snacks or beverages, other than water†ñ†as long as it is not too much water. Also, do not lie down right after eating, and if you reflux in the middle of the night, try adjusting pillows and bolsters so you can sleep in a more upright position.

8. Fashion and fitness doís and doníts. Do not exercise right after eating. Also, do not wear constricting clothing around your waist or tight belts because they increase pressure in the stomach, which contributes to reflux.

9. Establish new habits. Besides avoiding alcohol and late-night eating, eat frequent, smaller meals rather than fewer big meals, and give up or do not start smoking. If reflux is a serious problem for you right now, you may want to try a diet designed for people with acid reflux.

10. Consult your doctor. Describe your symptoms to your general practice doctor, but if you suspect you have silent reflux, you may want to see an ear, nose and throat specialist, as well. Acid reflux has been linked to fast-rising rates of esophageal cancer and pre-cancer (Barrettís esophagus), so if you have had symptoms for more than a few years, you will probably want to have an examination of your throat and esophagus ñ an awake endoscopy or transnasal esophagoscopy.

Dr. Jamie Koufman is a professor of clinical otolaryngology at New York Medical College, and is one of the worldís leading authorities on reflux and has lectured widely on the subject both nationally and internationally. She is director of the Voice Institute of New York and co-author of† ìDropping Acid: The Reflux Diet Cookbook & Cure.î

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