What goes up, must come down, but what goes down should not always come back up – especially when we’re talking about stomach acid in the oesophagus.
Everyone experiences occasional heartburn. However, if you are experiencing acid reflux more than twice a week, you may have gastroesophageal reflux disease (GERD), a chronic condition which causes stomach acid to frequently flow into the oesophagus, warns Kimberley-based registered dietician Frané Helm.
“This is a digestive disease which causes the stomach acid or bile to move up and down the oesophagus and actually cause irritation in the lining of your oesophagus.”
How to know when you have GERD
It is Sunday and you have just enjoyed a full serving of tamatiebredie to your hearts content.
In typical Sunday fashion, you know a lie down will bring some relief to your current bout of “meat sweats”.
Only this time something is bubbling behind your breastbone. Your burps are more acidic, and it feels like a volcano has erupted in your chest.
Yep. Stomach acid has made its way from the gut into your oesophagus, causing acid reflux or heartburn.
“Us South Africans like to eat big meals for lunch on Sundays, and then afterwards we go and have a lie down. It’s best to rather avoid that with a walk,” she says.
Helm explains there are multiple causes for GERD. “If we just think about the physiology behind it, at the entrance of the stomach there is a valve, which is like a ring of muscle called the lower oesophageal sphincter (LES).
“When you eat, it obviously opens and relaxes for you to let food go from the mouth through the oesophagus and into the stomach and once the food is in the stomach it closes again.”
GERD occurs when that sphincter works abnormally, or something is triggering it to decrease the contraction of the muscle.
“If the LES does not close all the way or opens too often, stomach acid can move into your oesophagus.
“People who have a very severe case will even feel like they’re having a heart attack, some patients will say they have a sensation like a nasal drip in their throat, and they will keep clearing their throat, sometimes that nasal drip can be a sign that they have GERD or acid reflux.”
Common GERD triggers include:
- Poor diet and obesity
- Fatty, large meals
- Spicy food
- Non-steroidal anti-inflammatory drugs, like aspirin
- Carbonated drinks
One trigger to note that is not related to diet is the diagnosis of a hiatal hernia, Helm says. A hiatal hernia occurs when the stomach forms a pouch. “That pouch pushes into the diaphragm which cases light pressure in the stomach and requires surgical removal because it is an abnormality in the stomach.”
Eat to heal
Make peace with the fact that you won’t be able to enjoy that skelm block of luxury milk chocolate with two glasses of wine anymore, because believe it or not, “Chocolate does contain caffeine. It depends on the cocoa solid that is in the chocolate, the darker the chocolate the higher the cocoa solid.”
If you are looking for a replacement, Helm suggests white chocolate. “White chocolate only contains cocoa butter, it has no cocoa solids, so white chocolate doesn’t contain caffeine.”
8 sure-fire foods to douse the flames:
Dairy: If you are not lactose intolerant or if dairy is not your trigger food, try blue cheese, butter, yoghurt and hard cheeses like parmesan and cheddar.
Nuts: Almonds, walnuts, cashews, pistachios.
Dairy alternatives: Soy milk, almond milk, rice milk, oat milk.
Spices and herbs: Sumac, ginger, seed cumin, fennel, coriander, and celery.
Proteins: Fish, eggs, chicken.
Grains: Brown rice, oats, couscous, brown pasta, whole grain breads.
Veggies: All green, leafy veggies, cucumber, mushrooms, avocado, sweet potato, carrots, beetroot, spinach, lettuce and butternut
Fruit: Banana, watermelon, honeydew melon, pear, apple, lychee.