How can you modify your lifestyle to relieve symptoms of GERD?

There are many changes you can make to your lifestyle that can help to relieve or reduce symptoms of gastroesophageal reflux disease (GERD). These are some suggestions.

Quitting tobacco use

If you smoke or chew tobacco, stop. The nicotine from tobacco relaxes the valve between the esophagus and stomach (lower esophageal sphincter). This can allow stomach acid and juices, the chemicals that break down food in the stomach, to back up (reflux) into the esophagus, which causes heartburn.

Because the nicotine in tobacco is addicting, stopping the use of tobacco is more difficult than simply changing a habit. Those who successfully quit using tobacco usually use a combination of strategies that may include:

• Professional counselling, either by telephone or in person.
• The use of medicines, to help overcome the addiction to nicotine.
• Participation in a proven smoking cessation program.
• Having a support group of peers who are also quitting or who do not smoke.

Using more than one of these strategies greatly improves your chances of successfully quitting. Quitting tobacco use may require several attempts.

Changing your eating habits

Developing healthier eating habits, losing weight if necessary, and avoiding foods that increase symptoms of GERD may make heartburn less likely to occur. Take your spouse or partner along with you when you go to your doctor to discuss diet habits. It will be easier to make changes in your diet if your family understands what you need to do and why.

Changes you may want to make include avoiding chocolate, peppermint, and alcohol. These can all make GERD worse by relaxing the valve between the esophagus and the stomach. It also may be a good idea to eat smaller, more frequent meals.

If you are overweight, lose weight. Being overweight puts additional pressure on your stomach and increases the likelihood of heartburn occurring. Losing just 2.5 to 4.5 kilograms can help.

Certain foods can be associated with reflux. Though they will not cause GERD, eating these foods can make the symptoms worse, and avoiding them can help reduce heartburn. These include citrus fruits, mint (such as peppermint and spearmint), fatty and fried foods, garlic and onions, spicy foods, and tomato-based foods like spaghetti sauce and pizza. Some people notice that their symptoms get worse after drinking coffee, tea, soda, or anything with caffeine. If you notice that your symptoms are worse after eating a specific food, you may want to stop eating it and see if your symptoms get better.

Reducing pressure on your stomach

Putting pressure on your stomach may push stomach juices into your esophagus, causing heartburn. Some ways to reduce heartburn include the following:

• After you eat, wait 2 to 3 hours before you lie down. Late-night snacks aren't a good idea. When you are lying down, the contents of your stomach can push against the valve between the esophagus and stomach (lower esophageal sphincter). Sitting up allows gravity to help food and stomach juices from the esophagus drain back into your stomach.
• Avoid tight clothing over your stomach. Tight belts, waistbands, or panty hose may push against your stomach and make your heartburn worse.
• Use care when lifting and bending. Bending over tends to increase the amount of stomach acid that can get into your esophagus. When lifting, bend your knees to avoid bending over at the waist.

Improving sleep position and habits

Raising the head of your bed 15 cm (6 in.) to 20 cm (8 in.) will help keep stomach acid from flowing into your esophagus when you are sleeping. You can do this by putting blocks underneath your bed frame or by placing a foam wedge under the head of your mattress. Using extra pillows will not work.

Lying down soon after eating will also increase the chance of getting heartburn. After you eat, wait 2 to 3 hours before you lie down. Late-night snacks aren't a good idea.