Lifestyle Treatment and Prevention

People with heartburn should first try lifestyle and dietary changes. Some suggestions are:

• Avoid or reduce consumption of foods and beverages that contain caffeine, chocolate, garlic, onions, peppermint, spearmint, and alcohol. Both caffeinated and decaffeinated coffees increase acid secretion.
• Avoid all carbonated drinks, because they increase the risk for GERD.
• Choose low-fat or skim dairy products, poultry, and fish
• Eat a diet rich in fruits and vegetables, although it's best to avoid acidic vegetables and fruits (such as oranges, lemons, grapefruit, pineapple, and tomatoes).
• Patients who have trouble swallowing should avoid tough meats, vegetables with skins, doughy bread, and pasta.

Prevention of Nighttime GERD

Nearly three-quarters of patients with frequent GERD symptoms have them at night. Patients with nighttime GERD also tend to experience severe pain. It is very important to take preventive measures before going to sleep, such as:

• After meals, take a walk or stay upright.
• Avoid bedtime snacks. In general, do not eat for at least 2 hours before bedtime.
• When going to bed, try lying on the left side rather than the right side. The stomach is located higher than the esophagus when you sleep on the right side, which can put pressure on the lower esophageal sphincter (LES), increasing the risk for fluid backup.
• Sleep in a tilted position to help keep acid in the stomach at night. To do this, raise the bed at an angle using 4- to 6-inch blocks at the head of the bed. Use a wedge-support to elevate the top half of your body. (Extra pillows that only raise the head actually increase the risk for reflux.)

Other Preventive Measures

• Quitting smoking is essential.
• People who are overweight should try to diet and exercise to lose weight.
• People with GERD should avoid wearing tight clothing, particularly around the abdomen.
• If possible, GERD patients should avoid nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Motrin, Advil), or naproxen (Aleve). Tylenol (acetaminophen) is a good alternative pain reliever.

Although gum chewing is commonly believed to increase the risk for GERD symptoms, one study reported that it might be helpful. Because saliva helps neutralize acid and contains a number of other factors that protect the esophagus, chewing gum 30 minutes after a meal has been found to help relieve heartburn and even protect against damage caused by GERD. Chewing on anything can help, because it stimulates saliva production.

Review Date: 07/11/2010
Reviewed By: Reviewed by: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)