Chronic Acid Reflux: Symptoms, Causes, Treatments and Food Tips

Chronic acid reflux is also known as gastroesophageal reflux disease.

Gastroesophageal reflux disease, or GERD in medical jargon, is a chronic digestive disease that causes a painful irritation of the esophagus.

As a whole, chronic acid reflux is the backflow of stomach contents into the esophagus due to being being overweight, eating large meals, smoking, or drinking alcohol. Symptoms include heartburn, bad breath, and chronic nausea. Treatments include a healthier lifestyle and low-fermenting food.

This occurs when food and liquids escape from the stomach and migrate upwards into the esophagus.

Chronic acid reflux: Introduction

Gastroesophageal reflux disease (GERD) is the backflow of stomach contents into the esophagus.

This disorder is a common condition in adults. It is related to a failure of the muscle closing this part of the digestive tract.

Many factors contribute to GERD, such as being overweight, eating large meals, smoking, or drinking alcohol.

If you have heartburn, bad breath and chronic nausea, you may be experiencing gastroesophageal reflux disease.

In this article, we will learn more about GERD.

The two types of gastroesophageal reflux disease

It is interesting to note that there are two categories of gastroesophageal reflux disease:

Gastroesophageal reflux disease considered physiological

This gastroesophageal reflux disease is intermittent and does not lead to complications. Indeed, it is most often manifested by symptoms that appear after meals.

Certain positions, such as bending forward, can trigger a brief rise in food intake. In these circumstances, GERD is said to be “normal.”

Physiological gastroesophageal reflux is brief, infrequent, and also not painful.

Gastroesophageal reflux disease considered pathological

This category of gastroesophageal reflux disease is the most common. Indeed, it lasts in time and can lead to esophagitis.

Acid reflux from the food bolus into the esophagus is persistent in this mechanism. Its duration is prolonged, contrary to those in physiological gastroesophageal reflux.

As a result, the acidity of this gastric fluid from the stomach irritates the lining of the esophagus over a long period, causing inflammation of the esophageal lining.

Gastroesophageal reflux disease is caused by a disturbance of the anti-reflux system between the stomach and the esophagus.

Causes of gastroesophageal reflux disease

Between the stomach and the esophagus, a protective system exists. The latter opposes the rise of the gastric liquid contained in the stomach. This system is composed of:

• A muscular ring that closes the orifice (called cardia in anatomical jargon) and acts as a protective valve
• An anatomical organization that causes the lower end of the esophagus to open into the stomach by passing through the diaphragm through an orifice called the hiatal orifice
• And finally, an acute anti-reflux angle is formed by the lower esophageal opening and the hiatal orifice.

Generally, GERD is caused by gastroparesis (which may cause acid reflux since gastric emptying is impaired) and by dysfunction of the lower esophageal sphincter, the band of muscle tissue between the esophagus and stomach.

This sphincter typically opens to allow food to pass into the stomach and then tightens.

However, a defective sphincter can allow acidic stomach contents to escape.

This can irritate the esophagus lining and thus be responsible for esophagitis, an inflammation of the esophagus.

Symptoms of gastroesophageal reflux disease

Symptoms of gastroesophageal reflux disease can take many forms, including heartburn, regurgitation, sore throat and difficulty swallowing.

It can also cause spitting, coughing, wheezing, and hoarseness of the voice.

These symptoms may also worsen after eating, bending the trunk over the pelvis, and at bedtime.

They may also involve other more general signs such as:

• Nausea
• A chronic sore throat
• Persistent bad breath due to the smell of stomach contents
• Tooth enamel wear due to the acidity of gastric contents
• Nocturnal asthma with no known allergic cause
• A hoarse voice in the morning, etc.

We can also describe the symptoms of gastroesophageal reflux in children and infants, which are characterized by

• Excessive regurgitation
• Vomiting
• A refusal to drink
• Pain with crying spells for no apparent cause
• Stunted growth because nutrients are not absorbed
• Anemia in more severe cases
• And more rarely, episodes of apnea.

In more extreme cases, one can find oneself facing alarming symptoms such as:

• A repeated need to clear the throat
• Pain on swallowing
• Recurrent vomiting
• Anemia
• A lack of remission in the medium term despite treatment, etc.

These are called alarming symptoms because they require a visit to the doctor as soon as possible.

These symptoms may also be a sign of a complication of gastroesophageal reflux disease or a manifestation of other conditions.

People prone to gastroesophageal reflux disease

Generally, these are people who have predispositions that favor installing mechanisms for the occurrence of gastroesophageal reflux.

This therefore includes:

• Pregnant women (the gestating baby presses on the stomach, which favors gastric fluid reflux, especially during the last trimester)
• People with hiatal hernia
• People who are overweight or obese
• People who make regular efforts (such as divers and athletes)
• Older people, because their muscles and hence, their sphincter, become less efficient with time (especially after 50 years).

The following promotes the development of gastroesophageal reflux disease:

• Large meals at dinner or high-fat foods
• Consumption of spices, alcohol, chocolate, tobacco, and acidic foods
• Certain medications such as progesterone or those for asthma, cardiovascular disease, etc.

Treatments for acid reflux

Generally, chronic acid reflux disease can be effectively managed with proper medical treatment. Indeed, medications can:

• Helps neutralize or reduce stomach acid
• Healing esophageal irritation
• And strengthen the esophageal sphincter.

People need to lose weight, observe good eating habits, and get quality sleep. In some cases, it is possible to propose a surgical treatment.

If no improvement is observed after a well-monitored medication, it may be a pathology other than gastroesophageal reflux disease.

In this case, a gastroenterologist will carry out explorations to confirm or refute these diagnostic hypotheses.

The gastroenterologist will perform a fibroscopy to observe the mucous membranes of the esophagus and stomach.

The physician who performs the exploration may also take samples to determine the exact cause of the patient’s discomfort.

In addition to the fibroscopy, the gastroenterologist may also perform more extensive tests such as esophageal pH monitoring (or pH-metry), which is a test that can differentiate between pathological and normal reflux.

Impedance-pH monitoring is a slightly more advanced variant of the previous examination. It allows to differentiate the nature of liquids (if they are gaseous, acidic, non-acidic, etc.).

When GERD is caused by a non-acidic fluid, it is called non-erosive reflux.

As a last resort, examinations such as upper manometry and oeso-gastro-duodenal transit can be used.

All these examinations can be performed to relieve the patient by finding the exact cause and proposing an adapted treatment.

Special diet for gastroesophageal reflux disease

The GERD diet is designed to counteract acid reflux into the esophagus and reduce symptoms by avoiding irritating, fatty foods and alcohol.

The essential points of a special GERD diet are to:

• Practice regular physical activity
• Split feeding
• Favor low-fat foods
• Avoid alcohol and irritating foods
• Adopt good reflexes to avoid reflux (in terms of postures, habits, etc.)

The benefits of the GERD diet

The special GERD diet has many benefits. Indeed, it allows to:

• Achieve and maintain a healthy weight
• Alleviate and prevent pain
• Reduce inflammation and irritation of the esophagus
• Avoid irritating foods that can cause pain
• Favor foods that protect the gastric mucosa.

Diet alone is often not enough to solve the problem, but it can help reduce reflux.

The GERD diet also helps to achieve and maintain a healthy weight

One of the main recommendations to reduce gastroesophageal reflux disease is losing weight in overweight or obese people.

Indeed, abdominal obesity plays a key role in worsening GERD symptoms.

With a special GERD diet, weight loss can be achieved and should help relieve symptoms effectively.

GERD diet for hiatal hernia

The GERD diet is also recommended for people with hiatal hernia, a condition whereby the upper part of the stomach slides out of the abdominal cavity.

In general, hiatal hernia causes similar symptoms that can be alleviated by adopting the GERD diet.

Foods to fight against gastroesophageal reflux

To fight against chronic acid reflux disease, it is advisable to favor easily digestible foods that protect the digestive system.

In this case, foods rich in soluble fiber, lean protein and omega-3 are favored and will be included in the GERD diet.

Regular physical activity and a divided diet can also prevent the discomfort of gastroesophageal reflux disease.

A low-fat diet

A high-fat diet is associated with a higher risk of gastroesophageal reflux disease.

Fats impair lower esophageal sphincter tension because of the time they take to digest and the time they spend in the stomach.

Ideally, you should consume less than 1.5 oz per day.

Fibers

To prevent constipation and abdominal bloating, a minimum of 1 oz. of dietary fiber per day should be consumed.

In addition, it is necessary to drink at least half a gallon of water well distributed over the day and preferably between meals.

Here are some fiber-rich foods to fight gastroesophageal reflux disease:

• Fruits and oilseeds
• The vegetables
• Legumes
• Wholegrain bread and cereals
• Wholemeal pasta

Omega-3s

To avoid omega-3 deficiencies, consume a sufficient quantity of vegetable oils and oilseeds every day.

For example, two servings of fatty fish per week can cover your omega-3 needs.

These are anti-inflammatory and can protect the gastric mucosa and esophagus from irritation.

As part of the GERD diet, include the following foods on your plate:

• Avocado
• Olive oil
• Rapeseed oil
• Walnut oil
• Linseed oil
• Nuts and almonds
• Flax and chia seeds
• Fish such as mackerel, salmon, trout, herring and sardines.

Lean protein sources

For a balanced diet, it is essential to favor lean protein sources.

In fact, protein-rich foods stimulate the secretion of gastrin, a hormone that promotes tension in the esophageal sphincter.

Foods suitable for special GERD diets include:

• Seafood
• Fish
• Poultry without the skin
• Game
• Milk and skim milk products
• Plant milk
• Lean cheeses
• Legumes
• Tofu
• Lean cuts of meat (roast, filet, etc.)

Snacks

When you split your diet, it allows you not to overload your stomach at mealtime.

By eating three small meals plus two snacks a day, you may experience a decrease in gastroesophageal reflux.

It is essential to always include a source of fiber and lean protein in your snacks.

Here are some examples of snacks:

• One slice of wholemeal bread + one cheese
• A bowl of cow’s milk or soy milk + a fruit
• 1 oz whole grain in milk
• Yogurt or cottage cheese + a fruit
• A handful of oilseeds + a compote
• Raw vegetables with hummus

Other recommended foods

• Physical activity
• Low-sugar products
• Natural sugars
• Antioxidants

Foods to avoid with gastroesophageal reflux disease

A series of foods should be avoided in cases of gastroesophageal reflux disease because they are either irritating or promote excess weight and abdominal pressure.

Irritating foods

As part of the special GERD diet, certain foods should be avoided as they can worsen symptoms of gastroesophageal reflux disease, such as burning or pain by increasing inflammation.

Therefore, it is advisable to avoid foods that could irritate the inner lining of the esophagus. As such, the inner lining can be protected from aggressive acidic juices.

The following foods should be avoided if you have gastroesophageal reflux disease:

• Soft drinks
• Alcohol
• Coffee (even decaffeinated)
• Spices
• Tea
• Chocolate
• Citrus fruits and citrus juice
• Mint products
• Tomatoes

These products can be replaced by herbal teas, plain water, herbs or fruits that are better tolerated.

Trans and saturated fats

Trans and saturated fats should be avoided as much as possible. They can be found in:

• Grilled chicken with skin
• Cooked ground beef
• Pork chops
• Lamb chops
• Cheddar type cheese
• Whole milk
• Pizza
• Whole cream
• Vinaigrette
• Milk chocolate
• Butter and oils
• Peanut butter
• Mayonnaise
• Black olives
• Butter croissant
• French fries
• Eggs

Refined products

Ideally, refined products should also be avoided for chronic acid reflux because they provide less fiber and nutrients.

Instead, here are some recommendations:

• Choose products with a minimum of 0.07 oz of fiber per serving
• Choose cereals enriched with dietary fiber
• Consume fruit whole rather than in juice form
• Replace refined products with wholegrain bread and starches
• Use wheat bran in your dishes and desserts

Fermentable foods

Bloating can also be caused by excessive fermentation in the intestine.

In fact, they aggravate gastroesophageal reflux by increasing the pressure in the abdomen.

Fermentation is produced by certain fermentable carbohydrates such as soluble fibers, sorbitol, fructose which makes us fat, etc.

Low-fermenting foods to be favored

The following foods are preferred:

• Corn, rice, rye, spelt, millet, quinoa, and kamut
• Fruits: red fruits, pineapple, banana, apricot, peach, kiwi
• Avocado
• Vegetables: lettuce, carrots, spinach, eggplant, squash, zucchini, green beans, celery
• Oilseeds
• Whole wheat and derived products: bread, pasta, flour, bran, etc.

Fermentable foods to avoid

The following foods are to be avoided:

• Barley
• Garlic, onion, turnip, leek green
• Cabbage vegetables: broccoli, cauliflower, Brussels sprouts, etc.
• Legumes
• Fruit: apple, pear, melon, cherry, grape
• Oat bran products: bran, bread, cereals and flour
• Dried fruits
• Psyllium

Some practical daily tips for following the GERD diet

Here is a series of practical tips to follow to avoid gastroesophageal reflux disease:

• Eat and drink slowly
• Drink between meals instead
• Make lean protein snacks like cheese, yogurt, soy milk, eggs, etc.
• Avoid bending over after meals
• Eat small meals and add snacks to avoid too much food in the stomach that will promote reflux
• Have dinner at least 3 hours before going to bed
• Engage in low-intensity activity after meals
• Engage in regular, moderate physical activity.
• Sleep with your chest slightly elevated with a pillow
• Do not wear clothes that are too tight and compress the waistband
• Avoid anything that causes gas: drinking through a straw, chewing gum, drinking soda, etc.

Chronic acid reflux: Conclusion

Gastroesophageal reflux disease (GERD) is the backflow of food from the stomach into the esophagus.

Due to the acidity of the gastric juice, reflux can cause inflammation of the esophagus and lead to unpleasant symptoms such as burning, nausea, and abdominal pain.

It is possible to prevent and treat reflux by adopting a GERD diet that should also be combined with regular physical activity.

Gastroesophageal reflux disease can also be effectively treated with well-supervised medical therapy.