Gastro-oesophageal Reflux (sometimes referred to simply as reflux or GOR) occurs when the stomach contents, including acid, move back up into the oesophagus, causing irritation. This is often referred to as ‘heart burn’ and feels like a burning sensation behind the breastbone. Occasionally heartburn is associated with regurgitation (food or fluid coming back into the mouth). Reflux is very common and almost everyone can experience it at some time in their life.

Frequent occurrence of ‘reflux’ is called Gastro-Oesophageal Reflux Disease (GORD).  This may be caused by:

• A hiatus hernia – when part of the stomach has pushed through the diaphragm, which can make reflux more likely.
• Dietary factors – some foods may alter the lower oesophageal pressure and increase the risk of reflux (see below).
• Cigarettes – smoking can also lower the pressure in the lower oesophagus and provoke coughing which can cause reflux.
• Obesity – extra abdominal weight may increase the pressure in the abdomen and cause reflux.

Chronic exposure of the oesophagus to acidic gastric juices can develop into Barrett’s Oesophagus. This is when the acidic environment causes the cells that line the lower oesophagus to alter in appearance and can lead to:

• Persistent heartburn
• Difficult or painful swallowing
• Vomiting
• Weight loss
• A sensation of fullness during eating

Strategies to assist in the management of reflux:

In addition to medications, there are various strategies that may help in managing the symptoms of reflux. These include:

• Offering 6 smaller meals spread over the day (rather than 3 large meals).
• Encouraging food to be chewed well and allowing adequate time for meals to be eaten.
• Avoiding excessive alcohol intake.
• Avoiding eating too close to bed time or lying down, as the effects of gravity can worsen reflux.
• Elevating the head of the bed while resting.
• Avoiding drinking fluids at the same time as meals. Ensure that adequate fluids are provided throughout the day, between meals.

Foods which can worsen reflux:

As previously mentioned, there are specific foods that may alter the lower oesophageal pressure and increase the risk of reflux, including:

• Caffeine (found in coffee, tea and cola drinks)
• Chocolate
• Peppermint
• Spicy foods
• Oily or high fat foods
• Some plant foods such as tomato, capsicum and garlic.

Some people also experience reflux that is not associated with any specific foods.

It is important to note that reactions to foods are very individual, so spend some time with your resident to find out which foods worsen their reflux.

It is important that foods are not excluded unnecessarily.

An Accredited Practising Dietitian can assist with ensuring your resident’s diet is balanced and assess any weight loss associated with GORD. A Speech Pathologist should also be consulted to address any swallowing difficulties as well as a doctor who may prescribe appropriate anti-reflux and/or anti-nausea medication if appropriate.