ACNAS

Managing Reflux

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Gastro-oesophageal Reflux (Reflux) 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 into the mouth). Reflux is very common and almost everyone can experience it at some time.

However 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 risk of reflux
  • 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

 

Factors to Consider

When considering reflux there are various strategies that may help. These include:

  • Offering  6 smaller meals spread over the day (smaller meals may be better tolerated)
  • Encouraging food to be chewed well with adequate time given for meals to be eaten
  • Avoiding excessive alcohol
  • Avoiding eating near to bed time
  • Elevating the head of the bed
  • Avoiding drinking fluids with meals (ensure adequate fluids are provided throughout the day)

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

  • Caffeine (coffee, cola drinks)
  • Chocolate
  • Peppermint
  • Spicy foods
  • High fat foods

However reaction to foods is very individual and some people also report reflux associated with other foods such as tomatoes, garlic and capsicum. Some people also experience reflux that is not associated with any specific types of foods. It is therefore very important that foods are not excluded unnecessarily.

An Accredited Practising Dietitian can assist with ensuring that foods are not unnecessarily excluded and assess any weight loss associated with GORD. A Speech Pathologist should also be consulted to address any swallowing difficulties and a Medical Doctor to prescribe appropriate anti-reflux &/or anti-nausea medication.