10 Tips for Avoiding Acid Reflux

Millions of people experience heartburn not only during the holidays, but year-round.

Have you ever indulged a little too much at a holiday buffet? Devoured a creamy dessert that was too rich for your digestive system? Enjoyed deep-fried chicken, only to pay the price as soon as you consumed the last morsel? Many people have at one time suffered from gastroesophageal reflux, which is also known as acid reflux, acid indigestion, acid regurgitation, heartburn and GERD. Acid reflux occurs when your stomach contents come back into your esophagus. The condition is common — more than 50 percent of the population reported experiencing GERD symptoms, according to a study published in 2014 in the journal Digestive Diseases and Sciences. The primary causes of acid reflux include obesity, smoking, overeating, eating late at night, consuming a high-fat diet, drinking beverages — like carbonated soft drinks — that are high in acid and eating spicy food, says Dr. Jamie Koufman, a laryngologist and director of the Voice Institute of New York. She’s also the author of four books on acid reflux, including “Dropping Acid: The Reflux Diet Cookbook & Cure.” Many people suffer from acid reflux after eating too much or the wrong thing, during the holidays, she says. “After New Year’s Day, my office is full of patients who fell into the reflux abyss over the holidays,” Koufman says.

Laryngopharyngeal reflux disease

GERD isn’t the only condition that can be caused by acid wreaking havoc in your digestive system. If you’re experiencing a cough, hoarseness, postnasal drip, a lump in the throat, shortness of breath and have difficulty swallowing, you may be suffering from laryngopharyngeal reflux disease, or LPR, which is a subset of GERD, says Dr. Scott Gabbard, a gastroenterologist who specializes in esophageal disoders. LPR, also known as respiratory reflux, refers to acid reflux that can come up into the throat and into the respiratory system, even the lungs, Koufman says. (Some ear, nose and throat doctors believe LPR is a separate condition from GERD, rather than being on the GERD continuum.) LPR is typically diagnosed by an ear, nose and throat specialist, says Dr. Samantha Nazareth, a board-certified gastroenterologist based in New York City. LPR affects about 50 percent of the population, says Dr. Stacey L. Silvers, an adjunct professor of otolaryngology at Touro College in New York City. She’s also board certified in otolaryngology by the American Board of Otolaryngology and is the associate medical director of otolaryngology at Gramercy Surgery Center. The condition refers to the backflow of food or stomach acid all the way back up into the larynx (the voice box) or the pharynx (the throat). LPR symptoms can develop as a result of stress, poor diet or a genetic predisposition, including a weak upper esophageal sphincter separating the swallowing tube from the throat. “Though the diagnosis may be recognized by a primary care physician based on symptoms, usually an ear, nose, throat doctor is required to confirm it by looking at the throat with a special flexible scope,” Silvers says. Experts recommend these 10 strategies to avoid acid reflux — not just during the holidays, but year-round:

1. Have a pre-party snack.

If you’re going to a holiday party or any other type of social gathering where food will be plentiful, eat a snack before the event. The best choice for a pre-meal holiday snack would be something healthy like a piece of fresh fruit or a handful of nuts, Koufman says. “Spoil your dinner” so that you won’t overindulge at the party, she says. Don’t try to save room throughout the day for the celebratory meal — eat a healthy breakfast and lunch, so you’re not hungry when you arrive. Drinking a glass of water before a large meal or between courses can also help you feel full, which can help you limit your consumption of calories and fats, Gabbard says.

2. Avoid foods that are high in fat.

High-fat foods cause reflux, Koufman says. “The reason for this is that high-fat foods cause the stomach valve to go limp,” she says. “Given a choice between chicken or beef, cheese or vegetables and fried vs. non-fried, pick the less fatty foods.” Making healthier food choices are also better for your waistline, your blood pressure and your cholesterol. Ideally, try to limit your meals to no more than 500 calories and a maximum of 15 grams of fat, Gabbard says. Research suggests that consuming low-calorie, low-fat meals results in less acid refluxing back into the esophagus than meals that are low-calorie but high in fat, Gabbard says. For example, a 4-ounce baked chicken breast, a cup of rice and a serving of steamed broccoli without butter would be an example of a meal with no more than 500 calories and less than 15 grams of fat.

3. Limit or avoid consumption of highly acidic beverages.

Of all the foods and beverages that we consume, soft drinks, seltzer water, fruit juices and energy drinks are by far the most acidic choices. “Most have the same level of acidity as stomach acid itself,” Koufman says. Water is by far your healthiest choice for a beverage.

4. Follow the two-to-one rule.

It’s hard to not eat some unhealthy items at a holiday party or any other large social gathering, Dr. Nazareth says. She suggests adhering to a ratio of two servings of healthy dishes — like fresh vegetables or a green, leafy salad — for every serving of fatty meat drenched in gravy or calorie-laden dessert. “The two servings of vegetables and leafy greens serve as healthy fiber,” she says. “Fiber keeps you feeling full, which will prevent overeating. The biggest problem with acid reflux during the holidays comes down to (eating) volume and food choices.”

5. Bring a healthy dish to the party.

Whether you’re going to a Thanksgiving dinner, a New Year’s party or a non-holiday-related social gathering, it’s hard to predict if any healthy food options will be available. “Most of the time, (you’re) expected to bring a dish to a person’s home anyway,” Nazareth says. “Therefore, why not prepare and bring a healthy side dish?” There are plenty of tasty options, like a homemade cranberry sauce with no added sugar, roasted Brussels sprouts or baked carrots.

6. Eat slowly.

Take the time to savor each bite and chew slowly, Nazareth says. Eating too quickly isn’t good for your digestive system. “Digestion starts right away in the mouth, and the process of chewing helps to break down the food,” she says. “It also takes up to 20 minutes for the brain to realize your stomach is full.”

7. Avoid side dishes that can trigger heartburn.

Some typical party dishes may be easy on your taste buds but tough on your digestive system. For example, green bean casserole topped with a cheesy cream, mashed potatoes made with cream and macaroni and cheese are staple side dishes at social gatherings that could give you heartburn, Nazareth says. For side dishes, you’re better off going with vegetables like collard greens, green beans, Brussels sprouts and carrots, provided they aren’t slathered in a cheesy or creamy sauce, she says.

8. Take a walk or help clean up after you eat.

Don’t go into complete relaxation mode and watch TV or go to sleep right after you’ve eaten, Nazareth suggests. You’re better off if you keep moving after eating a meal. “Digestion is aided by movement,” she says. “Also, gravity keeps everything in the stomach while you are digesting. The minute you recline after a big meal, this leaves an opportunity for acid to travel up into the food pipe or the esophagus and to feeling acid reflux, burning and belching.”

9. Don’t eat for three or four hours before you go to bed.

It takes about three to four hours for your stomach to digest food, Nazareth says. Therefore, if you eat at night, be sure you consume your food at least three to four hours before your bedtime. “Allow the stomach to do its job before getting into bed,” she says. “Digestion requires a great deal of energy. If you go to sleep before this time, it can become a very restless night.”

10. After a substantial meal, try sleeping on your left side.

Research suggests that sleeping on your left side, with your head elevated at least 7 inches above your torso, can help you avoid both GERD and LPR, Gabbard says. If you ate late or consumed foods that could lead to GERD or LPR, sleeping in this manner is helpful, according to research published in 2017 in the journals Diseases of the Esophagus and the American Journal of Otolaryngology. This strategy has reduced nighttime acid reflux in patients by about 75 percent, Gabbard says.

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