Heartburn and acid reflux are common problems. We have all seen our fair share of ENO adverts, after all. But what happens when you have exhausted all tummy settling remedies and the flame in your gut refuses to go away?
Chances are that you could have a condition called gastroesophageal reflux disease, or GERD, says registered dietician Jandri Barnard.
Barnard, who is also a spokesperson for the Association for Dietetics in South Africa, says that poor nutrition impacts everything from longevity to gut function.
You are what you eat, and to get “good” out of your body you must put “good” in.
“Poor nutrition can contribute to stress and tiredness and can affect your capacity to work. Over time it can contribute to weight gain and obesity, which in turn can lead to other health problems like heartburn, hypertension, diabetes, and GERD,” she says.
How it happens
Acid reflux occurs when stomach acids start to bubble up from the opening between the stomach and oesophagus (the muscular tube that connects the throat to the stomach). When rising acid reaches your oesophagus, it will cause irritation or a burning sensation.
Common foods know to trigger acid reflux include spicy food, alcohol, citrus fruits like oranges as well as tomatoes.
“Minimise your intake of these sources and rather stick to whole, single-ingredient foods as much as possible where you have control over the food you put into your body,” Barnard advises.
‘GERD is when the stomach contents consisting of acid, bile, enzymes and other chemicals in the stomach juice move up to your oesophageal tract.’
Speaking on the seriousness and prevalence of GERD, Barnard says that an estimated 10 to 20% of adults experience symptoms of GERD on a weekly basis in Western countries.
Its prevalence is only increasing with the rising prevalence of obesity. “There is an increase in South Africa, but most cases of GERD still go undetected, especially when people self-medicate with over-the-counter anti-reflux medication and avoid seeking medical attention from a medical practitioner,” Barnard says.
She adds that according to a 2019 study done in South Africa, GERD was more common in black females (22.9%) than in black males (4.1%). The prevalence of GERD in women furthermore rose with increasing body mass index (BMI).
Erosive oesophagitis is a common complication of GERD and can develop when the oesophagus becomes swollen or inflamed, says Barnard.
The common causes of GERD:
- Obesity: Excess weight increases abdominal pressure, making stomach acid leakage or backflow more likely.
- Transient relaxation of the oesophageal sphincter (LES): The lower oesophageal sphincter (LES) is made of a bundle of muscles at the low end of the oesophagus, where it meets the stomach. Barnard explains when the LES is closed, it will prevent acid and stomach contents from traveling backwards from the stomach. When the LES fails to close, however, it allows stomach acid to splash up from the stomach into the oesophagus, causing severe acid reflux and heartburn.
- Hiatal hernia: Hiatal hernias (when the upper part of the stomach bulges towards the chest) are caused by weakened supporting tissue and increased abdominal pressure. The hernia plays a role in the development in both acid reflux and GERD.
- Acid pocket: This develops due to poor mixing of acid with chyme (the thick mass of partially digested food) in the proximal stomach.
Beat the heat
To fight the prevalence and recurrence of GERD, be careful of consuming these foods in large portions, Barnard advises:
- Saturated fats and oils found in cured meats like salami, bacon and sausage.
- Trans fatty acids which are included in beloved baked goods like cakes, cookies and pies.
- Added sugar or fructose in concentrated juices, soft drinks and sweets, among others.
- Mercury in fish like tilapia.
- Red meat that is grilled or smoked at high temperatures.