Understanding GERD: A Nutritional Guide to Relief

Written By Isabella Meneses-Furuseth

Gastroesophageal reflux disease (GERD) is a very common digestive issue that people face today., I frequently encounter individuals who are struggling to manage their symptoms and find long-term relief. GERD can significantly impact your quality of life, but with the right knowledge and strategies, it is possible to address its root causes and regain digestive harmony. Let’s explore what GERD is, its symptoms, potential root causes, and steps you can take to alleviate and prevent it.

What Is GERD?

GERD occurs when stomach acid or bile flows back into the esophagus, irritating its lining. This happens when the lower esophageal sphincter (LES), or the muscle that closes the door between the esophagus and stomach, becomes weakened or the stomach is so full that the “door” won't close, allowing stomach content to escape upward. While occasional reflux can happen to anyone, GERD is a chronic condition requiring attention.

Recognizing GERD Symptoms

GERD symptoms can vary but often include:

  • Chest pressure or discomfort (sometimes mistaken for heart issues)

  • Heartburn

  • A burning sensation in the esophagus 

  • Regurgitation of food or liquid

  • A sour or bitter taste in the back of the throat

  • Frequent burping or hiccups

If left untreated, GERD can lead to complications like esophageal damage, making it essential to address these symptoms early.

Common Causes of GERD

1. Stress

Stress can play a significant role in GERD by putting your body into a "fight or flight" state (sympathetic nervous system). This impairs digestion because the body deactivates the "rest and digest" mode (parasympathetic nervous system),  Here’s why this matters:

  • Reduced stomach acid production: Under stress, the body prioritizes survival mechanisms, like increasing heart rate and blood flow to muscles, over digestion. Stomach acid production decreases, impairing proper food breakdown.

  • Delayed gastric emptying: When food sits undigested in the stomach for too long, it increases pressure, making it more likely for stomach contents to escape upward.

  • Nutrient depletion: Chronic stress depletes vitamins and minerals needed for digestive health, further compromising stomach acid production.

  • Cortisol impact: The stress hormone cortisol suppresses gastrin, the hormone responsible for signaling the stomach to produce acid.

Overall, being under stress can have negative impacts on your digestive processes and can lead to GERD symptoms. 

2. Age-Related Changes

Aging naturally decreases stomach acid production which can then lead to indigestion. The reasons that this could happen with age is because: 

  • Weakened LES muscles: Aging reduces collagen and elastin production, leading to decreased muscle tone, including in the LES. This makes it harder for the “door” to close properly. Additionally if you have had bad posture over the course of several years, it could also be a reason for a weakened LES muscle. 

  • Digestive inefficiency: Reduced stomach acid means food stays in the stomach longer, creating a "traffic jam" that increases pressure on the LES.

While these changes are natural, they’re manageable with focused attention on digestive health, such as stress reduction, proper chewing, and eating foods that support stomach acid production.

3. Lifestyle and Medical Factors

Several lifestyle and medical factors can weaken the LES or exacerbate GERD symptoms, including:

  • Proton pump inhibitors (PPIs) like omeprazol, lansoprazole, and pantoprazole: These medications work by blocking the hydrogen-potassium ATPase enzyme in the stomach, decreasing stomach acid production. These supplements can relieve symptoms at first and allow damaged tissues to heal. However, long-term use can lead to several negative effects due to chronic suppression of stomach acid, which we don't want. 

    • Stomach acid is crucial for nutrient absorption: vitamin B12, magnesium, calcium, and iron. 

    • Increased risk of gut infections: stomach acid acts as a killer against harmful bacteria and pathogens, so long term use can increase the risk of SIBO, H. pylori, & C. diff infections. 

    • Increased risk of gut dysbiosis: lower stomach acid changes the pH of the digestive tract and can lead to an imbalance of good and bad bacteria. This can increase symptoms like gas, bloating, and general digestive issues. 

    • Reduced digestive enzyme activity: stomach acid is necessary for triggering pancreatic enzymes and bile flow, without it, digestión becomes impaired. 

    • Rebound acid hypersecretion: This occurs after you have been on PPIs for a while and start experiencing symptoms. This is because the stomach is compensating for the reduced acid and upregulating the proton pumps and hormones that stimulate acid production. When someone stops taking PPIs suddenly, they can experience worse acid reflux than before. That's why it's important to taper off of them or not use them long term. Work on things like supporting stomach acid naturally, improve gut microbiome balance, reducing inflammation, and identifying triggers before coming off PPIs. 

  • Smoking: Nicotine weakens the LES, reduces saliva production (your body’s natural acid neutralizer), and decreases blood flow to the esophagus, impairing healing.

  • Hiatal hernia: This condition occurs when part of the stomach pushes through the diaphragm, disrupting the natural alignment of the LES and increasing the likelihood of reflux.

  • Increased abdominal pressure: Factors like obesity, pregnancy, tight clothing, poor posture, or certain exercises (e.g., crunches) can put excessive pressure on the LES, preventing it from closing fully.

4. Dietary Triggers

Certain foods and beverages can weaken the LES or irritate the esophagus, including:

  • Carbonated drinks: Increase pressure in the stomach by releasing gas.

  • High-fat meals: Slow digestion, delaying stomach emptying and increasing reflux risk.

  • Acidic foods: Citrus fruits, tomatoes, and similar items can irritate the esophagus.

  • Alcohol: Relaxes the LES, making reflux more likely.

  • Peppermint: While soothing for some, it can relax the LES in susceptible individuals.

  • Sugary and refined carbs: Can feed gut bacteria, producing gas that increases abdominal pressure.

5. Medications That Indirectly Affect the LES

Certain medications can contribute to GERD by weakening the LES or irritating the stomach lining:

  • Antibiotics: Can disrupt gut microbiota, leading to imbalances that increase gas and pressure.

  • NSAIDs (e.g., ibuprofen): Can irritate the stomach lining and increase reflux symptoms.

  • Sedatives: Relax the LES, making it less effective.

  • Statins: May affect muscle function, including that of the LES.

Addressing GERD Holistically

Step 1: Lifestyle Changes

Making small, consistent changes to your routine can help strengthen the LES and improve digestion:

  • Practice stress management: Techniques like deep breathing, yoga, or mindfulness activate the parasympathetic nervous system, supporting digestion.Smaller, more frequent meals: Prevents overloading the stomach, reducing pressure on the LES.

  • Avoid eating late at night: Finish meals 2-3 hours before lying down to allow proper digestion.

  • Chew thoroughly: Proper chewing aids digestion and reduces stomach workload.

  • Sleep on your left side: Keeps the esophagus above the stomach, reducing reflux risk.

  • Avoid drinking water while you eat: In order for the stomach to stay acidic and break down food properly, you want to avoid something that can alkalinize your stomach acid.

Step 2: Dietary Modifications

Evaluate your diet and identify potential triggers:

  • Foods to avoid: Alcohol, citrus, spicy foods, garlic, onions, and high-fat meals.

  • Consider a low-FODMAP diet: If gas and bloating accompany symptoms, this approach may help.

  • Limit histamine-rich foods: Aged cheeses, cured meats, and dried fruits can exacerbate symptoms in sensitive individuals.

Step 3: Investigate Deeper Causes

If symptoms persist, consider exploring underlying issues:

  • Testing for dysbiosis: Imbalances in gut bacteria can contribute to reflux.

  • H. pylori & SIBO  testing: This bacterial infection is a common cause of low stomach acid and reflux.

Supplements: Proceed with Care

Supplements can support digestion and relieve GERD symptoms, but they must be used thoughtfully:

  • Digestive enzymes: Aid in breaking down food, reducing stomach workload.

  • Digestive bitters: Stimulate stomach acid production before meals.

  • DGL (deglycyrrhizinated licorice): Soothes the esophagus and supports healing. Choose DGL if you have high blood pressure.

  • Melatonin: can help tone the LES

  • Marshmallow root: contains a gel-like substance that can coat and soothe irritated tissues. 

Avoid supplements that may irritate the stomach or weaken the LES, such as peppermint oil or magnesium citrate. Always consult with a healthcare provider before starting a supplement regimen.

When to Seek Medical Attention

While many cases of GERD can be managed with lifestyle and dietary changes, seek medical evaluation if:

  • Symptoms are severe or persistent.

  • You experience difficulty swallowing.

  • There is unexplained weight loss.

  • A hiatal hernia is suspected.

An endoscopy or other diagnostic tests may be necessary to rule out complications or underlying conditions.

Final Thoughts

GERD is a complex condition with many potential causes and contributing factors. By addressing root causes, making strategic lifestyle changes, and tailoring your diet, you can find relief and prevent long-term damage to your esophagus. Small, consistent changes can lead to significant improvements in your digestive health. Take it one step at a time, and don’t hesitate to seek support if needed.

Remember: Empowering yourself with knowledge is the first step toward lasting relief.

Disclaimer: Before making any any changes, especially to stop taking a medication, I always suggest talking to a health professional first to avoid any unwanted symptoms.

If you have any general questions, feel free to reach out to me via email - I love helping people out - but remember I cannot offer clinical advice for specific cases unless we are working together.

Isabella Meneses-Furuseth https://www.roothealingnwa.com
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