Lauren DorseyBrown- Nutrition

Stands for Gastroesophageal Reflux Disease Other “nicknames” include:

acid reflux, acid regurgitation, acid indigestion or heartburn.

When the acidic juices from the stomach rise up into the esophagus, it causes a burning

sensation

When the food rises back up into the esophagus, the burning sensation is felt near the heart, hence the feeling of “heartburn”.

“Burning” feeling A burning sensation that seems centralized in the area

of the heart, lower esophagus, upper stomach, chest or throat

Excessive salvation The body may increase salvia concentration to

counteract the acid in the esophagus Painful swallowing Acid taste in the mouth

A strong bitter/sour taste in the back of the throat, sometimes even pieces of food can resurface

Bad breath Dental erosion

The stomach acid is strong enough to begin the erosion of the tooth enamel

Trouble swallowingDysphasia: feels like food is stuck in the throat,

choking sensation, pressure and burning sensation in chest after eating

Nausea and vomiting Chronic cough

Acid can reflux into the lungs, or just irritate the esophagus

Asthma

The lower esophageal sphincter (LES) is a muscular value that allows passage of nutrients from the esophagus to the stomach, and prevents the return of them back into the esophagus Weak muscles surrounding the LES could result in

weak closing pressure of the valuesThe process of Transient LES Relaxation (burping)

could be uncoordinated If peristalsis is impaired, stomach acid that has

returned into the esophagus will not be pushed back into the stomach

If there are not enough digestion enzymes or stomach acid, food will not be digested properly in the stomachProduction of these decrease with age, illness,

food allergies or overuse of medications Food that cannot be digested and passed out

of the stomach will sit there and attempt to return back up the esophagus

The upper portion of the stomach can protrude though the hole in the diaphragm (esophageal hiatus) meant only for the esophagus

Food can be entrapped in The enlarged section, and Upward passage can happen Hiatal hernia can occur from an injury to the area or

pressure in abdomen from coughing or even pregnancy and delivery

32% of people over 50 years old 89% of people over 90 years old

Helicobacter Pylori: Infects mucosal lining in esophagus, stomach, and intestines70-90% of all ulcers are caused

by this bacteriaSymptoms of this bacterial

infection could be bad breath, stomach pain, nausea and vomiting

70% of people do not show symptoms, and a blood or stool test may need to be done.

Candida: A type of yeast that found in the gastrointestinal systemThe population of these microbes can grow due to

an immune problem or antibioticsProblems arise when the population increases

Eating foods that are chocolate, citrus, fatty or fried, garlic, mint, spicy, or tomato based foods such as chili or pizza

Eating a lot of food

Eating fast or under stress Not chewing thoroughly Eating right before sleeping

Gravity cannot help the food Make its passage down to thestomach easily

Smoking Pregnancy Obesity

Pregnancy and obesity increase your risk for a hiatus hernia

Antacids: Maalox, Mylanta, Rolaids and Tums Neutralize stomach acid Provide quick relief but do not heal the esophagus or

the LES H-2 receptor blockers: Pepcid AC, Zantac, Axid

Reduce acid production Provide longer relief than antacids but don’t work as

quickly Also in prescription strength

Proton pump inhibitors: Prevacid and Prilosec block acid production and heal the esophagus Also in prescription strength

Prokinetic agents: Benzamide and Domperidone and more medications that help the stomach empty faster, and

help the LES close tighter

Nissen fundoplication: tightening the LES by wrapping the top of the stomach over the esophagus laparoscopic surgery is used more and involves

small incisions with small instruments and a camera

Stretta ProcedureElectrode energy is used to heat the esophageal

tissue Creates scar tissue and damages nerves that respond

to the acid reflux Strengthens muscles around the LES and in the

esophagus EndoCinch endoluminal gastroplication

stiches are placed near the weakened LES and then strung together to create barriers to prevent acid from enter the esophagus

Eat meals 3 to 4 hours before going to bed Eat smaller meals Avoid being over weight Limit the consumptions of fatty foods,

chocolates, minty foods, spicy foods, coffee, cola, alcohol

Eat a high fiber dietPeople with a high fiber diet are 20% less likely to

have acid reflux symptoms Quit smoking Avoid tight clothes and belts which may

cause pressure to the abdomen

The inflammation in the lining of the esophagus can cause ulcers and bleeding which is esophagitis

Scars from the tissue damage can lead to narrowing of the esophagus which can make is hard to swallow

Barrett’s esophagusThe cells in the lining of the esophagus changes

shape and colorCan change to cancer—which is fatal when

untreated

Breakfast Calories (kcal) Fat (g) Fiber (g)1 cup hot oatmeal 307 5 8½ cup sliced papayas 148 0 31 slice whole wheat bread 65 1 18 oz skim milk 102 2 0Lunch2 cups cream of chicken soup

226 14 2

BLT on whole wheat 339 20 51/2 soy nuts 120 7 3½ cup steamed carrots 34 0 3Dinner1 small side salad 115 5 0Baked chicken 215 15 2White rice 159 0 2Steamed apricotes 74 1 21 glass water 0 0 0Total on day 1 1904 70 31

Breakfast Calories (kcal) Fat (g) Fiber (g)1 cup bran cereal 83 1 81 large banana 105 0 3

1 english muffin 130 0 2Glass of water 0 0 0Lunch2 cups cream of potato soup 290 13 21 cup artichokes 84 0 101 piece chicken breast baked

215 15 2

8 oz skim milk 102 2 0Dinner6 oz pork chop 236 12 11 cup steamed sliced peaches

66 0 3

1 baked potato 161 0 48 oz skim milk 102 2 0Total on day 2 1574 45 35

Breakfast Calories (kcal) Fat (g) Fiber (g)1 english muffin 130 0 21 cup sliced papayas 148 0 3½ cup of hot oatmeal 153 2 48 oz skim milk 112 2 01 glass of water 0 0 0LunchChicken wrap w/ fat free tortilla/lettuce

271 16 2

1 dill pickle 12 0 11 small side salad 115 0 51 glass of water 0 0 0Dinner1 cup steamed green beans 34 0 42 cups beef stew 218 12 38 oz skim milk 112 2 0Corn on the cob 211 6 2Small side salad 115 5 0Total on day 3 1535 45 26

1. What type of medicine neutralizes stomach acid and provides quick relief-Antacids

2. What is the Lower esophageal sphincter (LES)?-Valve that allows passage of nutrients from the esophagus to the stomach, and prevents the return of them back into the esophagus

3. People are 20% less likely to have GERD if they eat a diet high in _____?-Fiber

"Reflux Defense: Natural GERD and Heartburn Relief." Reflux Defense: Natural GERD and Heartburn Relief. Web. 29 Feb. 2012. <http://refluxdefense.com/>. http://refluxdefense.com/heartburn_GERD_articles/introduction-causes-and-symptoms.html

“GERD." - Medpedia. Web. 01 Mar. 2012. <http://wiki.medpedia.com/Special%3GERD>. http://wiki.medpedia.com/Gastroesophageal_Reflux_Disease_(GERD)

"WebMD - Better Information. Better Health." WebMD. WebMD. Web. 01 Mar. 2012. <http://www.webmd.com/>. http://www.webmd.com/heartburn-gerd/heartbrun-and-gerd

Food Composition Table; McGraw-Hill 2009 Contemporary Nutrition 8th Ed. Wardlaw & Smith,

New York