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This Thanksgiving, enjoy the turkey but keep the GERD

22 Nov. 2021 – John Farrell has mixed feelings about Thanksgiving.

“It’s great because I like to eat, but at 6, 7 o’clock I think, ‘This is not good,'” says the Virginia Beach, VA project manager. “I feel bloated, it leads into the reflux. I can feel the acid rising in my throat, that burning sensation. There is a lot of regret about everything I did that day. “

For about 5 years, Farrell (46) has been GERD, which stands for gastro-oesophageal reflux disease. With this digestive system disorder, your lower esophageal sphincter (LES, a muscle valve between you esophagus and yours stomach) does not work properly. It causes food and stomach acids to flow back – backflow – into your esophagus, which can cause discomfort and a burning sensation.

Most of us have occasional periods of reflux and the heartburn it can lead, but with GERD it happens twice or more a week. About 60 million Americans have heartburn at least once a month, and as many as 15 million experience it daily. If GERD is not treated, it can cause much worse symptoms and even lead to esophageal cancer.

General GERD triggers

While you may have heard that spicy, fatty or rich foods should be avoided to avoid heartburn, reality is more complicated than that.

“Each individual has a different trigger for them GERD, ”Says Rena Yadlapati, managing director, director of the Center for Esophageal Diseases at the University of California-San Diego. “I have patients who can eat spicy, spicy food, but they get reflux when they eat chocolate. I have others who just can not drink coffee, but any food is just good. ”

Stefanie Robinson, a medical and dental builder from Pleasant Valley, NY, knows her triggers: sour foods like tomatoes and stress. She has been struggling with GERD on and off for 20 years.

“I take [acid-reducing drug] omeprazole every night, ”she says. “I’ve been feeling tense lately, so it doesn’t seem to be doing much. I take Tums in between. And rice pudding or yoghurt will help calm my stomach – they seem to cover it. “

In addition to spicy foods and tomato products, Farrell says he has two other key triggers: overeating and going to bed too soon.

“The most important things with GERD are the amount of food you eat, and the relationship with sleep,” says Yadlapati. “It takes a few hours for the stomach to empty into the small intestine. Once the stomach is empty, you really do not have a risk of having reflux from the stomach. But until then, everything that is in the stomach will probably come back. “

Thanksgiving and GERD: a difficult combination

Thanksgiving poses particular challenges for people with GERD, for one simple reason: “GERD is all about pressure,” says Yadlapati. “The more pressure we have in our stomach, the more likely reflux is caused. And the thing that causes pressure is large amounts of food.”

Other things related to the holiday, such as the stress of travel and family gatherings, can make you more susceptible to an attack, she says.

“Stress increases the irritability of nerves in your esophagus. If you have small amounts of reflux on any other day, it may not cause symptoms. But under stressful conditions, it can cause severe chest pain and burns. “

Another common part of holiday celebrations can also cause trouble.

“Alcohol is known to relax the lower esophageal sphincter, which facilitates reflux,” says Allon Kahn, MD, an assistant professor of medicine at the Mayo Clinic in Scottsdale, AZ. “So it is likely, especially in the presence of a large meal, to make symptoms worse.”

While some people who have GERD take medication to help them produce less stomach acid, others get it right with lifestyle changes such as identifying and avoiding fast foods or waiting at least 3 hours after eating to go to bed. But on Thanksgiving, those careful practices often go out the window. Letting go can lead to a nasty attack from GERD.

“Medication-controlled patients may be less likely to worsen their symptoms because the acid is reduced to the point where it may not bother them as much,” says Kahn.

Enjoy the holidays – and what comes next

Whether you know you have GERD or you just get occasional heartburn, a few tips can help you end a pain-free Thanksgiving:

  • Exercise section control. As difficult as it is to resist a second serving of Aunt Martha’s stuffing, it’s really important to avoid overeating. “By the time you feel full, you’ve eaten way too much,” Farrell says. “To know that, I will try to stick to one plate.”
  • Be careful with alcohol. In addition to its effect on your LESSON, drinking can lower your inhibitions. It makes you more likely to have that second aid of stuffing after all.
  • Choose food carefully. Fried or very fatty foods are considered refluxogenic, says Yadlapati – they can cause more reflux. And of course, if you’re aware of your own triggers, do your best to avoid them. “I will be very selective in what I eat at Thanksgiving. I will stay away from salad because the salad dressing will have vinegar. I would just stick to mashed potatoes and turkey, ”says Robinson. “And I might bring my own dessert: rice pudding.”
  • Consider pre-medication. If you have managed your GERD with lifestyle adjustments, you may want to take an over-the-counter medication, such as Prilosec, 30 to 60 minutes before you sit down to eat, says Kahn. It can help reduce the amount of acid your stomach produces as you digest.

Even with the best of intentions, you may still experience pain in the Thanksgiving night. Here’s what you can do:

  • Be ready with antacids afterwards. If you are not comfortable taking pre-medication, Kahn recommends taking an antacid like Tums or Mylanta. “If you act fast, it can turn off reflux,” he says.
  • Avoid the urge to lie down. Because Thanksgiving meals are so much bigger than regular dinners, Yadlapati and Kahn both recommend waiting longer than usual before going to bed. Aim for 4 hours instead of 3. Or if you have to lie down earlier than that, use a wedge pillow to lift your torso.
  • Try to breathe stomach. “It can actually reduce reflux to come up, and it can strengthen your diaphragm,” says Yadlapati. “It also helps to relax the nerves in your esophagus.”
  • Get moving. A little gentle exercise can relieve your symptoms. “Going out after dinner for a family walk really helps,” Farrell says.
  • Manage your expectations. People who have GERD or frequent heartburn often know where their boundaries lie, and when they cross them. “If you go and drink late at night, it’s okay,” says Yadlapati. “Just know you might wake up in the middle of the night.”
  • Do not panic – but pay attention. “If you’re really experiencing chest pain or a pressure sensation, it’s foolish to assume it’s heartburn,” says Kahn. “Heart attack and heartburn can occur similarly, and eating a large meal is a stress on the heart. If you have never had this symptom and it is not mild, seek emergency care.”

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