9 ways to reduce symptoms of reflux disease

If you suffer from gastro-oesophageal reflux disease (GORD) you may live with painful symptoms such as heartburn, acid reflux, feelings of nausea and bad breath. Fortunately, these symptoms can be reduced by making some lifestyle changes.

Here, consultant gastroenterologist Dr Aathavan Loganayagam shares his tips on how to manage the symptoms felt during a GORD flare-up:
 

1. Lose weight - Studies have shown that overweight people experience greater relief from the symptoms with the more weight that they lose. Discuss an eating plan with your doctor.
    
2. Quit smoking – A study of people taking regular medicine for reflux found that stopping smoking almost halved the severity of their reflux symptoms. The improvements were mostly among people of normal weight.
    
3. Cut back on alcohol – alcohol may trigger reflux symptoms in some people.
    
4. Avoid trigger foods and drinks – Examples of triggers include fatty and spicy foods, chocolate and coffee. Different people have different triggers. It is only necessary to avoid the ones that affect you so that you do not end up restricting your diet. Possible trigger foods can be eliminated for two weeks and then reintroduced one at a time to determine your tolerance.
    
5. Raise the head of your bed – Some symptoms of reflux felt at night may disrupt your sleep. Try sleeping on a wedge pillow or wedging up your mattress by 20cm.
    
6. Avoid lying down after eating – This includes going to bed.
    
7. Eat smaller meals – Eating large meals increases stomach pressure.
    
8. Don’t eat three hours before bedtime – The stomach may take up to five hours to fully empty a meal so it is recommended to stop eating at least three hours before going to bed.
    
9. Avoid eating before exercise – Avoid the foods that trigger your reflux for up to three hours before working out.
    

What happens if symptoms of GORD are more frequent?

In cases where the symptoms appear more frequently, a drug called proton pump inhibitor (PPI) can be taken for 4-8 weeks to reduce the amount of acid produced in the stomach. Taken once a day, an hour before a meal, the tablet is effective at treating GORD reflux.
 

How can I stop or reduce GORD treatment?

After completing an initial course of PPIs, you may reduce the amount of medication you are taking and still maintain control of GORD symptoms. Up to 6 out of 10 people can also stop taking PPIs without symptoms returning (under the supervision of your doctor). When your doctor is reviewing your initial course of treatment, they may suggest you try to reduce your PPI medicine by:

• Lowering your PPI dose
• Taking PPI on alternate days
• Take PPI only when symptoms appear worse
• Stopping your PPI
   

What happens if I suddenly stop taking PPI?

If PPI is stopped suddenly, reflux symptoms may return for around four to five days because of what is known as rebound acid hyper-section. This occurs when the stomach has become used to a PPI and starts producing more acid. Some over-the-counter medicines can help to relieve symptoms as the stomach readjusts to no longer need a PPI.

To reduce the risk of rebound acid hyper-section, your doctor may gradually lower your PPI dose before stopping. Your reflux symptoms may change over time, so the dose of PPI you need may also change. You doctor can help you to manage this.
 

How important are lifestyle changes for reflux?

Lifestyle changes also remain important in managing GORD. After stopping PPI, they become even more important in controlling your reflux symptoms.

Do not hesitate to book an appointment with Dr Loganayagam if you're experiencing uncomfortable symptoms of GORD.