Q. Nutritional Management for gastro oesophageal reflux disease?
As mentioned above the nutrient requirements remain the same as per the RDI for most patients. It would be important to note here that if GERD has developed due to obesity, it is essential to prescribe a weight reduction diet for the patient. Nutrient requirements may also change during certain complications such as bleeding thereby necessitating an increased intake of dietary proteins, iron, B-group vitamins and vitamin C. Dietary pattern on the other hand needs to be altered for all patients.
Meals are the major aggravating factor of GERD symptoms, since they stimulate the production of gastric acid available for reflux into the oesophagus. Meals eaten within 2 to 3 hours of bedtime (which increase acid availability at night time), or with alcohol, can predispose patients to nocturnal reflux. Dietary fat in the duodenum also appears to be a strong reflux trigger, in part by impairing gastric emptying. Also, it is inappropriate to advise to reduce the fat content of their meals, as least, with regard to GERD symptom relief.
Patients include raw onions, chocolate, caffeine, peppermint, citrus juices, alcoholic Specific foods that have been identified as potentially aggravating factors in certain beverages, tomato products and spicy foods. Peppermint and chocolate are thought to lower LES tone, facilitating reflux. Citrus juice, tomato juice and probably pepper can irritate damaged oesophageal mucosa. Cola drinks, coffee, tea and beer can have an acidic pH, lowering LESP to precipitate symptoms. Potential oesophageal irritants should be restricted.