WHAT IS REFLUX
The stomach makes acid and
by design is capable of withstanding this acid
environment. The esophagus (swallowing tube) on the
other hand, has no such capacity. As such, if acid were
to enter the esophagus, it would irritate the esophagus.
With persistence of this irritation, inflammation and
ulcers can result. Reflux disease is caused by recurrent
irritation of the esophagus by the acid entering the
esophagus from the stomach.
WHY DOES REFLUX
A number of factors protect
the esophagus from acid injury. Chief among these
factors is a sphincter (a napkin ring like structure)
that helps prevent the movement of the acid from the
stomach into the esophagus. For many medical reasons
(one of which is the presence of a hiatal hernia) this
sphincter can relax, remain open and, as such, will lose
its ability to overcome the reflux movement of
WHAT CAN I DO ABOUT
In very simple terms, help
the sphincter overcome acid reflux:
1) DO NOT EAT OR DRINK FOR
4 HOURS BEFORE GOING TO BED: Acid production by the
stomach is high following a meal and remains so for at
least 3 hours. When standing up straight, gravity is
helping confine the acid to the stomach. When we lie
down however, we cancel the effect of gravity.
Therefore, it is very important not to lie down for 4
hours after meals. Before going to bed at night do not
eat or drink (not even water) for 4 hours.
2) IF YOU SMOKE, STOP. IF
YOU DON'T SMOKE, DON'T START: Smoking has been shown to
relax the sphincter, thus worsening the
3) RAISE THE HEAD OF THE
BED BY 6-8 INCHES: This will help keep acid in the
stomach when lying down. If you have a water bed, sleep
on a wedge-shaped pillow that is 10 inches high and 30
4) PROPER POSTURE DURING
DAYTIME WILL ALSO HELP: Avoid bending over from the
waist, use your knees instead. When sitting down, sit
upright and don't try lifting heavy objects.
5) IF YOU ARE OVERWEIGHT,
LOSING THE EXCESS WEIGHT WILL HELP: When you lie down,
the weight of the wall of your abdomen will be
transmitted to your stomach into the esophagus. The
larger that weight is, the more reflux.
6) AVOID WEARING TIGHT
FITTING GARMENTS OR BELTS: For the same reason as above,
the pressure from the tight garments will be transmitted
to your stomach thus helping push acid into the
7) AVOID ALCOHOL, FATTY
MEALS, COFFEE AND TEA: Alcohol will irritate your
esophagus, increase acid formation by the stomach, and
worsen the problem. Coffee and tea (even decaffeinated)
increase acid production and relax the sphincter
further. Citrus and tomato juices can be irritating and,
as such, best avoided.
HOW RIGID SHOULD I
BE IN FOLLOWING THESE INSTRUCTIONS AND FOR HOW
If you follow these
instructions for at least 6 weeks, there is a very good
chance that your discomfort will go away. After that, if
you are feeling better, we can advise you about which of
the measures you can eliminate.