Thanksgiving is one of the holidays that revolve around food and can be challenging for people with gastroesophageal reflux disease, also known as GERD, heartburn or acid reflux.
What is heartburn? It is the burning, bloated feeling in the chest and sometimes throat that is caused by the leaking of stomach digestive juices containing acid and pepsin (a digestive enzyme that breaks down proteins) into your esophagus (the tube connecting your throat to your stomach) and sometimes this reflux travels up into the throat which can irritate both your throat (larynx) and voice box (pharynx), cause difficult, painful swallowing, and lead to coughing, phlegm, and hoarseness. When these symptoms develop in the throat instead of the chest cavity they are referred to as extraesophageal reflux (outside of the esophagus or LPR/ laryngopharyngeal reflux).
It is pepsin that causes most of the tissue damage to the esophagus, throat, and voice box because it breaks down the protein structure in our tissues. When left untreated GERD can lead to Barrett’s syndrome which is pre-cancer of the esophagus.
Though reflux can occur during the day, by standing up, gravity helps keep it somewhat under control but when we lie down at night its much easier for the stomach juices to flow back into the esophagus and start the symptoms discussed above.
If you are often bothered by heartburn and GERD (or possibly LPR) you may take antacid medications to try to control the acid and burning symptoms by using the most popular drugs for this purpose which are known as PPI’s (proton pump inhibitors) these are drugs like Nexium, Prevacid, Prilosec.
It is not healthy to be on these drugs for longer than a month or two yet many people are threatening their health by being on them for much longer periods of time. These drugs have been shown to:
1. Increase the risk of early death,
2. Increase the risk of kidney disease, heart disease, bone fractures, dementia, and infections.
3. Decrease absorption of important compounds like magnesium, iron, and vitamin B-12 to name a few.
So here’s what to do:
1- Never eat within 2 ½-3 hours of going to bed.
2- Sleep with your upper back and head raised
3- Try to sleep as much as possible on your left side – The anatomy of your stomach makes it much more difficult for gastric juices to flow into the esophagus when you are on your left side. Side sleeping is an easy and effective method of natural relief that can not only relieve heartburn pain but can also help prevent damage to the stomach and esophagus. When lying on your back, the acid will pool up inside the stomach and can make contact with the esophagus. By turning to the left side and sleeping at an upward angle, excess acid will flow to its natural location, following the force of gravity, at the larger part of the stomach, reducing the likelihood of uncomfortable heartburn.
4- Decrease your use of the PPI’s slowly over 2 weeks and replace with H2 blockers like Zantac or Pepcid if you need relief and wean off those as you proceed with the other recommendations
5- Don’t eat your next day’s first meal for at least 15 hours after your last meal from the previous night. This in essence gives you a 15 hour fast which calms down your digestive symptoms, lowers the risk of reflux, and helps with blood sugar and weight control for added benefit.
6- Consider adding a forkful of natural sauerkraut during the day. It helps the stomach to maintain healthy acid levels and adds many good bacteria that can offset ingested pathogenic bacteria that can get into the stomach, release gas, and cause pressure that can force the gastric juices to reflux into the esophagus.
7- Eliminate as much sugar as you can from your diet. In addition to the danger of sugar to your overall health, it has been associated with GERD. The same applies to processed meats and foods.
8- Try using ½ teaspoon of baking soda (sodium bicarbonate) in ½ glass of warm water for relief. Gargle in your mouth for a few seconds and then swallow it. If your stomach acid levels are sufficient you should burp in no more than one or two minutes. Often “too little” stomach acid is the cause of reflux and NOT “too much.” Even if you have too little acid in your stomach when it refluxes it still burns, so it is the act of refluxing not necessarily that you have too much stomach acid! In fact, too little acid leads to poor control of gas-producing bacteria and the gas pushes the stomach juices into the esophagus.
If you need additional relief during the same day, instead of taking more medicine or another dose of baking soda, try swallowing a glass of 8.8 alkaline water which is sold in supermarkets. The combo of baking soda and alkaline water works very well together for both GERD and LPR.
9- If you have LPR symptoms and the above after a month or so hasn’t brought much relief, you can add a ½ teaspoon of sodium alginate to your ½ teaspoon of baking soda in warm water.
Though the sodium alginate does not dissolve too well in water, mix it as best you can, it will be clumpy but swallow it anyway. The sodium alginate and the baking soda combo form a harmless bridge that covers the top of your stomach fluids and prevents them from flowing backward into your esophagus.
10- Incorporate psyllium (fiber) into your diet. A 2018 study concluded that the use of Psyllium seed in the treatment of functional constipation in patients with GERD is very safe, effective, easily available, and this treatment also minimizes the chance of recurrence of GERD compared to omeprazole (a prescription treatment for GERD). Please note that you can also take psyllium for GERD even if you are not experiencing constipation.
TIPS TO ENJOY A HEARTBURN FREE THANKSGIVING HOLIDAY
Juicy turkey, savory stuffing, creamy casseroles, and buttery mashed potatoes make the perfect spread for a traditional Thanksgiving table, but if you suffer from GERD, these rich, indulgent foods, can aggravate acid reflux and lead to hours of discomfort long after you’ve put away the leftovers.
The key to enjoying a heartburn-free holiday lies in knowing which foods to choose and which ones to avoid. Also, eating too much overall or within a short time can trigger reflux, Here are some tips for a heartburn-friendly Thanksgiving meal:
Choose lean cuts of turkey – Turkey is relatively safe for GERD sufferers, but try to choose cuts of white meat instead of dark, as they contain less fat. You can also limit the fat content by removing the skin and keeping the gravy to a minimum.
Fix mashed potatoes with chicken broth – Mashed potatoes are a Thanksgiving tradition, but when you load them up with butter and sour cream, they become a reflux nightmare. Adding chicken broth to your mashed potatoes gives them a rich flavor without ramping up the fat content.
Season stuffing with herbs – Everyone loves a heaping scoop of warm, savory stuffing, but if it’s seasoned with garlic and onions, it’s likely to cause heartburn. Prepare your stuffing with a variety of freshly chopped herbs instead.
Make casseroles with low-fat ingredients – If your casserole recipe uses a cream soup base, you can instantly make it more heartburn-friendly by using low-fat condensed soup. Look for other ingredients that come in low-fat or fat-free varieties like cream cheese, sour cream and whipping cream.
Skip the alcohol – It may be tempting to indulge in a glass of wine or champagne at dinnertime, but alcohol is a major heartburn trigger. Keep your beverage heartburn-friendly by sticking to water, non-citrus juice, or decaffeinated tea. You can still participate in holiday toasts with a glass of sparkling cider or club soda!
Go easy on dessert – It wouldn’t be Thanksgiving dinner without the pumpkin pie, but just one slice has over 300 calories and 14 grams of fat. Keep the fat content to a minimum by choosing a smaller slice, skipping the whipped cream, and removing the buttery crust from the back portion of your pie.
Have a wonderful and healthy Thanksgiving holiday.
To the Best of Health,
Curt Hendrix, M.S. C.C.N., C.N. S.
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