Gastric reflux

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What is gastric reflux?

Gastric reflux occurs when acid produced and stored in the stomach travels up the esophagus. This acid can also reach the throat or larynx.

There are two different types of gastric reflux: gastroesophageal reflux (GERD) and laryngopharyngeal reflux (LRF); a person can have one or both types of reflux. 

GERD occurs when stomach acid flows from the stomach into the esophagus. It usually occurs at night when people are lying down. Symptoms can include heartburn, belching, regurgitation of stomach contents, and swallowing difficulties.

LRF It occurs when stomach acid flows up through the esophagus into the throat or larynx. It can occur during the day or at night. The acid irritates the vocal cords and surrounding tissues. Symptoms may include voice changes, clearing throat, postnasal drip, a feeling of mucus in the back of the throat, cough, sore throat, choking spells, difficulty swallowing, or a feeling of a lump in the throat.

How is gastric reflux treated?

Reflux can be treated through dietary and lifestyle modifications; as well as some proton pump inhibitor (PPI) medications, and in some cases surgery. Certain foods are more likely to cause acid reflux. By eliminating or limiting these foods you can reduce acid reflux and associated symptoms. 

* For a better reading of the graphic table, visualice in pc or tablet.

Food groupAllowed foodsFoods to avoid

Dairy products
Skim milk, low-fat milk, plant-based milk, and cheeses made with part-skim milk.Whole milk with or without flavoring, cream, whole milk cheeses and hot chocolate.

Protein and other protein alternatives.
Veal, beef, lamb, fish, poultry; as well as tofu, beans, peas, or lentils    Fried or fatty meats, pork, bacon, cold cuts, foods packed in oil.

Prepared without added fat. Egg white to taste.Fried eggs.

All prepared without added fat. Avoid vegetables that give you reflux or discomfort.Avoid tomato sauce or foods that contain baked or roasted tomatoes.
FruitsAnyone except those that may cause symptoms or discomfort.Avoid citrus fruits: banana, strawberries, etc. 

Commercial whole grain or enriched breads, French bread, hamburger buns, hard or plain rollsCommercial sweet bread, donuts, croissants and cakes. 
CerealsAll cereals, hot or coldNone
Potatoes and substitutesPotatoes, sweet potato, rice, noodles, spaghetti and macaroni.French fries or rice. Everything that is prepared with cheeses and creamy sauces. 

Butter, margarine, vegetable oils, mayonnaise, gravy, reduced-fat salad dressing, or lightly seasoned dressing.Lard, bacon fat, meat fat, commercial sauces or dressings. 

Natural or flavored water and substitute for sugar, coffee or decaffeinated tea.Green or black coffee or tea, citrus juice (orange, grapefruit, lemonade, cranberry), caffeinated beverages, shakes, carbonated beverages, and alcohol.

Consommé, dairy-free broth, consommé, packaged / dehydrated soup, and soups made with skim milk.Commercial cream soups (made with whole milk, cream, or added fat)

Sweet desserts
Fruit, jelly, fruit smoothies made with skimmed milk, water-based ice cream, meringues, jam, preserves, sugar, syrup and honey.Ice cream, commercial cakes, cakes, cookies and puddings made with whole milk Any dessert that contains chocolate, nuts, cream, coconut or whole milk.

Condiments and cough drops.
Mild condiments and sugar-reduced candiesSpicy condiments Cough drops that contain menthol, peppermint, or peppermint flavor.

Lifestyle modifications

  • Do not lie down or exercise after eating, avoid wearing tight clothing around the waist.
  • Eat 3 to 4 small meals throughout the day instead of 2 to 3 large meals.
  • If you are overweight, try to lose weight.
  • Reduce or stop tobacco use.
  • Evite comer 2-3 horas antes de acostarse.
  • If reflux occurs at night, raise the head of your bed (i.e. put old books under the front legs or buy an angled pillow)
  • Using 2 or more regular pillows can make reflux worse by causing the body to slouch.

How to take medication for reflux?

If you are taking PPIs like omeprazole, esomeprazole, etc. Take it in the morning on an empty stomach 30 minutes to an hour before breakfast or dinner.

How long will it take for you to notice improvement?

Acid damage or symptoms in your esophagus or throat may take 4-6 weeks to improve, so do not stop medications or diet or lifestyle modifications without consulting your doctor.

Complete resolution may take 3-4 months.

What problems can acid reflux cause?

Prolonged reflux can cause voice problems, Barrett's esophagus, and, in some extreme cases, esophageal or throat cancer.

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