By: Jean Johnson for Reflux1“It doesn’t surprise me that they’ve linked GERD to eating too much,” said Dorothy Saucorn of Castle Rock, Washington who suffers from GERD. “I know since I’ve cut back on the calories, my problems haven’t been as bad as they were when I just ate whatever, when whenever I wanted. Not that I’ve cut back that much.”
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Ways to Control Indigestion
Avoid lying down directly after eating.
Wear loose clothing.
Spicy foods are not culprits: Physicians advise eating smaller portions since acid back-up is stimulated by any type of food that enters the stomach.
Raise the head of your bed.
Don’t smoke, or drink excessive amounts of caffeine.
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Although a recent study published in the Annals of Medicine did not prove losing weight improves GERD, its analysis of nine other studies conducted over 18 years showed that that excess weight nearly doubles the risk of gastroesophageal reflux disease (GERD, also called acid or gastric reflux). “The association between BMI and GERD complications was markedly consistent,” wrote Howard Hampel, M.D. and his colleagues on the study team at the Michael E. DeBakey Veterans Affairs Medical Center at Houston’s Baylor College of Medicine. “People that are obese are almost twice as likely to develop symptoms associated with gastric reflux.”According to professor of medicine at Baylor and study author, Hashen El-Serag, M.D., researchers’ analysis of nine former GERD studies showed that in most instances as weight moved up the body mass index (BMI) scale, so did complications from GERD.
“There is credible evidence to incriminate obesity in yet another set of diseases,” said El-Serag. “Although there is little information on whether losing weight will reverse the risk of these complications, it is very likely that staying at a normal weight helps reduce the risk of GERD and its complications.”
Professor of medicine and Chief of Gastroenterology at Eastern Virginia Medical School, David Johnson, M.D., agreed. “The causal relationship is there, and it would be suggestive that reduction in obesity and overweight status would be helpful for lots of reasons.” Johnson also pointed out that a range of other medical problems have benefited from weight loss like heart disease and diabetes among others.
While the study demonstrated a connection between GERD and excess poundage, it did not explain conclusively why the relationship occurs. The researchers did, however, offer several theories. Since GERD or acid reflux occurs when the contents of the stomach flow back up into the esophagus, they speculate that excess belly fat compressing the abdominal area might be a factor. Also physicians think eating high-fat foods that take longer to digest and are therefore in the stomach longer might contribute to gastric reflux.
As usual, however, the medical world is stymied on how to get people to take off unwanted pounds. While healthcare providers understand the science and know that the equation between calories taken in and those expended must be rearranged, they continue to struggle with the emotional and behavioral components that seem to drive people to consume more than they physically need. At the same time, overweight and obesity rates are rising in the industrialized world. Study authors report that as many as 20 percent of adults in the United States suffer from GERD.
Acid reflux or GERD is problematic enough in its own right with a harsh burning sensation in the area under the neck beneath the ribs. Even patients on medication usually are forced to limit intake of certain foods as well as carefully control portion sizes.
“I’ve taken to snacking quite a bit,” said Saucorn. “Eating lots of mini-meals is the way I’ve figured out how to still get the amount of food I like without having that terrible heartburn and chest pain. I know it’s not good, and I should lose more weight, but it’s the best I can do.”
When asked if the results of the study might prompt her to change her habits, Saucorn was resolute. “Even now that I know about the study, I doubt that I’ll do anything differently. I’ve tried so many times to lose weight, and it’s always come back – that and a little extra,” she said. “So that’s what I tell my doctor. What’s worse, me staying where I am and stable or me trying to force myself and wind up carrying another 10 pounds?”
For his part, El-Serag hopes that the study will encourage some since it “adds another reason for patients to remain a healthy weight. This can help them avoid GERD with its associated nuisance, treatment and potential complications, including cancer of the esophagus.”
Hampel echoes his colleague’s cautionary remarks about more life-threatening diseases related to reflux. “Obesity raises the risk of GERD and two other conditions – erosive esophagitis and cancer of the esophagus.”
When pressed about more serious, even life-threatening problems Saucorn pressed her lips together and grew wistful. “You would think so, but I don’t know. I just don’t know. I guess I’m just too weak-willed. Or maybe I’m like an addict. I guess I just hope it doesn’t come to that.”
