This Thanksgiving, Enjoy the Turkey But Hold the GERD

Nov. 22, 2021 — John Farrell has combined emotions about Thanksgiving.

“It’s great because I love eating, but by 6, 7 o’clock, I’m thinking, ‘This is not good,’” says the challenge supervisor from Virginia Beach, VA. “I’m feeling bloated, it’s feeding into the reflux. I can feel the acid coming up my throat, that burning sensation. There’s a lot of regret about everything I did that day.”

For round 5 years, Farrell, 46, has had GERD, which stands for gastroesophageal reflux illness. With this digestive dysfunction, your decrease esophageal sphincter (LES, a muscular valve between your esophagus and your abdomen) doesn’t work correctly. It lets meals and abdomen acids reflux — circulation again up — into your esophagus, which may trigger discomfort and a burning sensation.

Most of us have occasional durations of reflux and the heartburn that may outcome, however with GERD, it occurs two or extra occasions every week. Roughly 60 million Americans have heartburn not less than as soon as a month, and as many as 15 million expertise it each day. If GERD goes untreated, it will probably trigger a lot worse signs and even result in esophageal most cancers.

Common GERD Triggers

While you could have heard that spicy, fatty, or wealthy meals needs to be averted to forestall acid reflux disorder, the fact is extra sophisticated than that.

“Every individual has a different trigger for their GERD,” says Rena Yadlapati, MD, director of the Center for Esophageal Diseases on the University of California-San Diego. “I have some patients that can eat spicy, spicy foods, but they get reflux when they eat chocolate. I have others that just cannot drink coffee, but any food is just fine.”

Stefanie Robinson, a medical and dental biller from Pleasant Valley, NY, is aware of her triggers: acidic meals like tomatoes, and stress. She’s been battling GERD on and off for 20 years.

“I take [acid-reducing drug] omeprazole every night,” she says. “Lately I’ve been feeling stressed, so it doesn’t seem to be doing much. I take Tums in between. And rice pudding or yogurt will help settle my stomach — they seem to coat it.”

In addition to spicy meals and tomato merchandise, Farrell says he has two different key triggers: overeating and mendacity down too quickly.

“The most important things with GERD are the amount of food you eat, and the relationship with sleeping,” Yadlapati says. “It takes a few hours for the stomach to empty down into the small bowels. Once the stomach has emptied, you really don’t have a risk of having reflux from the stomach. But until then, whatever is in the stomach is likely to come back up.”

Thanksgiving and GERD: A Tricky Combination

Thanksgiving poses explicit challenges for folks with GERD, for one easy purpose: “GERD is all about pressure,” Yadlapati says. “The more pressure we have in our stomach, the more likely reflux is to be triggered. And the thing that causes pressure is large amounts of food.”

Other issues associated to the vacation, just like the stress of journey and household gatherings, could make you extra susceptible to an assault, she says.

“Stress increases the excitability of nerves in your esophagus. If you’re having small amounts of reflux, on any other day, that might not cause symptoms. But under stressful circumstances, it might cause severe chest pain and burning.”

Another frequent a part of vacation celebrations may trigger bother.

“Alcohol is known to relax the lower esophageal sphincter, which facilitates reflux,” says Allon Kahn, MD, an assistant professor of medication on the Mayo Clinic in Scottsdale, AZ. “So it’s likely, especially in the presence of a big meal, to make symptoms worse.”

While some individuals who have GERD take medicine to assist them produce much less abdomen acid, others handle with life-style modifications like figuring out and avoiding set off meals or ready not less than 3 hours after consuming to lie down. But on Thanksgiving, these cautious practices usually exit the window. Letting free can result in a nasty bout of GERD.

“Patients who are controlled with medicine might be less likely to have worsening of their symptoms, because the acid has been reduced to the point where it may not bother them as much,” says Kahn.

Enjoy the Holiday — and What Comes After

Whether you understand you could have GERD otherwise you simply get heartburn sometimes, just a few ideas will help you pull off a pain-free Thanksgiving:

• Practice portion management. As onerous as it’s to withstand a second serving to of Aunt Martha’s stuffing, it’s actually essential to keep away from overeating. “By the time you feel full, you’ve already eaten way too much,” says Farrell. “Knowing that, I’ll try to stick to one plate.”
• Be cautious with alcohol. In addition to its affect in your LES, ingesting can decrease your inhibitions. It makes you extra prone to have that second serving to of stuffing in spite of everything.
• Choose meals fastidiously. Fried or very fatty meals are thought of refluxogenic, says Yadlapati — they could induce extra reflux. And after all, when you’re conscious of your personal triggers, do your greatest to keep away from them. “I’m going to be very selective in what I eat at Thanksgiving. I’ll stay away from salad, since the dressing will have vinegar. I’ll just stick to mashed potatoes and turkey,” says Robinson. “And I might bring my own dessert: rice pudding.”
• Consider pre-medicating. If you’ve been managing your GERD with life-style modifications, you may wish to take an over-the-counter medicine, like Prilosec, 30 to 60 minutes earlier than you sit all the way down to eat, Kahn says. That will help scale back the quantity of acid your abdomen produces as you digest.

Even with the perfect of intentions, you should still end up in ache Thanksgiving evening. Here’s what you are able to do:

• Be prepared with antacids afterward. If you’re not comfy taking medicine prematurely, Kahn recommends bringing alongside an antacid medicine like Tums or Mylanta. “If you act quickly, it can shut down reflux,” he says.
• Avoid the urge to lie down. Because Thanksgiving meals are a lot bigger than common dinners, Yadlapati and Kahn each suggest ready longer than typical earlier than mendacity down. Aim for 4 hours as a substitute of three. Or when you should lie down before that, use a wedge pillow to raise your higher physique.
• Try stomach respiratory. “It can actually reduce reflux from coming up, and it can strengthen your diaphragm,” says Yadlapati. “It also helps to relax the nerves in your esophagus.”
• Get transferring. A little bit mild train could ease your signs. “Going out for a family walk after dinner really helps,” says Farrell.
• Manage your expectations. People who’ve GERD or common heartburn usually know the place their limits lie, and once they cross them. “If you’re going to have a late night and drink, it’s OK,” says Yadlapati. “Just know you might wake up in the middle of the night.”
• Don’t panic — however listen. “If you’re truly experiencing chest pain or a pressure-like sensation, it’s foolish to assume it’s heartburn,” says Kahn. “Heart attack and heartburn can present similarly, and eating a big meal is a stress on the heart. If you’ve never had this symptom before and it’s not mild, seek emergency care.”