The anti-reflux diet

Hearty meals, fatty foods, fried foods, spices, sausages, carbonated drinks, alcohol and spirits: there are many dietary attentions to follow for those suffering from gastroesophageal reflux disease.

For those suffering from gastroesophageal reflux disease, a disorder characterized by gastric acidity and rising acid from the stomach to the esophagus, there are now numerous effective and safe drugs that can keep symptoms under control. In many cases, you can buy them at the pharmacy without having to submit prescriptions. The first choice are proton pump inhibitors (PPIs), such as omeprazole, which block the production of hydrochloric acid in the stomach, relieving the disorder.

However, it should be remembered that heartburn and gastric reflux, in the vast majority of cases, do not appear due to the presence of pre-existing anatomical or functional alterations at the level of the gastric mucosa or cardia (the valve that separates the stomach from the esophagus, preventing the ascent of acid and food), but are provoked by dietary errors, poor physical activity, inadequate lifestyle, overweight conditions or obesity and stress.

This means that, if you want to effectively prevent and treat gastroesophageal reflux disease, you need to review the way you eat and start taking better care of yourself in a more general sense. Here are some practical tips useful for everyone and to support drug therapy for those who are already taking it.

Avoid binge eating

In addition to medications, to be taken following the indications and advice of your doctor or pharmacist, it is very important to follow an anti-gastric reflux diet. Do not be too alarmed: it is not a question of having to give up eating tasty and satisfying dishes, but it is only necessary to avoid foods that put the most strain on digestive abilities and that promote greater acidity.

Too large meals should certainly be avoided, especially those rich in fatty or fried foods: it is a universally valid rule, which those suffering from gastroesophageal reflux cannot afford to ignore, especially in the evening.

In fact, abundant dinners overload the stomach before bedtime and favor unpleasant acid ascents and discomfort during the night, when the cardia “relaxes” and the horizontal position does not help.

To limit the inconvenience, we must try to better plan the intake of food throughout the day, providing at least 4-5 light meals and snacks and favoring breakfast and lunch over dinner.

Ideally, you should wait at least 3-4 hours before bedtime after eating: therefore, it is better to avoid having dinner too late. Another good habit to facilitate digestion after dinner (or after any other meal) is to walk a little: a relaxing walk of 10-15 minutes can really make a difference for those suffering from gastroesophageal reflux disease and also helps to keep body weight under control.

Instead, avoid intense physical activity or efforts after eating because rapid movements and pressure in the abdomen tend to loosen the tightness of the cardia and promote gastric reflux. In addition, the intensification of muscle metabolism and the recall of blood at the peripheral level distract the body from the digestive process, making it less efficient. To bring benefits on all fronts, sport should be practiced before or between meals.

Food friends and enemies

Regardless of whether or not you suffer from gastric reflux, the diet should always be varied, balanced, rich in fresh foods with high nutritional value and such as to guarantee an intake of calories and nutrients commensurate with individual needs, taking into account age, sex, type and intensity of physical activity practiced, as well as any special needs.

Good nutrition is essential for children and adults and to obtain it certain foods or entire categories of foods should never be excluded a priori from the diet, unless there are allergies, intolerances or specific contraindications, which must still be evaluated by the doctor and managed with the help of a nutritionist.

In the presence of gastroesophageal reflux disease, however, it is advisable to favor foods that stress less gastric secretion and annoying acid rises towards the esophagus and strongly limit those that tend to promote them.

The ideal foods, which can be consumed every day because they engage the stomach little and satiate for a long time, are:

• dough
• rice
• cereals
• potatoes

To ensure maximum digestibility, however, they must be cooked at the right point and combined with a light dressing: it is better to use small quantities of extra virgin olive oil “raw”, avoiding fats of animal origin, such as butter, lard or cream.

Tomato sauce is not prohibited (if subjectively tolerated), but must not contain onion, garlic or spicy spices.

In fact, among the declared enemies of those suffering from reflux there are:

• chili pepper
• paprika
• Pepper
• ginger
• cinnamon
• nutmeg
• curry
• cumin.

These spices promote the production of gastric juices and, in some people more than others, tend to loosen the tightness of the cardia. Also watch out for mint, anise and fennel seeds.

Aromas harmless to the stomach are:

• parsley
• thyme
• sage
• basil
• oregano
• rosemary

Licorice is not only allowed, but can even help relieve the symptoms of stomach acid and gastric reflux because the glycyrrhetinic acid it contains has a mild anti-inflammatory action, favorable for the gastric and esophageal mucosa. It should not, however, be taken in the form of candies (which contain sugars or artificial sweeteners and various additives), but as natural as possible, ie in logs, sticks or infusion preparations (perhaps to drink before bedtime).

Be careful not to exceed with salt: in addition to promoting hypertension, it is one of the main stimulators of gastric acid secretion. The advice to be able to use less salt without noticing too much of the difference in flavor is to gradually reduce the doses that are used while cooking and avoid adding it to foods when they are already on the table (often it is done instinctively, even before having tasted the dish).

Among the foods to avoid there are also grilled sausages, grilled ribs and fatty cuts of beef or pork, however they are cooked.

Few cold cuts and only lean, such as bresaola, raw ham, cooked natural. In this regard, it should be remembered that even the best quality non-fatty cured meats contain a lot of salt, spices and additives that facilitate stomach acid. When eating them, it is advisable to combine them with a little bread, which helps to attenuate their action of stimulating gastric secretion.

As for cheeses, fresh or aged cheeses should be preferred, as long as they are light and digestible, such as ricotta, grana, tender goat cheese, primosale or mozzarella.

Thumbs down, instead, for blue cheeses (gorgonzola, roquefort, blue) and fondants (fontina, taleggio, brie, tomini), as well as for burrata, creamier and fatter fresh cheeses and mascarpone.

Better to turn away from ethnic cuisine, whether Chinese, Indian, Maghreb or Mexican: too many spices and glutamate almost everywhere. Green light to sushi and sashimi, but avoid soy sauce and wasabi. Several sauces and accompaniments of the national tradition, on the other hand, are also contraindicated: from mayonnaise to green sauce, from mustard mustard to pickled or sweet and sour vegetables.

The most acidic fruits (citrus fruits, pineapple, kiwi and some berries) and those that are too unripe should also be taken in small doses, preferably consuming them during lunch, instead of dinner.

The following table shows schematically the foods allowed and those to be avoided.

Chew calmly

Good digestion begins in the mouth and good chewing is essential to prevent digestive difficulties, stomach acid and gastric reflux. It is enough to chew each bite at least 15-20 times, calmly, to help the stomach in digestion.

In this way the food is shredded into fragments more easily digested by gastric juices and the enzymes present in the saliva begin the first phase of digestion.

Better then to postpone to after lunch the conversations too agitated and the pressing phone calls. In addition to the well-known unfavorable action of stress on stomach function, talking while eating leads to swallowing a lot of air together with food, favoring the appearance of stomach swelling and consequent greater propensity to belching and gastric reflux.

A relaxed post-prandial conversation, perhaps while walking, is welcome, especially if it helps to do less than cigarettes and analogues: smoking, in fact, is absolutely to be avoided since it is a powerful stimulator of acid gastric secretion and one of the main factors that can worsen the disease of gastroesophageal reflux.