Gastroesophageal reflux disease (GERD) is the abnormal backflow, or reflux, of stomach acid and juices into the esophagus. The esophagus is the tube that leads from the throat to the stomach.

See a picture of the esophagus .

GERD occurs when the valve between the lower end of the esophagus and the stomach (the lower esophageal sphincter) does not close tightly enough. When this valve is not closed all the way, the contents of the stomach can move back (or reflux) into the esophagus. The main symptom of GERD is a frequent uncomfortable feeling of burning, warmth, heat, or pain just behind the breastbone, and it is commonly referred to as heartburn. Overeating or bending forward after eating sometimes causes heartburn and a sour taste in the mouth. Occasional heartburn does not mean you have GERD. In GERD, the reflux-and heartburn-last longer and occur more often.

Treatment for GERD is aimed at reducing reflux of stomach acid and juices into the esophagus. Treatment can prevent injury to the lining of the esophagus or help the esophagus heal if injury has already occurred. Preventing GERD from recurring and preventing other complications of GERD are also treatment goals.

Although changes to your lifestyle probably will not cure your gastroesophageal reflux disease (GERD), they can provide some relief from symptoms and make you more comfortable. Heartburn, the main symptom of GERD, can cause significant pain and discomfort during the day, keeping you from being productive at work and from leading an active life at home. Changes to your lifestyle that reduce GERD symptoms can help you stay focused at your job and make other activities more enjoyable.

In addition to discomfort during the day, GERD symptoms can keep you awake at night and can affect your sleep in the long term. Changing your sleeping position and habits can help you avoid GERD symptoms at night, allowing you to sleep better.

GERD symptoms that go untreated or persist despite treatment can turn into more serious problems. GERD can cause irritation, inflammation, or wearing away (erosion) of the lining of the esophagus (esophagitis), as well as crater-shaped sores (ulcers) in the lining of the esophagus. Some people who have symptoms of GERD may develop a condition called Barrett's esophagus that can lead to cancer of the esophagus.

There are many changes you can make to your lifestyle that can help to relieve or reduce symptoms of gastroesophageal reflux disease (GERD). These are some suggestions.

Quitting tobacco use

If you smoke or chew tobacco, stop. The nicotine from tobacco relaxes the valve between the esophagus and stomach (lower esophageal sphincter). This can allow stomach acid and juices, the chemicals that break down food in the stomach, to back up (reflux) into the esophagus, which causes heartburn.

Because the nicotine in tobacco is addicting, stopping the use of tobacco is more difficult than simply changing a habit. Those who successfully quit using tobacco usually use a combination of strategies that may include:

• Professional counseling, either by telephone or in person.
• The use of medicines, to help overcome the addiction to nicotine.
• Participation in a proven smoking cessation program.
• Having a support group of peers who are also quitting or who do not smoke.

Using more than one of these strategies greatly improves your chances of successfully quitting. Quitting tobacco use may require several attempts.

For more information, see the topic Quitting Smoking.

Changing your eating habits

Developing healthier eating habits, losing weight if necessary, and avoiding foods that increase symptoms of GERD may make heartburn less likely to occur. Take your spouse or partner along with you when you go to your doctor to discuss diet habits. It will be easier to make changes in your diet if your family understands what you need to do and why.

Changes you may want to make include avoiding chocolate, peppermint, and alcohol. These can all make GERD worse by relaxing the valve between the esophagus and the stomach. It also may be a good idea to eat smaller, more frequent meals.

If you are overweight, lose weight. Being overweight puts additional pressure on your stomach and increases the likelihood of heartburn occurring. Losing just 5 to 10 pounds can help.

Certain foods can be associated with reflux. Though they will not cause GERD, eating these foods can make the symptoms worse, and avoiding them can help reduce heartburn. These include citrus fruits, fatty and fried foods, garlic and onions, spicy foods, and tomato-based foods like spaghetti sauce and pizza. Some people notice that their symptoms get worse after drinking coffee or soda. If you notice that your symptoms are worse after eating a specific food, you may want to stop eating it and see if your symptoms get better.

Reducing pressure on your stomach

Putting pressure on your stomach may push stomach juices into your esophagus, causing heartburn. Some ways to reduce heartburn include the following:

• After you eat, wait 2 to 3 hours before you lie down. Late-night snacks aren't a good idea. When you are lying down, the contents of your stomach can push against the valve between the esophagus and stomach (lower esophageal sphincter). Sitting up allows gravity to help food and stomach juices from the esophagus drain back into your stomach.
• Avoid tight clothing over your stomach. Tight belts, waistbands, or panty hose may push against your stomach and make your heartburn worse.
• Use care when lifting and bending. Bending over tends to increase the amount of stomach acid that can get into your esophagus. When lifting, bend at the knees to avoid bending over at the waist.

Improving sleep position and habits

Raising the head of your bed 6in to 8in will help keep stomach acid from flowing into your esophagus when you are sleeping. You can do this by putting blocks underneath your bed frame or by placing a foam wedge under the head of your mattress. Using extra pillows will not work.

Lying down soon after eating will also increase the chance of getting heartburn. After you eat, wait 2 to 3 hours before you lie down. Late-night snacks aren't a good idea.

Now that you have read this information, you can begin to make some lifestyle changes to relieve your GERD symptoms. If you have any questions about these changes or need help making them, contact your doctor.

Organizations

American College of Gastroenterology
P.O. Box 342260
Bethesda, MD  20827-2260
Phone:	(301) 263-9000
Web Address:	www.acg.gi.org
The American College of Gastroenterology is an organization of digestive disease specialists. The Web site contains information about common gastrointestinal problems.
National Digestive Diseases Information Clearinghouse (NDDIC)
2 Information Way
Bethesda, MD  20892-3570
Phone:	1-800-891-5389
Fax:	(703) 738-4929
E-mail:	nddic@info.niddk.nih.gov
Web Address:	www.digestive.niddk.nih.gov
This clearinghouse is a service of the U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the U.S. National Institutes of Health. The clearinghouse answers questions; develops, reviews, and sends out publications; and coordinates information resources about digestive diseases. Publications produced by the clearinghouse are reviewed carefully for scientific accuracy, content, and readability.