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Acid Reflux During Cancer Care

Acid reflux (aka GERD aka heart burn) is no fun and it can be a common side effect from cancer treatment as well as a feature of modern American life (and diet). There are ways you can reduce the symptoms of reflux and I’m here to help guide you through some easy changes to make things more comfortable. An important note with reflux is that the triggers can be highly individual, so working with a dietitian to come up with a plan to manage your symptoms can be very helpful in keeping as much variety in your diet as possible while reducing problematic issues. You can always reach out to me and my team here to help lessen side effects!




Why reflux happens

There is a muscular sphincter between the stomach and esophagus, called the lower esophageal sphincter (LES), that is made to allow food down but not back up, reflux happens when there is a problem with this muscle and the acid in the stomach returns back into the esophagus causing the pain and symptoms you may feel. Certain chemotherapy drugs and anti-inflammatories can cause or exacerbate reflux symptoms.


GERD

Gerd is a chronic form of acid reflux, which stands for gastero-esphogeal reflux disease. This just means it happens regularly for a longer period of time. The symptoms of GERD can include a cough and the feeling there is a lump in your throat.


Lifestyle

Reflux can be exacerbated by certain lifestyle habits. Here are some things that can make symptoms worse and ways to help:

  • After eating anything that can cause pressure or disruption on digestion can make things more uncomfortable: bending over, lying down or exercising after a large meal can disrupt digestion. Try to eat smaller meals and go for an easy walk or keep your body upright for a while after meals. Also, try to eat 2-3 hours before you go to bed.

  • Clothing that is tight around the stomach can put pressure on the stomach and the valve forcing acid back up where it shouldn’t be. Wear comfortable clothing that isn’t tight in the waist area can help avoid symptoms.

  • Stress affects our muscles which can put more pressure on the stomach or affect the muscles allowing the acid to move backwards. Stress also may cause an increase in acid production in the stomach. Deep breathing and other mindfulness techniques can help with reducing stress and improving tone in these muscles.

  • Smoking can cause and exacerbate reflux in a few ways, it can relax the muscle that controls the valve, making it leak, it reduces saliva production and a smokers cough can increase pressure on the abdomen. Quitting smoking is probably the most beneficial thing you can do for your health in all ways, including reducing reflux.


Food and reflux

Food can affect reflux in many ways. Some foods soothe reflux and others are triggers for reflux. It can be helpful to keep a log of what foods you eat and when you experience reflux to get a clear idea of what your triggers are. Here are some common triggers and soothers:


Triggers

  • High fat or fried foods - these foods affect reflux in a couple ways, so they are good to limit to avoid reflux. Fat can cause the muscle to relax allowing increased reflux into the esophagus. Fat also is slower to digest, so it will stay in the stomach longer leading to increased reflux especially after a larger meal.

  • Acidic and spicy foods: Citrus fruits, tomatoes/tomato based foods, garlic/onion and spicy foods - the high acidity in these foods can irritate sensitive tissues and make symptoms worse. These foods do not cause problems for everyone, so if you are sensitive to them try to avoid them, if not keep eating them because they are healthy in other ways!

  • Dairy can be a trigger for some so monitor and see if this causes issues for you.


Reflux Soothing Foods

There is some good news here, there are some well studied foods that can help reduce reflux, so this is a great place to add some things into your diet instead of just removing foods.


High fiber foods have been shown to reduce reflux. Some good choices are:

  • bananas which contain fiber and can help to improve digestive issues while reducing reflux symptoms by coating the esophageal lining when irritated.

  • Oatmeal has been seen to help reduce reflux symptoms and absorb some of acid from both the diet and even within the stomach. Other high fiber foods include whole grains and vegetables.

  • Root vegetables: similarly to whole grains, root vegetables have fiber, nutrients and are a good texture for inflamed tissues.

Soothing herbs can help calm inflammation and sooth painful tissues

  • Fennel seeds are commonly used in traditional medicine to calm the stomach and can also help by reducing inflammation. Crushing or grinding fennel seeds to sprinkle in food or use as a tea can help digestion by relaxing muscles in your stomach, relieving constipation or acid reflux while soothing irritation. In some cultures chewing on fennel seeds after meals is a common way to improve digestion.

  • Ginger has been seen to help patients with reflux problems, nausea and vomiting. Ginger can act as anti-inflammatory and help reduce irritation. The great thing is you can consume ginger in tea, add it to your soup, in a stir fry, a salad or in other meals.

  • Chamomile has been known to have soothing and calming effects which can help improve reflux and reduce stress, both good things!

  • Marshmallow root is a mucilaginous herb, which is used to help with digestive upset. It has been shown to soothe inflamed digestive tissues. You can find this in teas that you can drink after meals. Important note, this does not include actual marshmallows, but there’s room for those too if you love them.


Acid reflux can be a very unpleasant feeling and can make eating less enjoyable. Making the effort to find what triggers your reflux is the key to avoiding discomfort. Discussing any concerns with your healthcare team, especially your dietitian, can be very helpful in helping to improve symptoms.


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