Nutrition Related Diseases

GASTROESOPHAGEAL/GASTRO-OESOPHAGEAL REFLUX DISEASE (GERD/GORD) / HIATUS HERNIA
What is the physiology behind this condition?

Reflux is a normal physiological function. Lower oesophageal relaxation allows for the venting of gas.

Problems arise when there is an increased occurrence of both gas and liquid entering and leaving the lower oesophagus (GERD/GORD). This results in oesophageal hypersensitivity. GERD can affect the oesophagus, larynx, mouth or lungs.

Symptoms of reflux include:
  1. Heartburn (6%) and regurgitation (16%)
  2. Pregnant women may experience heartburn (6-72% reported) with heartburn generally increasing in the third trimester.
  3. Symptoms of GERD also include chest pain and dysphagia, chronic non-specific cough (possible in 21-41% of patients), asthma (possible GERD symptoms in 51-59% asthma patients), and chronic laryngitis. Other symptoms may include dyspepsia (38%), epigastric pain, nausea, bloating and belching.
  4. A 2011 systematic review suggested the intensity of symptoms might decrease after age 50.
Risk factors for GERD/GORD:
  1. Obesity
  2. Age
  3. Genetics
  4. Pregnancy
  5. Trauma

These factors affect the normal oesophageal junction, by causing the lower oesophageal sphincter to relax, this leads to an increase in intra-abdominal pressure, ultimately creating a hiatal hernia. The other factors that may exacerbate impaired function of the oesophageal junction include:

  1. Individual-specific diet triggers
  2. Neuromuscular dysfunction
  3. Oesophageal fibrosis
Risk factors for Hiatus Hernia:
  1. Heartburn
  2. Regurgitation of food or liquids into the mouth
  3. Backflow of stomach acid into the oesophagus (acid reflux)
  4. Difficulty swallowing
  5. Chest or abdominal pain
  6. Shortness of breath
  7. Vomiting of blood or passing of black stools, which may indicate gastrointestinal bleeding
Dietary advice for Hiatus Hernia and/or GERD/GORD:
  1. Eat small frequent meals
  2. Do not wear tight fitting clothes
  3. Sit upright for at least 1 hour after meals
  4. Have an early dinner (at least 3 hours) before going to bed
  5. Attempt weight loss if you are overweight
  6. Avoid high-fat meals/food as this slows digestion (deep-fried foods, chocolates, oils, ready-made meals, takeaways, pastries)
  7. Avoid gas-forming foods
  8. Avoid spicy foods
  9. Elevate head when going to bed
  10. Avoid smoking
  11. Avoid coffee, peppermints and normal tea
  12. Have soluble and viscous fiber – fruit and veg

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