- Big meals can be a trigger for gastroesophageal reflux (GERD).
- Practical strategies allow you to enjoy the meal without acid reflux afterward.
- A secret to a GERD-free holiday meal is as simple as a stick of gum.
The holiday feast — candlelight glinting off goblets, platters of aromatic side dishes set around a centerpiece of a majestic turkey or roast, baskets of freshly baked rolls waiting to be spread with creamy butter, and an assortment of pies, cookies and other sweets awaiting on a side table. Who wouldn’t be tempted to overindulge? But a too-full plate can mean a too-full stomach, which can onset an episode of gastroesophageal reflux disease (GERD).
With GERD, that bountiful holiday dinner isn’t being digested properly, says Sabrina Yin, RN, a nurse navigator at the Swedish Digestive Health Institute in Seattle, WA.
“Normally when we eat, food is carried from the mouth to the stomach through a tube-like structure called the esophagus,” says Yin. “At the lower end of the esophagus, where it joins the stomach, there is our lower esophageal sphincter (LES). It opens and closes like a door as food passes through, but when it doesn’t work properly, stomach acids can flow back up into the esophagus.”
Acid reflux happens occasionally in all individuals. But over time, chronic GERD can cause not just bothersome symptoms but injury to the esophagus or the potentially pre-malignant condition, Barrett’s esophagus.
Yin says, “GERD can be caused by several things, including a hiatal hernia, smoking, pregnancy, obesity — and eating a large meal, which increases abdominal pressure on the LES and causes the door to be unable to shut properly.”
Fortunately, taking some smart approaches to holiday meals means you can still have your fruitcake and eat it, too. Yin, who says she began suffering from GERD after too many late-night, coffee-fueled study sessions in college, offers her personal recommendations.
- Avoid your triggers. Everyone has their foods that can set things off. “Holiday season is associated with overindulgence in what I call ‘heart attack specials,’ or high-fat foods, must-have desserts, gravies, and carbonated beverages,” Yin says. “Triggers could be grease, herbs, spices, or sugar. For me, I love sugar, so anything too sugary would cause me to have too much acidity. So, whatever your trigger, stay away from it.”
- Moderation is the key. This is the most important thing to remember during the holiday season, Yin says. “During the festive gatherings, it’s hard to tell people, ‘Stay away from that pumpkin pie with extra whip!’ That is impossible, because it’s just a once-a-year treat.” One of the best ways to moderate is to control your portions, which ensures you won’t feel overfull.
- Dress for success. Eschew fashion for function when it comes to what you wear to the holiday feast. Yin recommends loose-fitting clothing that doesn’t put extra pressure on the diaphragm and abdomen.
- Fill your plate wisely. If you can’t resist mashed potatoes, go ahead and have a reasonable portion of them along with one guilty pleasure — that means if you put butter on them, don’t pour gravy on top, too. (The same rule applies if you are making the mashed potatoes, too — choose butter or heavy cream, but not both.) Also, make the stuffing separately from the turkey so it doesn’t absorb fatty juices. Finally, limit alcohol, caffeinated drinks and carbonated beverages that can trigger GERD symptoms.
- No post-meal cigarette. Smoking isn’t healthy at any time, ever, but especially after a big meal, when it can aggravate symptoms. Download our brochure, How to Quit Smoking Confidently and Successfully.
- Don’t linger too long at the table. Once the meal is over, the sofa looks like a tempting spot to lay back and relax, but physical activity supports digestion. “Get up, move around, do the dishes, play a game,” Yin says.
- Pack a pack of gum. A post-meal piece of gum is Yin’s secret weapon against GERD after a feast. “Chewing gum can increase saliva and digestive enzymes production, which dilutes the acidity in your esophagus and encourages peristalsis, a series of wave-like movements that help food travel through your digestive system,” Yin says.
- Raise your head when you go to bed. The dishes are clean, the relatives have gone back home and you are ready for a good night’s rest. If you don’t want to wake up with acid reflux in the middle of the night, sleep with your head elevated six to eight inches to prevent stomach acids from flowing the wrong way. “You should also wait four hours after eating before laying down in bed,” Yin says.
Everybody can experience acid reflux, but if it happens frequently, it could be an indicator of GERD. Yin says, “There are common symptoms to watch for, such as a burning sensation underneath the breastbone, persistent upper stomach pain, regurgitation of food, or frequent night waking with a scratchy throat or chronic cough caused by stomach acids flowing back up to your esophagus.” If a primary care doctor suspects it’s a chronic condition, he or she may recommend lifestyle changes and, if those don’t work, over-the-counter medication. If needed, the patient would then be referred to a gastrointestinal specialist who could conduct any necessary exams such as an upper endoscopy.
If you’ve been experiencing acid reflux or GERD, there are some steps you can take to alleviate the symptoms. “The number one step is weight loss, because it decreases pressure on the lower esophageal sphincter,” Yin says. “However, that’s a long-term commitment. More immediate measures include cutting out your daily caffeinated beverages and decreasing your alcohol consumption, because caffeine and alcohol aggravate the lining of our stomach. You can also stay away from carbonated drinks, because they increase abdominal pressure, which puts pressure on the diaphragm and causes the sphincter ‘door’ to be unable to close properly. The sphincter is like a rubber band: if it’s stretched out over time, it doesn’t contract back easily.”
Yin adds, “There is a lot of material available about GERD, but the truth is that the keys are diet and lifestyle modification. We all live in a busy world and want things to be convenient, so we don’t always restrict what we eat, or we want to pop a pill to fix everything. What’s really important, on a daily basis, is to be mindful of what you eat, what you do and how you take care of your body in general.”
If you are experiencing GERD symptoms or other gastrointestinal issues and need to see a primary care doctor, find one in our physician directory. Learn more about the Gastroesophageal Reflux Disease (GERD) and Swallowing Center, part of the Swedish Digestive Health Institute.
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This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.