Natural or life-style changes

Lifestyle changes should be made that lessen the opportunity for acid to reflux into the esophagus. Sometimes these changes allow the patient to get relief of their heartburn symptoms on less medication or, less commonly, to avoid the use of medication all together.

Although there are no specific dietary restrictions, any food or substance that causes heartburn symptoms should be avoided. Examples of such foods are: chocolate, peppermint, tomato or citrus fruits. The head of the bed should be elevated using 6 inch blocks or a full-length foam wedge in order to make use of gravity to keep stomach contents below the chest and out of the esophagus at night. Using pillows to elevate the upper body is not sufficient. The evening meal should be small and no food or drink (except water) should be consumed for at least three hours before bedtime. A low fat diet may enhance gastric emptying and decrease the opportunity for food and gastric acid to bathe the esophagus, especially at night. It may also result in modest weight loss which could lessen reflux. All medications should be taken with a full glass of water -- some pills, if they remain in the esophagus, can themselves cause injury to the esophagus.

Since heartburn (gastroesophageal reflux disease - GERD) is a risk factor for esophageal adenocarcinoma (Barrett's esophagus cancer), it is also prudent to advise patients to adopt life-style changes that are believed to lessen the risk of cancer. Patients should stop smoking. Patients should be encouraged to eat a low-fat diet high in fruits and vegetables. This diet may not only lessen GERD, but is believed to decrease the risk of developing many types of human cancers.