Can I Beat Acid Reflux? Dr. K’s Top 10 Tips
At-A-Glance
- In this post I share my top 10 tips for beating acid reflux, especially Respiratory Reflux; some are easy, and some are hard. Yes, you can beat your reflux.
- The three most important “don’ts” are not eating too late at night, fried food, and soft drinks. It is true: You are what you eat and drink. And what you eat may be eating you.
- Whether you do some or all, 10% or 100%, each tip will help; just do your best. I have added links to many relevant posts that may help you understand the reasoning behind the tips.
Note: As of this writing, Respiratory Reflux and Laryngopharyngeal Reflux (LPR) are still synonyms – the terms can be used interchangeably. However, going forward, the term Respiratory Reflux should replace LPR, as it is more intuitive, easier to pronounce, and more comprehensive.
- Avoid Eating Diner or Snacking Late
- Moderate or Abstain from Alcohol
- No Fried or High-Fat Foods
- No Soft Drinks, Including Fruit Juice, Seltzer, Etc.
- Avoid Acidic Fruit, Especially Citrus
- Avoid ACE-Inhibitor Blood Pressure Medicines
- Moderate Caffeine and Eliminate Nicotine
- Sleep on an Incline
- Take Alginates Before Bed
- Drink and Spray Throat with Alkaline Water
Below are explanations for each tip as well as links that will help you further understand the background information. Plus, at the bottom of the post is the “Pearl of the Week.”
1. Avoid Eating Diner or Snacking Late
Ideally if you have reflux, you should go to bed with an empty and quiet stomach. Over the years, I have observed that the predominant pattern of reflux has changed; most people have Silent Nocturnal Respiratory Reflux. So, unfortunately eating – especially overeating, especially with alcohol – is the number one risk factor for acid reflux. By the way, eating anything before bed is a really bad idea, even worse is a nightcap.
Maybe so many older people eat at 5:00 pm for good reason? Recently I posted a Reverse Intermittent Fasting program in which the eat/sleep interval was 7 hours. So, if you don’t drink Alcohol and if you don’t make dinner your major refueling meal of the day (and no snacks), then 3 hours is probably still the right number. Add any of the other reflux risk factors, and the time eat/bed interval goes to 4-6 hours.
2. Moderate or Abstain from Alcohol
Alcohol is the second leading reflux risk factor for respiratory reflux. So if your reflux is bad, consider doing a dry this month (whatever month it is); obviously, it doesn’t have to be dry January. And party people, if you fall asleep on the sofa with a buzz, you’re going to reflux all night, period.
3. No Fried or High-Fat Foods
Fat makes the Lower Esophageal Sphincter relax, which then leads to reflux. So high-fat foods, like cheese, are bad. That said, there’s a big difference between putting a bit of Parmesan on your salad or pasta compared to eating half a wedge of brie.
For the refluxer, fried food and fast food are out. Some time in the future, you should be able to say I haven’t been to a fast food restaurant in 10 years. High-fat foods include meat, especially fatty beef and lamb.
4. No Soft Drinks, Including Fruit Juice, Seltzer, Energy Drinks, Etc.
You may not know, but the stomach enzyme, Pepsin, is what does the damage to your tissue; it causes inflammation, disease, and even cancer. Once you have reflux, some of that nasty enzyme is stuck on your vocal cords, your throat, wherever it lands. Getting rid of pepsin is a major goal of treatment, but …
If you drink a Coke, Pepsi, energy drinks, sports drinks, or even fruit juice, the acidity is so high (like stomach acid) that you activate the pepsin. My book Dropping Acid: The Reflux Diet Cookbook & Cure explains why soft drinks are so bad for you; it’s the acid. By law, anything in a bottle or can must be acidified to prevent growth of pathogens. I recommend drinking NOTHING in a bottle or can except still water, and then, preferably Alkaline Water.
5. Avoid Acidic Fruit, Especially Citrus
Acidic fruit is also a problem. Lemon, for example, pH of 2.7 is the most acidic thing in nature, and the same is true of limes. For any person with reflux all citrus should be avoided as well as green apples and most berries.
There is an exception, based on pH-Balancing. For example, if you are having oatmeal or cereal with some kind of (high pH) milk, then you can probably get away with adding some more acidic fruits, but still stay away from citrus. Here is the pH (acidity) of most Fruits and Vegetables.
6. Avoid ACE-Inhibitor Blood Pressure Medicines
ACE-inhibitors are the most commonly prescribed type of high blood pressure medicine in the U.S. today. Unfortunately, they cause reflux and Chronic Cough. So, if you are on an ACE- inhibitor, you may want to ask your doctor to consider another class of blood pressure medication for you.
7. Moderate Caffeine and Eliminate Nicotine
Nicotine and caffeine both make the lower esophageal sphincter relax; and it’s been shown that reflux events occur with 77% of cigarettes smoked. Nicotine causes reflux, same with tobacco chewing and vaping; all make the lower esophageal sphincter relax. If you smoke, quit. And it’s the same for Chewing or Vaping.
Caffeine is not a problem in moderation; but it can relax the lower valve, too. I recommend 2 cups of tea or Coffee a day, and moderately more if decaffeinated. If you drink a pot of coffee before noon, you’re going to have big-time reflux.
8. Sleep on an Incline
If you come home after a big night out, sleep your recliner at 45° … gravity helps. Meanwhile, sleeping inclined is good for all refluxers, especially during Reflux Detox. Gravity helps keep stomach contents in your stomach.
For respiratory refluxers, a regular “reflux wedge” is not high enough. “Pillow it up” or try the recliner. If you have Serious Reflux or Barrett’s Esophagus, you may want to purchase a bed that goes up and down.
9. Take Alginates Before Bed
Taking Alginates like Gaviscon Advance Aniseed before bed is a good idea. After it is swallowed, it forms a “raft” in the stomach and rises to the top helping to mechanically block the lower stomach valve (LES). It is a really good non-medical treatment.
10. Drink and Spray Throat with Alkaline Water
Alkaline water pH 9.5 or higher is great; it kills pepsin so if you can drink it and spray it. This will especially help people who have a lump-in-the-throat, sore throat, and/or a voice problem. You can both Drink and Spray Alkaline Water; and it is Completely Safe.
Pearl of the Week
Although Banana (pH 5.7) is one of the best fruits for refluxers, especially during Reflux Detox; it is a reflux trigger for about 5% of people. And for those with banana as a trigger it appears that the riper the banana, the more likely it is to trigger reflux … perhaps it’s the in ester in ripe bananas.
Resources
If you would like to schedule a virtual consultation with me, Book Online. For more information about diagnosis and treatment of respiratory reflux, see my two companion books on Amazon: Dropping Acid: The Reflux Diet Cookbook & Cure and Dr. Koufman’s Acid Reflux Diet, and for chronic cough: The Chronic Cough Enigma.
