Prevention

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The primary focus of prevention for gastroesophageal reflux disease (GERD) is to pay attention to your lifestyle and avoid activities or triggers that cause symptoms.

Remember: GERD occurs when stomach acid washes back up into the esophagus, the long, muscular tube that connects the back of your mouth to your stomach.

To prevent mechanical dysfunction of the lower esophageal sphincter, you should avoid activities that increase the amount of pressure on your abdomen or increase the pressure on the lower esophageal sphincter. These include:

• Bending over and other exercises that squeeze your abdomen, and exercising on a full stomach.

• Tight clothing around your waist, such elastic waistbands and girdles can increase the pressure on your stomach.

• Lying down after a meal. If you are flat on your back after a large meal, it's easier for your stomach contents to wash back up into your esophagus. For this same reason, no late-night snacks just before going to sleep. And elevate the head of your bed six to eight inches to aid gravity in keeping acid in your stomach, where it belongs, while you're sleeping.

• Large meals. Large amounts of food in the stomach put more pressure on the lower esophageal sphincter, causing it to remain open.

To prevent functional problems, which weaken the lower esophageal sphincter or irritate the lining of the esophagus:

• Stop smoking and avoid tobacco products. Some studies indicate that nicotine causes relaxation of the lower esophageal sphincter. Other studies show that smoking changes the saliva so acid isn't cleared from the esophagus quickly enough, resulting in damage to the esophagus.

• Avoid foods that trigger symptoms such as citrus products, tomato sauces, peppermints, chocolate, onions, coffee, fried foods, and carbonated beverages.

• Avoid drinking alcoholic beverages. Alcohol can relax the lower esophageal sphincter and cause erratic contractions of the esophagus that can allow acid to reflux into the esophagus and cause heartburn.

• Check your medications. Some medications may make your symptoms worse. But don't stop taking any without first consulting your health care professional. Common drugs that might have these effects include drugs to treat asthma and emphysema such as theophylline; anticholinergic drugs used to treat Parkinson's disease and asthma and found in some over-the-counter cold medications; hormones such as progesterone that may be found in birth control pills and some calcium-channel blockers, alpha-blockers and beta-blockers used to treat heart conditions or high blood pressure; certain drugs that affect the central nervous system; iron tablets.

While some drugs make GERD symptoms worse, others can cause pill esophagitis, a condition that results in symptoms similar to GERD but is not actually due to reflux. Pill esophagitis occurs when the pill is swallowed but doesn't make it from the esophagus to the stomach because it gets stuck on the esophagus wall. This burns the lining of the esophagus, causing chest pain, pain when swallowing and esophageal ulcers. Medications associated with pill esophagitis include aspirin, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Aleve), alendronate (Fosamax), potassium and some antibiotics (especially tetracycline or doxycycline).