If you have had occasional heartburn, you know how uncomfortable it can be, and about 20% of Americans experience heartburn at least once a week.
People who experience chronic heartburn may have GERD, or gastroesophageal reflux disease, often called acid reflux. This reflux is caused by stomach acid that flows back into the esophagus. Over a period of time, complications from chronic reflux can lead to complications with swallowing and increase the risk for esophageal cancer.
Nearly all studies conducted have found a relationship between obesity and GERD. The increased incidence of GERD and excess weight is believed to be caused by excess belly fat putting pressure on the stomach, and the higher the weight, the more likely one is develop GERD. Treatment for GERD includes lifestyle changes, medication, and/or surgery.
An effective treatment for GERD is lifestyle modification includes:
· Weight loss
· Increased physical activity
· Eliminating foods that typically cause reflux such as; alcohol, caffeine, chocolate, fried foods, spicy foods, cooked tomato sauces, mint, an carbonated beverages
· Eat smaller meals
· Don't lie down 3 hours after eating
Your doctor may also recommend medication, either by prescription or over-the counter. And if you are obese, your doctor may recommend you have bariatric surgery to resolve your problem.
Roux-en-Y gastric bypass surgery has been consistently shown to improve GERD symptoms. At this time it's not clear if the improvement is due to weight loss or related to the actual surgery itself which creates a pouch. Adjustable gastric banding may or may not improve GERD so many surgeons do not recommend this procedure because of conflicting data and outcomes. A more recent surgery, the gastric sleeve, has little long-term data on the improvement of GERD. The long, narrow pouch may actually worsen or cause reflux. For this reason, if someone has GERD a sleeve should be done with caution.
The best treatment for you is the one you discuss with your physician, and after weighing your options, you both agree to a remedy that meets your health needs and fits your lifestyle.
Vicki Bovee, MS, RDN, LD, Bariatric Expert
Friendenberg, F., Xanthopoulous, M., Foster, G., & Richter, J. (2008). The association between gastroesophageal disease and obesity. Am Jour of Gastroenterology, 103, 2111-2122.
Kushner, N. & Kushner, R. (2012). Obesity & heartburn: What is the link?. Your Weight Matters: Obesity Action Coalition.
Prachand, V., & Alverdy, J. (2010). Gastroesophageal reflux disease and severe obesity: Fundoplication or bariatric surgery?. World Jour of Gastroenterolgy, 16(30), 3757-3761.