DIET AND FITNESS:

What Is GERD?
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Last updated July 11, 2016 (originally published January 26, 2008)
By Susan M. Callahan, Associate Editor and Featured Columnist


GERD, gastrointestinal reflux disease, is defined as the
condition in which you experience acid reflux more than twice a
week.  The treatment for GERD is therefore the same as the
treatment for acid reflux or heart burn.

GERD afflicts up to 40% of us in the United States, according to
a 2006 study from the Medical University of South Carolina.
Around the world, the incidence of GERD varies. In Argentina,
for example, 21% of people experience GERD, and in Finland
31% of people have GERD, while only 12% of Japanese and
4.7% of Koreans have GERD.


There are factors which increase your risk for GERD, including
frequent alcohol use, eating spicy foods and foods with
excessive oil, and
stress. Research has not yet determined
whether bacteria, such as the bacteria which has been
implicated in causing peptic ulcers, may also be at fault for
causing GERD and other intestinal diseases such as Crohn's
disease.

Being Obese Raises Your Risk for GERD

But one of the biggest risk factors for GERD is being obese,
according to a recent study.  A 2011 study from the HUNT
Research Center's Department of Public Health and General
Practice at the Norwegian University of Science and Technology
in Levanger, Norway studied the health records of 30,000
people. The research team discovered that your risk for
developing GERD  increases as you  age and as you put on
weight.

























How Scientists View GERD Is Changing

GERD was once thought of as a condition that started in the
stomach and affected the esophagus.  The theory was that acid
in your stomach flushed back upward into the upper throat
area, causing a burning sensation in your throat.

Acids which are in your stomach to break down food were
believed to be the culprits for the burning in your throat known
as "heart burn".

That theory still holds true. But is has now been expanded.
Now, researchers have identified another culprit in the
symptoms of GERD. That culprit is an enzyme called "peptin".

Peptin is only produced in your stomach.  That is why when
peptin was discovered in unusual places outside the stomach
--- such the ears and the lungs --- scientists knew that GERD's
damage was no longer confined to the throat.

Also, patients with GERD were complaining also of ear
problems and breathing issues.  That led scientists to isolate
peptin's role in causing GERD damage. As a 2012 study led by
Dr. Karna Dev Bardhan of the Rotherham General Hospital in
the UK noted: "
we are increasingly aware reflux can reach
much further, extending beyond the upper esophagus into the
pharynx, larynx, airways, and middle ear, and may damage
these structures".

How can acids and peptin in your stomach end up in your ear?
The UK study proposes a theory that peptin reaches your ear
and lungs because it is expelled from your stomach not as a
liquid but as an aerosol spray.

If you suspect that you have GERD, it is important to bring up
to your doctor or nurse any other unusual symptoms that you
may be experiencing such as ear problems.


How Do You Combat Pepsin Aerosol?

Pepsin depends on acidity, according to a 2011 study led by Dr.
Karna Bardhan from Rotherham General Hospital in the UK.
Pepsin is "stable" up to a PH 7.  When the environment
becomes more acidic than PH7, pepsin is "regains activity after
re-acidification".  Thus, one way you may be able to better
control pepsin's aerosol assault is to manage the PH of foods
that reach your stomach.


But in which direction should you manage the PH? Higher or
lower than 7?  Foods or drinks are "acidic" if they have a PH
below 7.   Any substance with a PH above 7 is called "basic".

To manage GERD, scientists say that you have to become a PH
detective.


Research has determined that the "normal esophageal PH is 7",
and that the accepted definition of GERD or acid reflux is when
the PH of the esophagus reaches 4, according to 2006 review
study led by Dr. Radu Tutuian and Dr. Donald Castell of the
Medical University of South Carolina.

You should therefore avoid eating foods, especially close to
bedtime, which would drive the PH of your esophagus below 7
and close to 4.

At the top of the "don't eat/don't drink" list are carbonated
drinks, wines and juices, which the researchers note have the
power to "increase reflux episodes and esophageal acid
exposure time."  In fact, avoid all acidic foods or drinks.
Lemons, the classic acidic fruit, for example, have a PH of 2.2.  
So, never have lemons on your fish, lemons in your salad
dressing at dinner and so on.

By the way, some would take issue with the advice to avoid
lemons, since they believe that lemons, once they are digested,
are actually not acidic but are the opposite (alkaline). Just test
your own saliva every morning before you eat or drink to see
how various foods and drinks affect you personally. You may
find that lemons actually make your blood less acidic.

Which brings us to the most important point. You have to test
yourself. Invest in a PH testing kit, which you can usually
obtain for a few dollars at your local drugstore or online.

Not sure about the PH of a food or drink? Consult the
FDA's list
of PH of common foods
.











































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Red peppers and other spicy
foods can cause
gerd.