Your esophagus is the tube that carries food downward from your mouth. A round lower esophageal sphincter (LES) muscle opens so food can enter your stomach. It’s supposed to close when digestion begins so stomach acid can’t flow back up into your esophagus. But when you have gastroesophageal reflux disease (GERD), your LES doesn’t function properly. The resulting acid reflux can cause painful heartburn. While your stomach can handle the harsh effects of your digestive juices, the lining of your food pipe can’t. Over time, chronic GERD can cause erosive esophagitis (EE). This inflammation, irritation, tenderness, soreness, and tissue damage can lead to complications such as Barrett’s esophagus, a precancerous condition. Start feeling better today by following experts’ advice on overcoming and avoiding recurring EE.
Diagnosis and Treatment for Erosive Esophagitis
Pain and severe heartburn are the primary symptoms of both GERD and erosive esophagitis. See your doctor if you feel abdominal pain and burning that extends up into your mid-chest area. Other symptoms may include difficulty swallowing, nausea, vomiting, sore throat, cough, and bad breath. An esophagoscopy procedure can diagnose erosive esophagitis. Intravenous sedation will calm you and prevent discomfort. Using an endoscope, a flexible lighted viewing tube, your doctor can examine the internal structures of your esophagus. If EE is evident, he may prescribe a proton pump inhibitor (PPI) like Nexium (Esomeprazole). It blocks the effects of all three major final common pathways of acid secretion — histamine, acetylcholine, and gastrin — for acid stimulation. Nexium heals the majority of erosions in the esophagus in about four to eight weeks. It also reduces continuous acid reflux, so long-term use can help prevent EE from returning. In some cases, surgery may be necessary to repair the esophageal sphincter muscle.
Erosive Esophagitis Diet Tips
Patricia Nevins, RN, MSN, provides eating tips and advises which beverages and foods to avoid and consume to prevent EE recurrence.
Eating habits: Acid reflux is worse after large meals, which cause increased gastric pressure. So eat small quantities more frequently throughout the day to aid in digestion. Drink between meals instead of while eating. Remain upright for a few hours after each meal. Keep a beverage and food diary to determine which ones aggravate your symptoms so you can eliminate them from your diet.
BRAT diet: Replacing GERD-aggravating foods with a bland diet during acute episodes of erosive esophagitis gives it a chance to heal and helps minimize your symptoms. One strict option is the BRAT diet. Consisting of bananas, rice, applesauce, and toast, it encourages easily digestible foods. In addition to boiled white rice, you also may eat processed oats and cream of wheat cereals. Breads should contain refined flour.
Beverages: Avoid all caffeinated drinks. Caffeine decreases the pressure around your LES, which allows food and acid to backflow from your stomach into your esophagus. Medical-Surgical Nursing recommends not drinking carbonated beverages because they also reduce pressure on the sphincter muscle at the lower end of your esophagus. Avoid problematic alcoholic beverages that can stimulate acid production. Drink herbal teas, decaffeinated coffee or tea, and water instead. Fruit juice and vegetable broth make good alternatives if they don’t contain acidic fruits or vegetables like orange and tomato.
Fruits and vegetables: Produce is important for providing vitamins, minerals, and fiber in your diet. However, you need to avoid fruits and vegetables that are hard to digest and cause gas. Carrots, peas, potatoes, and squash are easy to tolerate if you cook them. Bananas, peeled apples, and pears are good fresh fruit choices. You also may include applesauce, canned peaches and pears, and frozen blueberries.
Lean meat: Skip fatty and fried meats because they take longer to digest. Fat also is another culprit that decreases LES pressure. Choose lean poultry, fish, and pork instead. Buffalo is a leaner option for red meat than beef. Bake, broil, or boil meats. Season them with spices that aren’t irritating to your stomach or esophagus. Small amounts of salt and pepper, rosemary, thyme, and basil are unlikely to cause pain.
Dairy: Avoid high- and full-fat options. Select skim milk and low-fat yogurt and cheese instead.
Helpful Lifestyle Changes for GERD
Don’t smoke: This bad habit affects esophageal motor function and increases air swallowing, which results in frequent belching to vent your distended stomach.
Lose weight: Carrying excess pounds, especially around your middle, and wearing overly tight clothes that press on your abdomen can force stomach acid up into your esophagus. Dropping that extra weight and trimming your waistline can bring symptom relief.
Exercise: Physical activity helps alleviate stomach pressure from bloating and gas. But the National Heartburn Alliance warns against exercises like headstands that reverse the natural path of digestion and crunches that stress abdominal muscles. Modify other workout routines to decrease the chance that they’ll push digestive juices back up your esophagus. Switch from jogging, running, or weightlifting to low-impact walking, bicycling, hiking, swimming, dancing, or Pilates.
Elevate the head of your bed: Gravity is important to keep gastric contents in your stomach and return regurgitated material when reflux occurs. Lying down too soon after eating can trigger GERD, so wait at least three hours. Raise your torso and head higher than the rest of your body when sleeping. Use a wedge pillow or place blocks under the head of your bed to elevate it and avoid nighttime reflux.