[Healthy Living in the 100-Year Life Era] Lifestyle Habits to Prevent Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) commonly presents with symptoms such as heartburn and acid reflux. However, GERD can manifest with various symptoms including a foreign body sensation around the esophagus and throat, throat discomfort, indigestion, hoarseness, bitter mouth odor, difficulty swallowing, burning sensation behind the sternum and epigastric area, belching, and chronic cough.

GERD generally refers to a condition where stomach contents, along with gastric acid, reflux into the esophagus causing damage to the esophageal mucosa. Unlike the stomach, the esophagus lacks a protective mucosal layer against gastric acid, making it vulnerable to injury. GERD is a common condition in modern society, primarily caused by decreased lower esophageal sphincter pressure and irregular eating habits. Since the COVID-19 pandemic, many people have reported GERD symptoms due to irregular eating patterns, stress, and weight gain. When diagnosed with GERD at a hospital, patients are often prescribed acid suppressants. Usually, symptoms improve after taking medication for 2 to 4 weeks, allowing for discontinuation of the drugs. However, if lifestyle habits that cause or worsen GERD are not improved, the condition is likely to recur. Therefore, this article will focus on lifestyle habits that help prevent GERD.

First, overeating should be avoided because it causes stomach distension and increases acid secretion, making reflux more likely. It is better to eat small, regular meals and avoid lying down immediately after eating. It is recommended not to lie down for at least 3 hours after meals, and light walking or a gentle stroll can aid digestion. Eating slowly and reducing or avoiding fatty foods, carbonated drinks, coffee, chocolate, and alcohol?which can relax the esophageal sphincter or irritate the stomach?is advisable. Tight clothing and belts should also be avoided as they can increase abdominal pressure.

Late-night snacks should be avoided, and food intake should stop at least 2 hours before bedtime. Elevating the upper body or head by about 15 to 20 cm during sleep can help prevent acid or stomach contents from rising. If it is difficult to keep the upper body elevated, lying on the left side, considering the shape and orientation of the stomach, may also be beneficial. Additionally, constipation increases pressure on the upper gastrointestinal tract, so improving constipation with a fiber-rich diet and reducing straining during bowel movements can help. Abdominal obesity is also a risk factor for GERD, so losing weight and maintaining a normal weight if overweight or obese is helpful. Quitting smoking is beneficial for relieving and preventing GERD symptoms; studies have shown that smoking prolongs the time acidic food remains in the esophagus. Furthermore, long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen can cause GERD, so it is important to review not only newly started medications but also those taken long-term.

Acid suppressants are effective for GERD symptoms, but prolonged use has been reported to increase the risk of pneumonia, osteoporosis, and stomach cancer. However, GERD is a condition that frequently recurs, and lifestyle management is ultimately the most important factor for symptom control and prevention. A study conducted in the United States found that the more of five lifestyle habits to prevent esophagitis (maintaining normal weight, quitting smoking, exercising 30 minutes daily, following a healthy diet such as the Mediterranean diet, and limiting coffee, tea, and carbonated drinks to fewer than two cups) were practiced, the greater the preventive effect against GERD. Following all five habits reduced the incidence of GERD by about 37%. By adhering to the dietary and lifestyle recommendations outlined above, you can overcome GERD symptoms.

Jo In-Young, Professor, Department of Family Medicine, Samsung Medical Center