Gurgle, burp, ouch—millions of Americans know too well the painful symptoms of acid reflux. The digestive disorder, marked by a hot, burning feeling that rises up from the stomach, is also called gastroesophageal reflux disease (GERD). Not only is it uncomfortable, but it can harm the esophagus over time, too, sometimes even triggering esophageal cancer.
Acid reflux arises when the lower esophageal sphincter, the circular muscle that acts as a gate between the esophagus and stomach, loosens too easily or does not maintain its tone. That allows caustic gastric acid to backwash into the esophagus, causing difficulty swallowing, wheezing, shortness of breath, persistent dry cough, hoarseness, and the feeling that you have a lump in your throat. But contrary to conventional wisdom, heartburn sufferers aren't destined for a life of bland eating, says Jorge Rodriguez, a California-based Gastroenterologist. "I'm a Cuban-American, and I always thought heartburn was just something you lived with, especially since I ate a lot of spicy Cuban food. But that doesn't have to be the case." His new book, The Acid Reflux Solution (Ten Speed Press, $21.99), outlines a cooking and lifestyle plan to manage and cure heartburn symptoms. He recommends snacks and meals to dig into, and warns against those that will cause flare-ups. What's on the menu may surprise you.
Forget, for example, what you've heard about avoiding tomatoes and spicy dishes. While these are indeed acidic, they're not "trigger foods," Rodriguez says. (Keep in mind, however, that everyone responds to food differently and has different tolerance levels.) Fewer than 12 substances have actually been scientifically proven to trigger GERD. These include: mint and anything containing mint oil, chocolate, deep-fried foods, coffee, and alcohol.
Some of these foods, like chocolate and mint, chemically cause the lower esophageal sphincter to loosen, triggering acid reflux. Others that are greasy or high in saturated fat slow digestion, which can spell heartburn. Most likely to spur an acid reflux attack? Deep-fried foods, since they're extremely hard to digest. Spicy meals, meanwhile, are OK, provided you're not in the midst of an attack. "They don't cause heartburn," Rodriguez says. "But when your esophagus is already irritated, they will burn on the way down. Once you've healed, you can eat anything you want in moderation."
While there's no absolute eat-this-not-that list, Rodriguez suggests following these tips:
Get lots of fiber. Fiber improves digestion: Some types draw moisture into the gastrointestinal tract, while others add bulk or feed the good microbes in our gut. Load up on fiber-packed fruits, veggies, nuts, and whole grains, Rodrigruez suggests. Each day, aim to eat one whole fruit, four different non-starchy veggies, and a mix of soluble and insoluble fibers, like beans, grains, and nuts.
Befriend ginger and fennel. A few ingredients are considered digestion-aids, Rodriguez says. Two standouts include ginger and fennel. Sailors have long touted the calming digestive powers of ginger, and research suggests it speeds up the passage of food from the stomach into the small intestine. Fresh, dried, candied, or pickled varieties are all good bets. And fennel, a high-fiber vegetable that can be eaten raw or cooked, is thought to relieve bloating.
Pay attention to preparation. How you prepare your food counts, too. Instead of frying meals, try roasting, grilling, or poaching. Use extra-virgin olive oil instead of butter or margarine.
Take care with dairy. Opt for goat's milk dairy products, which contain less fat and are easier to digest than cow's milk dairy. If it's cow's milk dairy you crave, reach for reduced-fat and fat-free varieties.
Eat like an Italian. The incidence of reported heartburn among Italians is only 14.8 percent, versus 38 percent in much of northern Europe and 42 percent in the United States. One reason could be that Italians eat small portions, making it easier to enjoy even trigger foods without difficulty. (Having too much food in your stomach at any one time will likely cause an attack.) They also add just enough sauce to coat pasta lightly, rather than drowning noodles in sauce, and begin most meals with a small serving of vegetables. Dessert is usually fresh fruit, and afterwards, Italian families like to take a walk together. A slow walk aids digestion, research suggests.