What is GERD?
Gastroesophageal reflux disease (GERD) is a chronic relapsing disease in which a spontaneous, regularly repeated reflux of the stomach contents into the esophagus occurs. As a result, the lower esophagus is affected. Throwing the stomach content into the esophagus is considered normal if it occurs occasionally and is not accompanied by negative factors. The disease is evidenced by the frequency of casting and inflammatory processes of the gastrointestinal tract.
The most important principle of therapeutic nutrition in GERD, regardless of the phase of the disease, is frequent fractional nutrition (5-6 times a day) in medium portions. It is extremely important not to go to bed or to remain in an uncomfortable sitting (bent) position for 1.5-2 hours after eating, not to eat food just before bedtime. It is not advisable to wear tight clothes, tighten your belt. Sleep better with an elevated headboard. For people with excess body weight, weight loss is advisable. Animal fat contained in products should be evenly distributed over all meals and excluded (minimized) in the last meal before bedtime.
Reduce acid aggression and prevent reflux of gastric contents into the esophagus
When eating, part of the acid accumulated in the stomach is “consumed” by the digestion process. When eating a small amount of food per meal, overstretching of the stomach is excluded, which is an additional factor contributing to the excessive secretion of hydrochloric acid. At the same time, not even a large meal is enough to bind and remove enough acid from the stomach. Reducing acid aggression is achieved by fractional nutrition in small portions of food, as well as by controlling the quality of the diet (animal fat lingers in the stomach for as long as possible, which is accompanied by significant secretion of hydrochloric acid after eating). The most important aspect of clinical nutrition for GERD is the timely evacuation of food from the stomach to the intestines. A recumbent and half-bent sitting position hinders the normal evacuation of food from the stomach. Overeating and tight clothing increase the pressure in the abdominal cavity and contribute to the throwing of gastric contents into the esophagus.
Thus, with the help of lifestyle modification, the severity of gastroesophageal reflux can be reduced.
Methods of cooking and characteristics of food
Food should be steamed, eat it better in boiled or stewed form. In the period of exacerbation of GERD and the presence of erosion in the esophagus, all products must be served in a wiped form. In the period of remission and the presence of non-erosive reflux disease, the use of baked dishes is also possible. The temperature of the served dishes should be 40-50°C.
Mechanically coarse food can injure the mucous membrane of the esophagus and stay in the stomach longer, which contributes to additional secretion of hydrochloric acid, excessive gastric motility, and reflux of the gastric contents into the esophagus. This can increase heartburn, belching, regurgitation and provoke the appearance of pain in the epigastrium and behind the sternum. Perfect food temperature ensures timely evacuation of food from the stomach. When eating cold dishes, food lingers for a long time in the lumen of the stomach, since adequate digestion begins only when the temperature reaches 38°C inside the food lump. Hot food has a traumatic effect on the mucous membrane of the esophagus and stomach.
Recommended foods and dishes
Fats
Butter, sunflower and olive oil in its natural form or added to dishes.
Bread and flour products
Wheat bread from the flour of the highest and 1st grade of yesterday’s baking or dried; non-rich buns (1-2 times a week); dry biscuit, cookies without butter (shortbread, crackers).
Fish
Low-fat types without skin in a piece or the form of a cutlet mass in boiled form, aspic on a vegetable broth.
Dairy
Whole milk (add to tea, cereals), one-day yogurt, fresh non-sour cream, and cottage cheese in dishes (lazy dumplings, casserole, pudding, etc.); mashed cheese.
Meat and poultry
Low-fat meats (beef, veal, rabbit), boiled chicken or skinless or steamed, mashed (meatballs, dumplings, meatballs, mashed potatoes, soufflé, roll) and steamed beef tongue and liver.
Eggs
Soft-boiled or hard-boiled, steam omelet and scrambled eggs (up to 2 eggs per day).
Vegetables
Beets, potatoes. Carrots, cauliflower, green peas, cooked in water or steamed and mashed (mashed potatoes, souffle); steamed puddings, zucchini, and pumpkin, sliced. In boiled form. Onion and garlic in small quantities as an additive to heat-treated dishes. Occasionally ripe non-acidic tomatoes in small quantities, fresh cucumbers.
Soups
From mashed vegetables, milk cereals, mashed from homemade noodles with mashed vegetables. Soup-dairy purees, from vegetables, from pre-cooked chickens or meat.
Cereals, pasta, and legumes
Porridge boiled in milk or water (semolina, well-boiled rice, buckwheat, and oatmeal). Steam puddings, soufflés, ground cereal cutlets. Boiled pasta.
Drinks
Tea with milk or cream, weak cocoa on milk, sweet fruit and berry juices, broth of wild rose, wheat bran.
Sauces and spices
Dairy, sour cream, egg-butter sauces. Dill, finely chopped parsley in soups and salads, vanillin.
Fruits, sweet foods and sweets
Ripe sweet fruits and berries in the form of jelly, mousses, mashed compotes. Sugar, honey, jams, and preserves from sweet berries and fruits, candy, marshmallows.
Excluded Foods
Bread and flour products
Fresh rye bread, pancakes, pies, pastries.
Dairy
High acidity dairy products, spicy cheeses.
Fish
Fatty species (sturgeon etc.), smoked, salted, fried.
Eggs
Scrambled eggs and fried omelet.
Fats
Lard, animal fat in meat dishes, refried butter.
Meat and poultry
Fatty and fried meat and poultry, canned food.
Sauces and spices
Very spicy sauces and spices.
Cereals, pasta, and legumes
Millet, pearl barley, bean.
Drinks
Beer, fortified wine. Strong alcoholic drinks, coffee, carbonated drinks, juices of sour berries and fruits.
Vegetables
White cabbage, eggplant, onions, garlic, mushrooms, canned vegetables.
Soups
With fish or mushroom broth.
Fruits and sweets
Sour and unripe berries and fruits in raw form, chocolate, halva, nuts, uncooked dried fruits.
