This Ramadan, save yourself from GERD

Dr Vito Annese, consultant gastroenterology, Fakeeh University Hospital
Dr Vito Annese, consultant gastroenterology, Fakeeh University Hospital

The acid reflux caused from either overeating or wrong food can lead to serious disorders



By Anam Khan

Published: Wed 20 Apr 2022, 3:17 PM

Last updated: Wed 20 Apr 2022, 3:19 PM

Ramadan is the time of fasting as well as celebrations. After we break the day-long fast, most of us desire our favourite comfort foods, but they frequently come with adverse digestive effects. Heartburn or acid reflux (gastroesophageal reflux disease or GERD) may detract you from the festive mood. A review study published in the journal Gut reports that the Middle East has approximately 33 per cent of GERD prevalence.

Dr Mustafa Hakam, consultant in interventional gastroenterology and hepatology, Fakeeh University Hospital
Dr Mustafa Hakam, consultant in interventional gastroenterology and hepatology, Fakeeh University Hospital

The issue is that you know that a minute of enjoyment now can result in hours of suffering later due to GERD. But this does not have to be your lifelong problem. You may savour most of your favourite delicacies without discomfort and suffering if you prepare ahead of time and make a few sacrifices. Here is everything you must know about the risk of GERD during the festivals and how to minimise your discomfort.

What is GERD?

Gastroesophageal reflux disease (GERD) is a digestive condition in which the stomach acid spills back into the oesophagus, affecting the oesophagal lining. Acid reflux and heartburn are signs of GERD. Though acid reflux and heartburn are normal, you may be suffering from GERD if these symptoms persist often or chronically.

The role of overeating

When we eat in moderation, our bodies operate optimally. With Iftars and Suhoors planned all around the town after a long pandemic-induced break, overeating is almost unavoidable.

Speaking about the food intake during the Holy Month of Ramadan, Dr Vito Annese, consultant gastroenterology, Fakeeh University Hospital, said: “Overeating causes two issues. First, having too much food in your stomach raises your chances of belching and acid reflux. Overeating can worsen the symptoms of heartburn and abdominal discomfort in those who already have GERD.”

Excessive eating causes an increase in calories. Excess calories are converted to fat and stored in the body, leading to weight gain and obesity. Excess carbohydrates will also strain the pancreas, an organ that generates insulin to regulate the glucose levels in body. Long-term overeating can result in diabetes, obesity, and metabolic disorders such as elevated cholesterol levels.

How can overeating during Ramadan cause or trigger acid reflux?

Dr Mustafa Hakam, consultant in interventional gastroenterology and hepatology, Fakeeh University Hospital, explained: “Our stomach can expand and accept a limited quantity of food and drink. Eating past fullness (satiety) raises the risk of acid reflux. When a person consumes a meal, the acid generated in the stomach tends to build up on top of the food. The acid pocket is located towards the top of the stomach when a person stands upright. Overeating increases the likelihood of belching, which exposes the lower oesophagus (food pipe from the throat to the stomach) to the caustic effects of gastric acid.”

He further added: “Gastric acid has the potential to induce chemical damage to the upper abdomen or the central lower chest. This burning feeling might be confused with the chest discomfort of a heart attack. Acid and food reflux does not happen just with large meals or eating too fast, but also when one lies down too soon after eating. In some people, lying down within three hours of eating raises the risk of acid reflux.”

Foods that can trigger acid reflux or heartburn

Several foods can induce or aggravate acid reflux and heartburn, and these may be specific for everyone. You should pay special attention to how you feel after consuming specific meals. Foods rich in fat, salt, or spice are generally the worst triggers, such as:

• Spicy meals high in citrus, tomato sauces, and vinegar

• Fatty meats can persist and raise stomach pressure, allowing acid to enter the oesophagus

• Caffeine, chocolate, peppermint, fizzy beverages

• Processed snacks, cheese

• Fast food

• Fried food

• Black pepper, garlic, raw onions

Foods that help avoid GERD

As per Reshma Devjani, clinical dietitian, Fakeeh University Hospital, along with your iftar/suhoor menu items and snacks, you can stock your pantry with items from the following three categories:

Alkaline foods

Foods with a low pH value are acidic and more prone to causing reflux. Those with a higher pH are alkaline and can assist in balancing out strong stomach acid. Alkaline high foods include salads, nuts, cauliflower, fennel, melons, bananas, and more.

Watery foods

Eating meals high in water might dilute and decrease gastric acid. Include foods like cucumber, celery, watermelons, lettuce, etc.

High fibre foods

Fibrous meals help you feel full, which reduces your chances of overeating, which may lead to heartburn. So, fill up on fibre-rich meals like whole grains (oatmeal, whole wheat, quinoa, and brown rice), root vegetables (sweet potato, carrot, turnip, and beetroot), and green vegetables (broccoli, asparagus, cauliflower, leafy greens, cucumbers, and green beans).

Additional tips to avoid GERD

These are some of the ways that can aid you in lowering your chances of developing GERD or reducing its symptoms this Holy Month of Ramadan:

• Control your portion size

Heartburn symptoms are not only associated with what you eat, but also with how much you consume. Excessive eating might cause heartburn. Limiting meal sizes can significantly lower the likelihood of developing heartburn. Break up your meals over time by eating smaller portions and being too full at one go.

• Avoid sleeping immediately after your meal

Heartburn is also caused by eating a large meal just before going to bed. You may avoid this by scheduling two or three hours between your last meal and your bedtime. This will allow your stomach to effectively digest meals.

If you get reflux before going to bed or while sleeping, consider raising your head at night. By adding a couple of additional pillows or a wedge pillow to your bed, you can limit the amount of acid that can move back up your oesophagus and avoid reflux.

• Choose the right food

To avoid heartburn, make wise meal choices. Avoid acidic, high-fat, spicy food and any food that may cause heartburn symptoms. Root vegetables, such as potatoes and carrots, are excellent for combating GERD and acid reflux symptoms.

• Reduce caffeine intake

Caffeine and energy-boosting beverages increase acid production and are known to induce heartburn. Instead, try decaffeinated or herbal teas.

• Be active

Exercise should be on your Ramadan to-do list since it will get your digestive system working. Get out and walk whenever you can, especially after a large meal. When possible, use the stairs.

What are the treatment options for GERD?

Surgeries for severe GERD:

• Fundoplication

• Transoral incisionless fundoplication (TIF)

• Stretta Procedure

• LINX Surgery

• Bariatric Surgery

Treatment for mild to moderate GERD:

• Lifestyle changes

• Over-the-counter medications

• Prescription medicine

Treatment for GERD should only be started after a thorough diagnosis and consultation with a gastroenterologist.

Ramadan’s essence is in healing, offering, sharing, enjoyment, and happiness. We must recognise that overindulging in food is not the actual core of Ramadan or Eid celebrations, but rather the road that draws additional issues into our life. So, if acidity occurs after a festival excess, home remedies, lifestyle changes, and medicines may help. Consult your doctor if you still have acid reflux/heartburn nearly every other day. They may recommend medicine or other treatments in some situations.

For more information related to GERD or gut health, visit

www.fuh.care/patient-education/stomach-digestive-system


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