e’ve all been there – Thanksgiving dinner, the table looks beautiful, there are ten different kinds of side dishes on the table next to the turkey and they all look amazingly delicious. You must try them all, so you overindulge in rich, fatty foods, and later find yourself up at night with a stomach ache and a fiery feeling in your chest.

Most of us are familiar with those feelings: a burning sensation near your heart; a sour taste in your mouth; an irritated esophagus; belching; bloating; perhaps even nausea or an irksome little cough—all of these are symptoms of heartburn. About 60 million Americans experience heartburn once a month, which is considered normal, but 15 million of that group have it daily. When heartburn occurs frequently (twice a week or more), it is diagnosed as Gastroesophageal Reflux Disease, or GERD.

GERD symptoms occur when the sphincter (a ring-like valve) between the esophagus and the stomach (called the lower esophageal sphincter) becomes relaxed and acid from the stomach backs up into the esophagus, larynx, trachea and, sometimes, the lungs. This reflux causes heartburn symptoms and, in 10-15% of people, non-heartburn symptoms including asthma, laryngitis, chronic cough and chest pain. GERD is not merely uncomfortable and irritating, but it is also dangerous. Over time, the exposure of the delicate tissue that lines the esophagus to stomach acid causes erosion and, in some cases, a pre-cancerous condition called Barrett’s esophagus. GERD can also interfere with your sleep, making you groggy during the day and increasing your desire for caffeinated beverages and carbohydrates, all of which can make GERD worse.

Just because GERD is common doesn’t mean that you should resign yourself to living with it – there are many dietary and lifestyle measures that you can take to treat it. If you are overweight or pregnant, smoke, take certain medications or have a family history of GERD, then you are much more likely to experience it. Although you can’t change your genes or speed up your pregnancy, you can modify your eating and smoking habits and explore alternatives to your medications with your doctor or pharmacist.

Losing weight can help relieve heartburn symptoms, especially for younger women, since estrogen may be related to some cases of GERD. Carrying weight around the midsection puts extra pressure on the stomach, which can force stomach acid upwards into the esophagus and connected organs. Since men and some women tend to carry extra weight in that area, losing weight will be helpful for those with apple-shaped bodies, too. Similarly, avoid wearing tight clothing, especially belts and waistbands, since it can put pressure on your stomach that can cause acid reflux.

Smoking even one cigarette occasionally is known to irritate the digestive system and relax the sphincter between the esophagus and stomach, allowing stomach acid to reflux upwards, so quitting smoking entirely can help cure GERD for most smokers.

Sleep position also seems to play a major role in treating GERD. Elevating the head of your bed when you sleep and sleeping on your left side can be tremendously helpful. Stomach contents seem to stay put better when GERD sufferers sleep on their left sides as opposed to any other sleeping position. Use a foam wedge on top of your mattress or blocks under the bed frame to elevate the head of your bed four to six inches; it’s important to elevate your whole upper body, not just your head, so that gravity can help move food downwards. It’s also imperative to remain vertical for at least two hours after eating, so avoid late dinners and midnight snacks. Wait 30-60 minutes after eating and then go for a walk to help move things along.

What and how you eat can also have a major effect on your heartburn—just think about how you feel after a Thanksgiving meal. Overfilling your stomach with food puts upward pressure on your lower esophageal sphincter, so eating five smaller meals instead of three larger meals may be helpful if you tend to overeat.

Most people with GERD find that certain foods are irritating, but those foods are different for everyone. Commonly irritating foods and beverages are coffee (decaf and regular), carbonated drinks, fruit juices, alcohol, deep fried foods, spicy foods, fatty foods, chocolate, peppermint, tomato products, citrus, garlic, dairy products and starchy grains such as rice and wheat. The best way to figure out what affects you is to keep a food journal and record everything you eat. When you experience symptoms of GERD, mark it in the journal and go back over what you ate that may have caused irritation. Confirm your suspected foods with a test of eating each food individually.

Chewing gum after a meal can be soothing for some people because it stimulates saliva production, which helps to neutralize stomach acid. However, it may make GERD worse for people who swallow air when they chew or for those who are sensitive to sugar alcohols. Another potentially helpful strategy is to cut back on fluids that you drink while eating and drink most fluids in between meals. Water is the best choice, since it is hydrating and free of any potential irritants. Also try higher protein meals instead of starchy or fatty meals, since protein helps the lower esophageal sphincter stay shut. Plenty of fiber is also important for helping food move through you in a downward direction. Aim for at least 40 grams of fiber a day.

Finally, stress can really irritate your digestive tract. Try relaxation techniques like deep breathing and meditation, or even walking or yoga—whatever helps you feel calmer inside. Regular exercise can help tone the gut muscles and improve blood flow to the digestive tract. The following gentle twisting and bending stretches can be soothing:

1. Sit sideways in a chair with a low back, feet planted on the floor under your knees. Close your eyes and take deep, calming breaths. Sit up tall and as you exhale, turn towards the back of the chair and take a hold of it. Inhale into your ribcage. As you exhale, twist your torso and head further towards the back of the chair. Go deeper into the twist with each exhale, but not beyond your comfort zone. Hold the pose for several breaths, gently release, and repeat on the other side.
2. Sit as described above. As you inhale, lift your chest and sit tall. As you exhale, gently roll your torso over your lap, bending from the hips and leading with your chest. Allow your head and arms to hang down freely and take a few relaxing breaths. Gently roll up to the starting position on an inhale. Repeat 4-6 times.
3. Lie flat on your back with your feet slightly apart, arms at your sides with palms facing up. Close your eyes and as you slowly inhale, expand all sides of your belly. As you slowly exhale, contract your belly. Pause and repeat 20-30 times.

The bottom line is that losing weight, elevating the head of your bead and sleeping on your left side are the most helpful measures for alleviating GERD. Since dietary irritants are very individual, there is no clear-cut food that should be eliminated, though it’s important to figure out what irritates you and avoid it. Talk to your doctor if it takes less than a Thanksgiving-type meal to set off your heartburn symptoms. Medication may be necessary to eliminate GERD and allow damaged tissue to heal.

Eating should be a pleasurable and gratifying experience, not a painful and regretful one. If you’re suffering from GERD, then try the effective strategies discussed here to help bring the enjoyment back to eating by keeping your stomach acid where it belongs.

GERD Irritants

• Carrying extra weight, especially around the middle
• Pregnancy
• Smoking
• Lying down too soon after eating
• Overeating
• Wearing tight clothes
• Stress
• Constipation
• Drinking alcohol
• Eating fatty, spicy, acidic or starchy foods
• Being sedentary

• Loosing weight
• Stopping smoking
• Remaining vertical 2-3 hours after eating
• Elevating your head of bed
• Sleeping on your left side
• Eating small frequent meals
• Wearing loose clothing
• Using a relaxation technique
• Eating plenty of fiber
• Minimizing alcohol intake
• Avoiding foods and drinks that irritate you
• Increasing protein in diet
• Exercising