GERD: Symptoms, Dietary Tips, and Concerns - Gastroenterology and Hepatology

Gastroesophageal reflux disease (GERD), abdominal bloating?

Hello, doctor.
At the end of last month and the beginning of this month, I experienced two episodes of acid reflux and suspect I might have gastroesophageal reflux disease (GERD).
As a result, I have reduced my food intake and avoided spicy and fried foods.
However, in the past few days, I have occasionally experienced diarrhea after breakfast, which usually resolves by noon, occurring about every two to three days.
Yesterday, I felt pain in my upper abdomen, a persistent bloated sensation, and increased belching, about once every hour or two.
Therefore, I visited a gastroenterologist who performed an ultrasound, but due to the pandemic, the clinic did not conduct an endoscopy.
The doctor informed me that these symptoms are typical of GERD and noted that I have significant bloating.
They prescribed medication for me and advised scheduling an endoscopy in the future, as well as providing dietary recommendations.
I have a few questions I would like to ask:
1.
Could these symptoms be indicative of stomach cancer?
2.
The doctor mentioned that I should avoid flour-based products or bread because they can ferment in the stomach and cause bloating.
However, I found online that it may be related to high-fat types of bread.
Is white toast suitable for consumption?
3.
I understand that I should avoid caffeine (such as coffee or tea), but the doctor also said I should not drink barley tea.
I found some information online stating that barley tea is beneficial for the spleen and stomach, aids digestion, and is caffeine-free.
Can I drink hot, unsweetened barley tea?
4.
Besides white rice, what other foods can serve as staples? I also found that it is recommended to separate dry and wet foods, suggesting that noodles and porridge may not be suitable.
Thank you, doctor, for patiently reading my questions.
I appreciate your help.

Felix, 30~39 year old female. Ask Date: 2021/06/27

Dr. Zhang Kebin reply Gastroenterology and Hepatology

Hello Mr.
Felix,
You inquired about experiencing two episodes of acid reflux from the end of last month to the beginning of this month, and you suspect you may have gastroesophageal reflux disease (GERD).
You have reduced your food intake and avoided spicy and fried foods.
However, you have recently experienced occasional diarrhea after breakfast, which resolves by noon, occurring about every two to three days.
Additionally, you felt upper abdominal pain yesterday, with a persistent feeling of fullness and increased burping, approximately every hour or two.
Consequently, you visited a gastroenterologist who performed an ultrasound, but due to the pandemic, the clinic did not conduct an endoscopy.
The doctor informed you that these symptoms are typical of GERD and noted that you have significant bloating.
They prescribed medication and advised you to schedule an endoscopy in the future, along with dietary recommendations.
You have a few questions:
1.
Could these symptoms indicate stomach cancer?
Early-stage stomach cancer typically does not present with symptoms, but it may cause nonspecific symptoms such as indigestion, discomfort, or upper abdominal bloating.
Therefore, an endoscopy is recommended to rule out the possibility of stomach cancer.
2.
The doctor advised against consuming flour-based products or bread due to fermentation in the stomach causing bloating, but I found online that it may be related to high-fat types of bread.
Is white toast suitable for consumption?
Since a definitive diagnosis has not yet been established, specific dietary recommendations should be discussed further with your treating physician.
3.
I understand the need to avoid caffeine (such as coffee or tea), but the doctor also mentioned not to drink barley tea.
I found information online stating that barley tea is beneficial for the spleen and stomach, aids digestion, and is caffeine-free.
Can I drink hot, unsweetened barley tea?
Caffeinated beverages can exacerbate GERD symptoms, but since a definitive diagnosis has not been established, dietary recommendations should be discussed further with your treating physician.
4.
Besides white rice, what other foods can serve as staples? I also found that separating dry and wet foods suggests that noodles and porridge may not be suitable.

Since a definitive diagnosis has not yet been established, specific dietary recommendations should be discussed further with your treating physician.
Thank you for your inquiry!

Reply Date: 2021/06/27

More Info

Understanding Gastroesophageal Reflux Disease (GERD) is crucial for managing symptoms and improving quality of life. GERD is a chronic condition where stomach acid flows back into the esophagus, leading to symptoms such as heartburn, regurgitation, and discomfort. Your recent experiences with acid reflux, abdominal pain, and frequent belching are indeed indicative of GERD, and it’s wise to consult a gastroenterologist for further evaluation, including the suggested endoscopy.

1. Could these symptoms indicate stomach cancer? While it’s natural to worry about serious conditions like stomach cancer, the symptoms you describe are more commonly associated with GERD. However, persistent symptoms, especially if they worsen or are accompanied by weight loss, difficulty swallowing, or gastrointestinal bleeding, warrant further investigation. It’s essential to follow up with your doctor for a thorough assessment.

2. Dietary considerations regarding bread and pasta: Your doctor’s advice to avoid flour-based products is based on their potential to ferment in the stomach, leading to increased gas and bloating. White bread, particularly if it’s low in fiber and high in refined carbohydrates, can contribute to these issues. However, not all bread is created equal. Whole grain or sourdough bread may be better tolerated due to their lower glycemic index and potential prebiotic benefits. It’s advisable to monitor your body’s response to different types of bread and adjust accordingly.

3. Can you drink barley tea? Barley tea (mugicha) is generally considered gentle on the stomach and is caffeine-free, making it a suitable option for many individuals with GERD. However, individual tolerance can vary. If you find that drinking barley tea does not exacerbate your symptoms, it can be a good alternative to caffeinated beverages. Always opt for unsweetened varieties to avoid added sugars, which can also trigger reflux.

4. Alternatives to white rice as a staple: While white rice is often recommended for its blandness and ease of digestion, other options can also be suitable. Quinoa, for instance, is a nutritious grain that is high in protein and fiber, which may help with digestion. Oats can be another excellent choice, as they are soothing to the stomach and can help regulate bowel movements. Sweet potatoes are also a nutritious alternative, providing fiber and vitamins without being overly heavy on the stomach.
In addition to these dietary adjustments, consider the following tips to manage GERD effectively:
- Eat smaller, more frequent meals: Large meals can increase pressure on the lower esophageal sphincter, leading to reflux. Smaller meals can help mitigate this risk.

- Avoid trigger foods: Common triggers include spicy foods, citrus, chocolate, mint, and high-fat foods. Keeping a food diary can help identify specific triggers for your symptoms.

- Stay upright after meals: Remaining upright for at least two to three hours after eating can help prevent reflux.

- Elevate the head of your bed: If nighttime symptoms are an issue, elevating the head of your bed can help reduce nighttime reflux.

Lastly, managing stress through relaxation techniques or gentle exercise can also be beneficial, as stress can exacerbate GERD symptoms. Always consult with your healthcare provider before making significant changes to your diet or treatment plan, especially considering your recent symptoms and medical history.

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