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Reflux in Rheumatology

One major problem in scleroderma that affects the quality of life of the patients are the symptoms of reflux.

What is the cause of this problem?

Reflux is a “backwards flow” of stomach acid moving back up into the esophagus.  Normally stomach acid stays in your stomach because it is blocked from going up by the lower esophageal sphincter. When a person has a reflux problem, the sphincter is too weak to hold the acid back.

What are the symptoms?

Heartburn is a burning sensation in the chest that is caused by stomach acid moving backwards into the esophagus. The pain is in the left side of your chest and can move down into your left arm.

Stomach acid can also cause atypical chest pain, coughing, asthma-like wheezing due to aspiration, hoarse voice and a feeling of gagging.

What can I do to limit reflux? These are not restricted to scleroderma but can be applied if you suffer from reflux

  1. Don’t eat within two hours of bed time.
  2. Move the main meal towards midday
  3. Eat more frequent small meals instead of one or two large meals.
  4. Eat sitting up.
  5. Eat slowly.
  6. Chew food thoroughly.
  7. Drink sips of water between bites and make sure each mouthful is fully swallowed before taking the next bite.
  8. Avoid carbonated drinks. They will fill your stomach with air and push the contents up.
  9. Don’t exercise after eating.
  10. Elevate the head of the bed at least four inches by placing it on wooden blocks. Just propping your head up on pillows won’t work because it doesn’t lift your esophagus above your stomach. Pillows should be wedged from the low back upward to avoid bending the neck or torso.
  11. Limit actions that increase pressure on your stomach such as bending, vigorous exercise or tight clothing.
  12. Try to keep your body weight within a healthy range. An overweight abdomen can put pressure on your stomach.
  13. Scleroderma patients are encouraged to reduce the amount eaten at a time and increase the number of meals they eat eg if they eat three times a day, eat between 5-6 small potions during the day with the evening meal being the lightest.

Are there certain foods and/or drink that I should avoid in order to reduce my reflux and heart burn? Yes.

  1. Alcohol
  2. Caffeine, coffee (regular and decaf)
  3. Chocolate
  4. Acidic foods (citrus fruits like oranges, tomato sauce)
  5. Fried foods
  6. Raw vegetables
  7. Foods with high fat content (fast foods, nuts, dairy products)
  8. Spicy foods
  9. Onions

Smoking will also aggravate reflux.


Source: Johns Hopkins Scleroderma Center