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    Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.

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  • July 26, 2008

    Helping a loved one with special dietary needs

    By Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.

24 comments posted

I was just looking through a recent issue of the journal "Nutrition in Clinical Practice" and came across a review article on "Diet and Lifestyle Modifications in the Management of Gastroesophageal Reflux Disease" — or GERD. The article listed some statistics:

  • GERD is the most common gastrointestinal related diagnosis given by U.S. physicians.
  • 44 percent of the population has bothersome symptoms at least once monthly.
  • 17 percent have weekly occurrence, 7 percent are bothered daily.
  • In 2004 medication to treat GERD was among the top 5 selling drugs — costing in excess of $10 billion dollars.

Long-standing or inadequately treated GERD can lead to adenocarcinoma among other conditions that can affect swallowing — pretty serious.

Why my interest? My husband has GERD. But rather than go into detail about what this condition is, I thought I'd approach it from the perspective of a spouse. (See the links below for a full description and a neat video.)

About 10 years ago, my husband would suddenly sit upright in bed in the middle of the night gasping. Since I began my practice in gastroenterology we quickly determined that it was probably acid reflux and got over-the-counter antacids. We also implemented several lifestyle changes such as smaller meals and avoiding foods he knew were aggravating like garlic and caffeine. We don't smoke, and he's skinny so his weight is not an issue.

Some time later, we were having dinner (complete with guests) and he again gasped, clutched his chest (heart attack?) and off to the ER we went. He was diagnosed with esophageal stricture with spasms (due to reflux) — a very painful condition that mimics a heart attack. OK, time to get really serious. He had a procedure that stretched his narrowed esophagus, and was put on stronger prescription medication. It was a certainty that we needed further lifestyle changes.

We've found we need to eat early — no later than 6:30 pm in order to control symptoms so we can get to bed at a decent hour. We get off work at 5 p.m. So things get really hectic in order to get dinner served and eaten. We have also found that our evening glass of wine needed to be eliminated. Our friends have learned that our dinner parties start at 5 and end early. For elevating the head of the bed we tried the typical 6-inch blocks you can get at the home improvement center. Not good enough. Finally we got an 8-inch by 6-inch railroad type tie. He also supplements this with a foam wedge that elevates his upper torso about another 4 inches for a total of 1 foot. Perfect! We've also implemented all of the other recommended lifestyle changes listed in the links below.

My point is that when medical problems occur, they impact the lives of family members and friends. My husband appreciates that I've improved his quality of life by changing many things in our diet and being a partner in his care. (He also appreciates that I must put up with clinging to the head of the bed to keep from sliding down and off!)

Seriously, I fully recognize that there are other medical conditions that are considered more grave. These include cancer, heart disease, diabetes, trauma and end of life maladies that require many changes in diet and life style. But common conditions like GERD are also important and they need the help of a spouse, family member or friend. (My husband also has celiac disease — but that will be another blog.)

I'd like to hear from you if you have a spouse, family member or friend with special dietary needs and how you help make their lives a bit better.

24 comments posted

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  • September 29, 2009 4:54 p.m.

    Thanks for your help, Jennifer. The good news is that the small tumor was a leftover from when they removed the first mass. A PET scan now shows him to be cancer-free. YES!!

    - Kathy

  • July 8, 2009 9:08 a.m.

    Kathy - You may also want to check out these web sites: (1) http://www.cancer.gov/cancertopics/pdq/supportivecare/nutrition/Patient/page1 (2) http://colon-cancer.emedtv.com/colon-cancer/colon-cancer-nutrition.html. I hope this information is helpful. Best wishes to you and your friend.

    - Jennifer Nelson

  • July 8, 2009 9:06 a.m.

    Kathy - Nutrition is important before, during and after treatment for colon cancer. Nutritional needs and specific food recommendations will vary from person to person so it is very difficult address your request. What I recommend is that your friend ask the doctor to arrange an appointment to see a registered dietitian. This way diet can be tailored according to the stage of cancer, previous surgery, current treatment, nutritional status/needs and individual food preferences and tolerances. Here are links to articles on our site that address nutritional issues during cancer treatment: (1) Chemotherapy nausea and vomiting -http://www.mayoclinic.com/health/cancer/CA00030 (2) No appetite -http://www.mayoclinic.com/health/cancer/HQ01134 (3) Diarrhea -http://www.mayoclinic.com/health/diarrhea/CA00040 (4) Mouth sores - http://www.mayoclinic.com/health/mouth-sores/CA00054

    - Jennifer Nelson

  • June 4, 2009 10:28 a.m.

    I need a clear and concise list of food (or diet) for someone who is going back on chemo for recurring colon cancer (5FU is the chemo cocktail). Please PLEASE lay it all out, then tell me where to find it. Thank you!

    - Kathy

  • April 10, 2009 6:11 a.m.

    A good and informative blog, but I wanted to know more about GERD. Thanks.

    - swapnakaj

  • March 22, 2009 1:57 a.m.

    I've had most of the symptoms you all mention and have had 2 dilations of the esophogeal stricture. Now my life has been changed and I am completely free of GERD. Go to www.greattastenopain.com and download free trial information. This is so simple and makes so much sense!

    - Joy

  • February 23, 2009 4:29 p.m.

    My husband has severe GERD also diabetes,copd and Barretts Esophogus. I find the doctors not helpful but the internet info keeps me sane. I havenever blogged before. We eat 5-6 small(as I can make him eat) meals a day and I TRY to eliminate the BAD food and also consider the diabetes he has. We are in our 80's and basically alone. Maybe talking by posting online will be helpful as I read other persons problems also. Thank you.

    - Rita

  • January 27, 2009 10:48 p.m.

    I also have GERD, Hiatial Hernia, 2 stomach lining ulcerations, acute diverticulitis and I think this is ALL I want. I take (2)Protonix 40mg-am & pm 30 min. before meals. I have to lose 35lbs. and guilty of 4 glasses of tea a day. I have finally realized that diet is 100% the problem. I,too, have had the terrible pain in the upper stomach; at one episode, I went to my knees and to the ER. I have found when there is a lot of burping, gas that rubbing the lower and upper stomach very firmly in a counterclockwise round motion has helped me tremendously. I just keep rubbing until the burps and gas start to expel usually about 15 min. I would like to know if anyone knows if there is some kind of surgery and/or laser treatment for the ulcerations on the stomach lining or do they just remain as an ulceration. The gastro. doctor did not elaborate too much on the subject just to be checked PRN; well how ofter is this??? Also is it better to eat alkaline foods that do not produce an acid condition?? This seems to include a very Green diet but I will do anything to ease or get more relief from these conditions. I do know that stress is a big contributor or am I wrong in this matter?? Any suggestions will be greatly appreciated. I also have high blood pressure, take chol. meds, antidepressants--so I am to the point of any help is appreciated. Thanks and looking forward to losing weight and feeling better!!

    - Marian B.

  • January 27, 2009 2:04 p.m.

    Where can I find food that I CAN eat, with Gerd? I know what I can't eat. Can't seem to find receipe's or a list of GOOD foods. Thanks

    - Elaine

  • January 20, 2009 6:46 p.m.

    As an individual who experienced GERD as a teenager, surgery at age 20 and occasional dilatations of an esophageal stricture, I appreiate your article and admire you for being completely supportive of your husband's condition and the lifestyle changes he has had to make. Without loving support, it can be a long journey.

    - Janet Bolton

  • January 5, 2009 2:08 p.m.

    I got the results of my 1st A1C test and it was 6%, which my Dr. said was excellent. My cholesterol dropped from 202 to 139. I have been walking 45 minutes every day and have now lost 21 lbs., with 20 more to go. Counting carbs is not difficult and has really helped me to be alot healthier. I do not really feel deprived, if I want a piece of candy I eat it as long as my numbers are ok. The main thing I miss is not being able to eat much in the way of beans and pasta, they are just loaded with carbs. Thank heaven I do not have to go on meds. I just hope I can keep this up and avoid medication.

    - Sharon

  • January 3, 2009 6:09 p.m.

    My husband had his esophagus removed because of Barrett's. We are still trying to fiqure out after 2 years the what and what not's. He has dumping syndrome. He still gets acid indigestion. He sleeps sitting up. Is there anything I can suggest to him?

    - Barbara

  • December 18, 2008 6:20 p.m.

    I was just diagnosed with signs of Barretts esophagus. I have been going to a research clinic nmed West Wind'r research. They are now giving me medicine to stop the Gerd. And serious talks on prevention and understanding of my condition. I'm going in tomorrow for a second Endoscopy to see if their treatment has helped my diagnoses. Although they have informed me a must seek medical help at the end of the study. This treatment alone has given me a time period to adjust my eating habits over the course of their treatments. By the way, because of their treatment, I haven't had heart burn for 4 months. I love these people.

    - Jim

  • November 11, 2008 8:29 a.m.

    My husband was just diagnosed with Barretts esophagus. Does anyone have suggestions about menus, recipes, web sites that will help me plan meals? Like Lucille, I want to look forward and do positive things to help, and make life better for my husband. Maybe there could be another blog for posting symptoms and experiences. Thank you!

    - Jane

  • October 13, 2008 1:32 p.m.

    I really found your article helpful. I did not get to sleep until almost 4 am this morning. I am on meds and have a foam wedge, going to try railroad tie under bed. I am thin and I am very careful about my diet. I think the railroad tie may work! Thank u

    - Barbara

  • September 20, 2008 9:25 p.m.

    thank you so much. Your experience seems to mirror my husbands except he does not have celiac disease. Your comment about more serious diseases is true but this is still stressful and hard for us. We are learning slowly what helps but reading of other people doing the same thing is encouraging please keep it up Thank you

    - liz

  • September 7, 2008 6:58 a.m.

    I expected details about diet for GERD, not a personal history.

    - lucille helman

  • August 23, 2008 9:44 p.m.

    After suffering acid reflux for years, and recently, on a daily basis, usually in the middle of the night, I started reading up on the topic. I now am on the first day of a 14-day treatment with over-the-counter omeprazole (one pill, 20 mg per day, first thing in the morning) and am altering my lifestyle. I feel much better already. For dinner this evening, I had raisin bran, skim milk and a banana. I plan to lose weight. I am biking two miles to college each day, where I teach journalism. I was glad to see one chart that said beer is an accepted beverage when avoiding acid reflux. Cool. I can still drink modest amounts of the suds. I was sad to see I should cut back on coffee and tea. About six months ago, I had an acid reflux incident, while sleeping, in which I inhaled acidic liquids and woke up choking. Within an hour, I had chills and violent shaking. My lungs were having a pnemonia reaction to the liquids. The chills lasted for over an hour. It was awful. My temp was 102.5. I don't want to experience that again. My doctor, in the morning, found it to be a very interesting case. He prescribed an antibiotic and told me to be careful about eating heavy meals just before bed. That's it for now. Cheers!

    - Alan, in Kansas

  • August 13, 2008 5:00 p.m.

    My fiance has high blood pressure and GERD. I have had a healthful, mostly vegetarian diet for years, and when we got together I started cooking for him. In the first six months he dropped almost 40 pounds and was able to stop taking one of his two blood pressure medications, and reduced Nexium to every other day. Simply reducing the amount of red meat and fast food he was eating made a huge difference! I feel very blessed to be with someone who has been willing to embrace these changes and try new and different foods. I think that support between partners who want to make healthful lifestyle changes is critical to success. If you do not have that support at home - as some of the other posters have indicated - try joining a support group (I know that there are celiac support groups in my area, for example).

    - Glaphre

  • August 8, 2008 1:56 p.m.

    I have a hiatal Hernia, GERD, and Barretts Esophagus. Three nights ago, I woke up in the middle of the night gasping for air and chocking. This has happened before, but not as bad. For the last month or so, I feel like a popcorn kernel has been stuck in my throat, I can't keep anything down, the bile comes up my nose, the smell of food is enough to send me running to the bathroom. I'm starting to lose weight (ok, that's not exactly a bad thing, just not the way I want to do it.) Yesterday I was told I need the surgery and I'm very scared. My husband just doesn't seem to be very concerned; he still thinks its just heart burn. Since he's never been sick a day in his life and is extremely healthy, I don't get much sympathy and understanding from him. What foods can I eat? It seems everything comes up these days. Banana pudding is about the only thing that stays down. Does anyone have more information about the recovery time for the surgery? Will they be able to do it through my throat without opening me up? Hope to hear from anyone soon.

    - Yvonne

  • August 2, 2008 9:52 a.m.

    I too have celiac disease and look forward to your blog on this subject.

    - Linda

  • July 30, 2008 1:25 a.m.

    I also have celiac disease and have found that my invitations to eat with friends have now declined as they are afraid to make me inadvertantly sick or think I have to have a very special meal prepared for me. Also, then the conversation turns to my medical issue and gets stuck there and I really do not want to bore anyone with my 'problem'. As you can appreciate I am really looking forward to your blog on the subject.

    - PompeyPrincess

  • July 29, 2008 4:37 p.m.

    I have celiac disease and I am blind. In situations related to the celiac, my friends take advantage of my blindness. It's not in a mean way--quite the contrary. Someone will say something about food, and if they know it's stuff I can't eat, they will tell me I don't want to know. Most of the time, they don't say a thing at all, and I inadvertently discover the stuff. Like I said, it's not a mean thing; it actually expresses great sincerity and sensetivity.

    - NativeRose

  • July 26, 2008 6:48 a.m.

    My husband has low esophageal motility, among other gastrointestinal issues, and we are always fine-tuning "what helps." One important help has been the elimination of Diet Cokes (or any carbonated beverage). He, too, is slender, and works out frequently, which helps. We also try to eat early, light suppers. Sometimes a small snack during the day of lean protein (i.e. a rolled up slice of plain turkey) seems to be very helpful. And the best thing we've found recently is a half hour swim before bed time. Thanks for your "railroad tie" tip!

    - Beth W.

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