June 14, 2013—The gastrointestinal system is the body’s primary site of digestion and absorption of nutrients. It is also one of the body’s largest immune systems and communication centers, and plays a major role in the health and well-being of the entire body. At a community health seminar offered at The Miller Practice at NYU Langone Medical Center, Dr. Sophie M. Balzora and Dr. Lisa Ganjhu provided vital information and practical tips on how to minimize symptoms such as heartburn and maximize our digestive and overall health.
Heartburn: What It Is, How To Treat It, and When To Call a Doctor
More than 60,000 Americans experience heartburn at least monthly. “Heartburn is the hallmark symptom of gastroesophageal reflux disease, or GERD, a condition in which the acid produced in the stomach comes up into the esophagus, and over time, can injure the lining of the esophagus,” said Sophie M. Balzora, MD, clinical instructor in medicine, NYU School of Medicine, and Board-certified gastroenterologist at The Miller Practice at NYU Langone Medical Center. People who smoke, are obese, have diabetes, or are pregnant are at increased risk for GERD.
According to Dr. Balzora, some simple lifestyle measures can help many people reduce the occurrence of heartburn. For example, choosing to go for a walk instead of lying down immediately after a meal can aid digestion, thereby preventing the food from sitting in the stomach, rising into the esophagus, and triggering heartburn. In addition, eating smaller meal portions and avoiding certain trigger foods can help to reduce the occurrence of heartburn. “The dietary triggers vary from person to person, so while eliminating all potential trigger foods is unrealistic, knowing what causes heartburn for you is key,” Dr. Balzora explained (more tips for reducing heartburn).
Dr. Balzora noted that chronic GERD can lead to repetitive injury to the lining of the esophagus, and in some people, progression to a pre-cancerous condition called Barrett’s esophagus. This makes the diagnosis and treatment of chronic GERD especially important. If an individual is diagnosed with GERD, his/her gastroenterologist may prescribe medications to reduce stomach acid. “Antacids act to neutralize the acid present in your stomach. Proton pump inhibitor (PPI) agents, however, get to the heart of the matter, by working to reduce the production of acid in the stomach,” Dr. Balzora explained. If chronic GERD is caused by a hiatal hernia or a relaxed valve between the stomach and esophagus, endoscopic and surgical interventions may also be options to prevent future GERD. For people who are diagnosed with Barrett’s esophagus, PPI agents are commonly prescribed to prevent further injury to the lining of the esophagus. In some cases of severe Barrett’s esophagus, certain procedures such as radiofrequency ablation (RFA), photodynamic therapy, or endoscopic mucosal resection (EMR) may be performed to treat the injured tissue and prevent progression to cancer.
“Occasional heartburn is not a cause for concern. But heartburn that is persistent or frequent could be a symptom of an underlying medical condition and should be evaluated by your doctor,” Dr. Balzora concluded.
Treating Yourself Well:
Healthy Eating and Lifestyle Tips to Maximize Your Digestive Health
“To optimize our digestive health and maintain a healthy body weight, three main components are necessary: healthy diet, exercise, and sleep,” said Lisa Ganjhu, DO, clinical assistant professor of medicine, NYU School of Medicine, and Board-certified gastroenterologist at The Miller Practice at NYU Langone Medical Center.
A Healthy Diet
A healthy diet is a one that contains a balance of a variety of non-processed, healthy vegetables and fruits, protein, fats, carbohydrates, and starches, in the appropriate portion size. “Each meal should consist of approximately 50% fruits and vegetables, 30% protein, and 20% whole grains and starch. For each food category, there are healthy options, along with not-so-healthy options to avoid,” Dr. Ganjhu explained. Examples of healthy food choices include vegetables: brussel sprouts, spinach, broccoli, kale, artichoke hearts, bell peppers, onions, garlic, beets, carrots; fruits: berries, cherries, apples, and tomatoes; grains: oats/oatmeal, quinoa, flax, and brown rice; proteins: milk, yogurt, eggs, beans, lentils, lean white meats, salmon, sardines, tuna, and soy; fats: nuts, olive oil, canola oil, nut-based oils, avocados, flax and chia seeds, and dark chocolate. Ensuring adequate water intake is also important, with most men needing 3 liter and women 2.3 liters per day—more when pregnant, breastfeeding, exercising, in warmer weather, and at higher altitudes. “In addition to choosing healthy foods, it is essential to exercise portion control. If our portions are too large, we will feel uncomfortable and we will gain weight,” Dr. Ganjhu said.
Dr. Ganjhu stressed that fad diets, meant to be followed for a short period of time for the purpose of weight loss, are not good choices in achieving a sustained, healthy diet. “A healthy diet needs to be a way of life that is economical, portable, and sustainable,” she said.
An Active Lifestyle
According to Dr. Ganjhu, three types of exercise—aerobic, resistance, and balance—are beneficial to our digestive and overall health. “While aerobic exercise helps to burn calories and increase endurance and fitness, resistance training helps to build muscle, increase metabolism, and improve glucose tolerance and balance training assists in improving our posture, core strength, and mind-body wellness,” she explained. Even a walking regimen of 30 minutes per day can be beneficial—and walking after a meal can help in the digestive process. Dr. Ganjhu noted that it is important to check with a physician before starting any new exercise program.
Sleep, Sleep, Sleep
“With our busy schedules today, we sometimes cheat ourselves of the sleep our body needs to function well and stay healthy. In fact, sleep deprivation can lead to irritability and may increase our risk of a number of effects, such as cognitive impairment, impaired immune system, diabetes type II, heart disease, and obesity,” Dr. Ganjhu noted. In closing, Dr. Ganjhu emphasized the importance of getting at least 7 to 8 hours of good, quality sleep to improve digestive function, mental function, weight loss, and overall health.