Gerd and Diet

For your information GERD is an abbreviation of  “Gastroesophageal Reflux Disease”

Click on this link to read a full description of Gerd:

The following is an extract of Notes by Debbie Breslawsky of the MAC (NTM) Support Meeting Notes,Palm Springs and Desert Cities Group, April 7, 2014.


Some of the specialty doctors are noticing patterns in their patients regarding reflux and NTM Measures have been suggested to curtail reinfection and proliferation of the bacteria in our lungs. These suggestions were provided by one of the NTM specialists in the US.

 here are two aspects to consider. One aspect is behavior modification and the other, the foods we eat.

Reflux occurs when a ring of the muscle at the bottom of the esophagus called the lower esophageal sphincter (LES) doesn’t function properly. Normally, the LES keeps stomach contents in the stomach and prevents the backflow by tightening up after swallowing. In people with GERD, the LES is weak and relaxes, allowing acid and stomach contents to flow back up the esophagus. It is unclear exactly what causes the LES to weaken.

It has not been scientifically proven as to the correlation of GERD and its impact on NTM. However, many of the specialty doctors have noticed patterns that may indicate that aspiration of stomach contents into the lungs, which may proliferate the infection.

 Many people refer to this condition as “acid” reflux. Let’s avoid using this term. Acid may be good for NTM bugs. It may hold back growth.

 A preferred term is “sloshing”, which can occur when there is a greater proportion of liquid to solid stomach contents. No pill stops sloshing.

 So as not to dilute acid, some of the NTM specialists will not prescribe Protein Pump Inhibitors or PPI’s (Nexium, Prevacid, Prilosec, Aciphex, Protonix and their generics) unless the patient has severe heartburn, ulcers or Barrett’s Esophagus


 It is thought that a probable cause of many respiratory issues, not limited only to NTM is aspiration.

 To test for GERD, a gastroenterologist may perform a test called a GI series or a PH Probe.


 Limit liquids in stomach. Yet, as NTM patients, it is important to stay hydrated.

 It is best to drink no more than 6 oz. of water per hour with food. Be sure you have foods of oatmeal consistency, crackers, Nature Bar etc. in your stomach to absorb the liquid. Try to limit liquids to no more than 10 oz. after 6 pm. This includes anything that can turn to liquid such as ice cream, yogurt, etc. The bacteria in the stomach can be carried (aspirated) to the lungs in a liquid consistency. It is more difficult for solid consistency to be aspirated.

 Be aware of your body positions. Limit vulnerable positions. Avoid bending from the waist. Rather bend from the knees.

 Suggested hints:

  1. No inverted Yoga positions (downward dog, headstands , etc.) Preferred exercises include such things as walking, Tai Chi or any others that do not involve the upper body being bent over.
  1. Before working out, do not ingest liquid, or if necessary, consume little liquid with an Energy Bar to absorb the liquid. Regular exercise can be beneficial.
  1. Do not bend from the waist to tie shoes. Better to sit and extend legs, bending at the knees.
  1. For sports such as golf and tennis bend from the knees to pick up the ball, or for golf, to place ball on tee.
  1. Be aware of body position when doing chores, such as loading the dishwasher, clothes dryer, etc. Bend from the knees rather than bending over from the waist.

 Tips for sleeping:

            Motorized bed is best. Incline upper body 30-45 degrees. Raise legs to prevent upper body from sliding down to a flat position.

            If you do not have a motorized bed, place solid supports to tilt the head of your bed a few inches above your feet. Pile 2-3 pillows under head and shoulders. Be sure to place another pillow or two under thighs so that body is in a vee position to prevent sliding to a flat position.

When sleeping, never sleep on your stomach or right side. Sleeping on your back is best, left side is second best.

Practice a relaxation strategy. Stress and anxiety can worsen reflux symptoms.

Keep a food log to track foods and beverages consumed that worsen symptoms. However, keep in mind that you may experience “silent” GERD…. no symptoms.


The following foods can aggravate reflux and should be limited or avoided:

Fatty or fried foods

Peppermint & spearmint

Whole milk



Creamed foods and soups

Most fast foods

Citrus Fruits and juices



Other caffeinated beverages or foods (coffee ice cream)

Carbonated beverages

Spicy or acidic foods



The following foods are recommended for individuals with GERD:

Whole Grain Breads & Grains

Foods high in fiber (to absorb liquids in stomach)


Fruits (non citrus)

Low fat meat, chicken, fish, turkey (without skin)

Low fat milk & milk products

Sweets and dessert made with no or low fat (less than or equal to 3 grams of fat/serving.

Decaffeinated non mint herbal tea, juices, water

Soups: fat free or low fat


*Keep in mind that these are recommendations for the average person. There may be other conditions that exist for which some of these foods could be detrimental. It is best to consult your physician or a licensed nutritionist for your personalized program.

Debbie Breslawsky 2014



Click on the following heading to learn more about Nutrition

NTM Info and Research Nutrition Guide

Here are some foods and snacks, high in protien you may like to try



Some of the medications used to manage NTM can cause the stomach contents to flow backwards up the Esophagus (food tube)  into your  throat causing a burning sensation in your throat. This sensation in mild form is often called Heartburn, but in more severe causes it’s correct name is Gastroesophageal Reflux Disease (GERD)

Here are some links that explain GERD further