The stomach is an organ that we both love and hate.

We love it because it can hold hot pots, barbecues, crayfish, cola, milk tea, lemon tea, lychees, watermelons, cherries, and more.

We hate it because it's too prone to problems, with symptoms like acid reflux, heartburn, and fiery, painful sensations coming on suddenly.

Visiting the hospital, the doctor says it's gastroesophageal reflux disease (GERD), medication is needed, and if it doesn't improve, surgery might be required! Sob...

"You make it sound so scary! Isn't it just an upset stomach? Just have some porridge for a few days, and it'll be fine!"

Yes, that's a big mistake! The Huaxi expert here must say that porridge does not actually nourish the stomach, especially for those with GERD. Drinking porridge can make gastric acid reflux worse and cause more burning in the stomach!

**People Who Like Solid Food Don't Like Porridge**

**Actually, It's Because It Doesn't Keep You Full**

Below, Dr. Hu Renwei from the Department of Gastroenterology at West China Hospital of Sichuan University, along with students from the 2020 eight-year program at West China Clinical Medical College, will explain what GERD is and why patients with this condition should not drink porridge.

Gastroesophageal reflux disease refers to a common digestive system disorder where partially digested food or stomach acid flows back into the esophagus and even the mouth. How common is it? According to multiple studies, the incidence of GERD in the Chinese population is about 8%, and about 17.93% in the elderly.

This disease not only brings a series of impacts to digestive organs such as the stomach and esophagus but can also cause a range of issues in the respiratory tract, ears, and even the mouth.

When the refluxed food or stomach acid flows down the esophagus, it can damage the mucous membranes of the affected tissues and organs, causing a variety of uncomfortable symptoms. These include typical symptoms that everyone can think of and atypical symptoms that may come as a surprise.

**Typical Symptoms of GERD:**

Acid reflux, heartburn, stomach pain, upper abdominal discomfort, chest pain, etc.

Q: "Wait, doctor, how is chest pain related to the stomach?"

A: It's greatly related!

Chest pain needs to be explained separately. When people think of chest pain, they often think it's a heart problem, but it's also a common symptom of GERD. When GERD occurs, corrosive stomach acid and food flow upwards from the stomach, reaching the esophagus and even affecting the trachea. When it reaches the middle and lower parts of the esophagus, some patients' esophagi can be stimulated, and this area coincides with the position behind the sternum, causing a burning chest pain that is sometimes mistaken for angina.

So, when there are symptoms of acid reflux, heartburn, stomach discomfort, and chest pain, this chest pain may be caused by GERD!

**Atypical Symptoms of GERD:**

In addition to the typical symptoms mentioned above, GERD can also cause a range of atypical gastrointestinal, respiratory, and oral symptoms. Be aware, atypical does not mean uncommon; many patients with these symptoms do not pay attention and delay treatment.

1. **Other Gastrointestinal Symptoms:** Dysphagia, foreign body sensation in the throat, upper gastrointestinal bleeding.

As the disease progresses, GERD can cause a series of gastrointestinal complications, mainly esophageal stenosis, esophageal ulcers, and even Barrett's esophagus, esophageal intraepithelial neoplasia. To put it plainly, these are precancerous conditions of esophageal cancer, which can cause symptoms such as dysphagia and upper gastrointestinal bleeding.

2. **Respiratory Symptoms:** Asthma, cough, shortness of breath, choking cough, etc.

GERD can affect the respiratory tract, potentially causing conditions like chronic bronchitis, recurrent lung infections, bullous lung disease, cor pulmonale, etc.

3. **Ear Symptoms:** Itching in the ears, tinnitus, etc.

4. **Oral Symptoms:** Bad breath, dental caries, oral ulcers, etc.

This point also needs emphasis. Because people lie flat when sleeping, those with GERD can have stomach acid flow back into the throat and even the mouth, causing bad breath and dental caries. So, if you have good oral hygiene habits but suffer from severe bad breath and dental caries, and you also have symptoms like heartburn and stomach burning, you might want to consider that your oral problems may be caused by GERD!

At the junction of the stomach and esophagus, there is a complex structure called the esophageal anti-reflux barrier. It's hard to explain what it is specifically; just think of it as a valve. If there is a problem with any part of this valve or a decrease in function, it can lead to GERD. There are mainly three problematic situations:

1. **Decreased Lower Esophageal Sphincter Pressure**

Under normal circumstances, after the esophagus moves food into the stomach through peristalsis, the lower esophageal sphincter at the junction of the stomach and esophagus will contract, keeping food and stomach acid inside the stomach.

Under normal conditions, the lower esophageal sphincter is usually in a contracted state, maintaining the pressure of the barrier higher than the pressure inside the stomach. Once the contraction of the lower esophageal sphincter is not strong enough and the pressure decreases, the pressure difference between the esophagus and stomach will decrease. At this time, if the pressure inside the stomach increases, the stomach contents will flow back into the esophagus along the pressure difference.

2. **Structural Changes at the Gastroesophageal Junction**

There is a diaphragmatic angle at the gastroesophageal junction, and the diaphragmatic esophageal ligament and the angle between the esophagus and stomach (the His angle) are important guarantees for anti-reflux function. Once these structures are abnormal and the angle becomes larger, it may lead to GERD.

3. **Reduced Esophageal Clearance Function**

Under normal conditions, the esophagus mainly relies on propulsive peristalsis and neutralization by saliva to clear the stomach contents that flow back into the esophagus. Once these functions are impaired, the stomach contents that flow back into the esophagus cannot be normally cleared and will stay in the esophageal cavity for a long time, causing damage to the esophageal mucosa.

**IV**

Contrary to popular belief, although porridge seems easy to digest, it is more likely to cause or worsen the symptoms of GERD.

This is because the main component of porridge is carbohydrates. A large intake of carbohydrates can lead to a decrease in the tension of the lower esophageal sphincter, and the short gastric emptying time of porridge significantly reduces its ability to neutralize stomach acid, which can lead to acid reflux and heartburn.

In an article published by experts from the Vanderbilt University Medical Center in 2016, a study was conducted on the relationship between a high-fat, low-carbohydrate diet and GERD. The study included 144 obese women who followed a high-fat, low-carbohydrate diet and observed their gastric acid reflux conditions. The results showed that by adjusting their dietary habits, the symptoms of GERD decreased, and after 10 weeks, all patients' symptoms disappeared. Researchers also found that for every additional spoonful (4.2 grams) of sugar consumed, the chance of suffering from GERD increased by 13%.

In addition, porridge has a single nutritional component and is low in protein. Drinking only porridge cannot meet the needs of daily life, and long-term consumption can lead to malnutrition. So even for normal people, we do not recommend eating porridge often.

**V**

Based on the causes of GERD and existing research, the high-risk groups for GERD currently include the following six categories:

1. People over 60 years old;
2. Obese individuals, especially those with abdominal obesity;
3. Smokers and alcohol drinkers;
4. People who love spicy, irritating foods, sweets, and high-fat foods;
5. People with hiatal hernias;
6. People who are tired, mentally stressed, and prone to anger.

If you belong to the above high-risk groups and have symptoms such as acid reflux, heartburn, difficulty swallowing, and chest pain, it is recommended to go to the hospital and see a gastroenterologist as soon as possible!

Q: "Doctor, I don't belong to these high-risk groups, but I often have acid reflux, heartburn, and stomach burning. Can I just go and have a gastroscopy to see if I have this disease?"

A: We do not recommend doing so; it's best to see a specialist first.

Because a gastroscopy