Diet and Barrett’s Esophagus

Many of the dietary recommendations for Barrett’s esophagus are similar to the diet recommended for patients with GERD (gastroesophageal reflux disease).

Here are some recommendations for reducing GERD and decreasing the amount of acid and food exposure in the esophagus

Stay upright for 3 hours after eating – this will allow your food to digest more completely and reduce the amount of reflux you have when you lay down

  • Elevating the head of the bed – this can also decrease the amount of reflux that occurs when you lay down as gravity will help keep food in your stomach. Propping on pillows may not be as effective as putting blocks, books, or bricks under the upper posts of your bed. A big pile of pillows can cause you to hunch over, which may increase reflux
  • Eat a low-fat diet – lower fat meals will digest more quickly, so you’ll have less reflux
  • Don’t smoke – while smoking is more strongly associated with squamous cell cancer of the esophagus, it can also contribute to esophageal adenocarcinoma, which is the kind of esophageal cancer related to BE
  • Reduce caffeine intake – caffeine relaxes the lower esophageal sphincter, which is the muscle at the bottom of the esophagus. When this muscle is relaxed, you’re more likely to have reflux of stomach contents into the esophagus. A little caffeine is probably okay, but multiple cups of coffee a day is too much. Remember that a standard size cup of coffee is actually pretty small, so one giant cup of coffee is actually equal to 2 or 3 cups of coffee! Many carbonated sodas also contain caffeine and tea (hot and iced) also contain some caffeine. To find out the caffeine content of beverages, a quick internet search for ‘caffeine content’ will pull up several sources, such as this one:
  • Alcohol – drink in moderation. Alcohol relaxes the lower esophageal sphincter and can increase reflux. However, there are some studies that suggest moderate wine or alcohol intake can lower the risk of Barrett’s and esophageal adenocarcinoma (this will be addressed in a separate post)
  • Weight loss – weight loss will also help improve reflux symptoms. Obesity increases the risk of both Barrett’s esophagus and esophageal cancer

– posted by Kerry Dunbar, MD