Gastroesophageal reflux (GERD), also called heartburn, is caused by a backflow of food and acid from the stomach into the esophagus. This can feel like a burning sensation that radiates from the stomach upward. Reflux is a common condition that may be present prior to a cancer diagnosis or aggravated by the disease or its treatment.   

Cancer-Related and Other Causes of GERD

• Medications that you may take for medical problems or to help relieve symptoms or side effects of cancer 

• Ibuprofen (Advil, Motrin IB, etc.)  

• Aspirin 

• Potassium supplements 

• Antibiotics 

• Bisphosphonates taken by mouth 

• Iron supplements 

• Quinidine 

• Location of tumor (if your cancer is located in your upper GI tract - esophagus, stomach, or throat) 

• Other health conditions (for example, hiatal hernia, obesity, chronic anxiety, pregnancy)

• Lifestyle and food (eating large meals, fatty foods, chocolate, peppermint, caffeine, and alcohol) 

• Stress and anxiety 

Common Symptoms of GERD

• A painful, burning sensation behind your breastbone that rises towards your throat 

• Regurgitation of stomach contents back up into your throat or mouth, leaving an acidic taste  

And, less commonly, you may experience:

• Nausea 

• Problems swallowing or pain with swallowing 

• Symptoms affecting the mouth, throat, or lungs, such as a chronic cough or hoarseness 

• Metallic, bitter, sour, or acidic tastes in the mouth  

Fortunately, there are many steps you can take to manage reflux, which may be a combination of diet and lifestyle strategies and medications. 

How to Manage Reflux

The best solution for managing reflux is an individualized approach that addresses the specific things that aggravate your reflux.

The following is a list of strategies that may improve symptoms:

• Avoid eating large meals. Instead, eating smaller amounts of food spread over the day may be better tolerated.

• Eat meals slowly (over 20-30 minutes).

• Make note of foods that aggravate reflux and avoid them. Common gastric irritants include garlic, onions, peppers, chocolate, spearmint, peppermint, citrus fruits (orange, grapefruit), tomatoes/tomato products, alcohol, and spicy or fatty foods. Some dietary supplements may also cause reflux.

• Limit your caffeine intake from coffee, tea, and soda.

• Reduce your intake of fatty foods (fried foods; creamy, rich sauces; fatty snack foods; pastries/donuts; pizza; foods with cream or cheese sauces; sausages; bacon and other fatty meats; full fat milk, cheeses, and ice cream), or limit to small portions, making note of which cause more symptoms.

• Limit added fats like butter, cream, oil and salad dressings.

• Try not to eat two to three hours before bedtime.

• Elevate the head of your bed or elevate your upper body with pillows or a wedge when sleeping or laying down.

• Avoid wearing tight fitting clothing or belts around the waist after meals.

• Stop smoking.

• Take medications for reflux as prescribed and let your doctor know if they are not working (several options exist).

• Speak to your team about use of over-the-counter medications for heartburn, like Tums®, Rolaids®, Maalox®, or Milk of Magnesia®, Pepcid®, or Zantac®.

Additional Tips

• If you are overweight and can safely lose, weight loss may significantly improve your reflux.

• If your reflux is aggravated by chemotherapy, you may also need an anti-nausea medication to manage it. Speak to your team about the best medication or combination of medications for you.

• Chewing gum or drinking carbonated beverages both encourage the swallowing of air which can increase pressure in the stomach, making acid reflux worse. Make note of how you feel after consuming these to see if they may be aggravating your symptoms.