Sid Roberts wrote:
>
> On the neuro-chief-mgh-Harvard site there is a section dealing
> with PD and stomach/intestinal conditions affecting treatment
> which raises a diet/nutrition question.
>
> It says that there have been a few instances where Sinemet and
> dopamine agonists "open the valve between the gullet and the
> stomach resulting in gastric juices flowing back into the gullet
> and causing an inflamation of the gullet. ... Patients who have a
> Hiatus Hernia are especially vulnerable to this complication. ...
> Patients who have a Hiatus hernia, and take antiparkinson drugs,
> should follow an appropriate diet. In addition, such patients
> may require antacids or other measures to decrease the
> inflamation."
>
> My question is: what is "an appropriate diet" for a PWP with both
> reflux and a Hiatus hernia? Are there foods that should be
> avoided? TIA!
Sid,
Gastroesophageal reflux is all too common among my clients. This is
because I work with older adults, and GERD becomes more common with age.
An appropriate diet for hiatal hernia and GERD is the same, but may
differ from person to person; not all foods affect everyone the same
way. However, there are some common offenders. Just as important as the
type of food, is the AMOUNT of food. GERD is more likely when the
stomach is overfilled, and the contents push upward against the valve
that closes off the esophagus.
I highly recommend three small meals with two small snacks in between.
The evening meal should be eaten as early as possible, to allow the
stomach to completely empty before lying down in bed. The head of the
bed may need to be raised slightly, so that stomach contents do not push
upward.
For PWP, who may experience "freezing" due to protein, the 7:1
carbohydrate diet might be a good choice. It allows frequent meals with
less interference from protein. I understand that about 2/3 of people
with PD experience better results from their Sinemet using this plan.
For further information, a page from my newsletter follows.
Best regards,
Kathrynne
---------------------------------------
Q: I'm a 64-year-old woman and have been having heartburn for the past
several years. Now my doctor has just told me this is "reflux." What's
the difference between heartburn and reflux, and what can I do about it?
My doctor gave me a list of foods to avoid--will this get rid of reflux?
A: Heartburn and acid indigestion are common names for a condition known
in healthcare as "gastroesophageal reflux" or GERD. Many people
experience GERD occasionally, especially as they get older.
Normally, when we swallow food, it passes down the esophagus, through
an opening called the "sphincter," and into the stomach. The sphincter
has a flap that closes tightly, so the food stays in the stomach. But
sometimes, this flap doesn't stay closed. Then stomach acids flow
upwards, through the sphincter, and into the esophagus, causing a
burning feeling.
An occasional occurrence of GERD is not cause for alarm. But doctors
are concerned when GERD becomes common. This is because chronic GERD
can result in serious illness. The powerful acids can damage the
delicate lining of the esophagus, causing sores, erosion, and scarring.
If scarring becomes widespread, it may become difficult to swallow, and
may even become cancerous. Sometimes surgery is needed to correct the
condition.
Since your doctor has not prescribed any medication for your reflux, it
is probably not serious as yet. Your doctor wants to prevent it from
becoming a problem.
GERD has many possible causes. Most often, it is triggered by certain
foods, lifestyle, alcohol, smoking, excess weight, and increasing age.
Foods that often trigger GERD are acid foods like citrus fruits and
tomatoes, spicy or fatty foods, coffee, tea, and caffeinated cola
drinks, alcohol, chocolate, and peppermint. Fatty foods, such as fried
foods, pizza, and desserts, take a long time to digest. This causes
acids to remain in the stomach longer. People who are overweight may
suffer from GERD, as excess weight in the abdomen may push stomach
contents upward against the esophageal sphincter. Also, stressful
circumstances may lead to GERD.
To control reflux, avoid troublesome foods, smoking and alcohol. Eat
small meals to avoid overfilling the stomach. Instead of three
substantial meals, eat five small meals, and do not eat anything for
several hours before bedtime. If you are overweight, reflux may be
relieved by losing some weight. Try to relieve any stressful
circumstances that might contribute to your reflux. Try sleeping in a
more upright position, by placing extra pillows under your head and
upper back.
Most people can avoid use of strong medications by adopting these
measures. Controlling reflux now may prevent more serious conditions
later on. Here's to your good health!
--
Kathrynne Holden, MS, RD
Editor-in-Chief,
"Spotlight on Food--nutrition news for people 60-plus"
Tel: 970-493-6532 Fax: 970-493-6538
http://www.fortnet.org/~fivstar
You may wish to contact:
Better Business Bureau of the Mountain States,
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for further information.
