Recently, when the weather gets cold, there have been more "familiar faces" in the gastroenterology clinic. Many friends have similar troubles: they are fine during the day, but when they lie down at night, their chest is burning with pain; Sleeping soundly in the middle of the night, suddenly awakened by a mouthful of sour water; I woke up in the morning with a bitter taste in my mouth and a hoarse throat. These seemingly insignificant small problems are often caused by gastroesophageal reflux disease (GERD). Why is this disease prone to "rising" in winter? How should I eat and sleep? Is the legendary 'raising the pillow' really useful? Today, gastroenterologists will talk about the tricks involved and help everyone enjoy a comfortable winter. Why does the stomach get emotional when it gets cold? Many patients wonder: Why is this stomach disease still seasonal? In fact, winter is indeed the "high-risk period" for reflux esophagitis, mainly for three reasons. The body's "parts" contract due to freezing. Cold air is a stimulus that stimulates the sympathetic nervous system of the body. At this point, peripheral blood vessels contract and blood flows more towards internal organs such as the stomach. This change may not only increase gastric acid secretion, but also relax the lower esophageal sphincter (the "valve" that prevents acid reflux). If the valve is not tightly closed, stomach acid will naturally run upwards. The taste of food has become heavier, and it's getting cold. Everyone wants to eat something hot and high calorie. Hot pot, thick soup, hot coffee, hot tea, and even a little wine to warm up. These high-fat foods and hot drinks, although satisfying to the mouth, can slow down the emptying speed of the stomach, stimulate gastric acid secretion, and further reduce the pressure on the "valve", causing the risk of reflux to skyrocket. The activities have decreased due to the cold weather, and everyone doesn't like to move. After dinner, snuggle up on the sofa, watch TV shows, use your phone, or curl up in tight warm clothes. These habits can increase abdominal pressure, squeeze the stomach, and force the contents of the stomach to flow back into the esophagus. Dinner requires time management. Since we know this disease is related to eating, let's start with dinner first. To avoid burning your heart at night, you need to follow these rules. Remember one principle: after eating, wait at least 3 hours before lying down. If you are used to sleeping at 10:30 at night, you have to put down your chopsticks at 19:30 at the latest. Give your stomach enough digestion time and don't go to bed with a full stomach of food. Control your appetite for dinner, don't overeat, 70% full is the most suitable. Too much food in the stomach, high pressure, and easier reflux. Pay attention to food "traffic lights". The so-called "green lights" refer to recommended foods, such as low-fat and high protein foods (steamed fish, chicken breast, tender tofu, etc.), alkaline fruits and vegetables (pumpkin, spinach, bananas, etc.). "Yellow light" is a moderate amount of food, such as warm grains Congee, sugar free yogurt. Red lights "refer to foods that should be avoided as much as possible, such as spicy foods, high-fat foods (fatty meat, deep fried), strong coffee, chocolate, mint, citrus, tomatoes, carbonated drinks, spirits, etc. Seemingly "health preserving" but actually harmful to the stomach misconception: Drinking a cup of hot milk before bedtime can help sleep. Whole milk is high in fat and protein, and can also promote gastric acid secretion. After drinking milk for about 2 hours, the secretion of stomach acid reaches its peak. At this time, you have just fallen asleep and your heartburn is even more severe. Misconception 2: Drinking alcohol to warm up can directly stimulate the esophageal mucosa, causing damage and inflammation. Drinking alcohol only warms the surface of the skin, but it harms the inside of the esophagus, which is not worth the loss. If you sleep in the wrong position, you will suffer. If you eat right, you still need to sleep right. For patients with reflux esophagitis, their sleeping position directly determines whether they will have a peaceful or painful night. We rank common sleeping positions and summarize them as follows: if you can sleep on the left side, do not sleep on the right side; if you can lie on your side, do not lie on your back; and never sleep on your stomach. The recommended sleeping position for the first place is on the left side, which is determined by the anatomical position of the stomach. The greater curvature of the stomach is on the left side, with the opening of the cardia (the entrance to the stomach) facing upwards. When lying on the left side, it is very difficult for stomach acid to "climb" and reflux back into the esophagus, as the esophagus has the shortest contact time with acid. The second place is in a supine position with a moderate risk of reflux. However, it should be noted that if you snore or are overweight, lying on your back can easily lead to breathing pauses and trigger a vicious cycle of "suffocation reflux". The sleeping position on the right side is not recommended for third place. Because when lying on the right side, stomach acid is more likely to flow into the esophagus, and the time of acid corrosion is significantly longer than when lying on the left side. The last sleeping position that is absolutely prohibited is prone. Sleeping on your stomach is the worst. This will directly increase abdominal pressure, compress the chest cavity, not only causing reflux, but also potentially leading to nighttime coughing and suffocation. Many friends have heard that 'sleeping with a high cushion can prevent reflux', so they go home and raise their pillows too high. However, the next day, their neck aches and heartburn problems have not been solved. The wrong approach is to only raise the head. If you just raise the pillow, making the head 15 centimeters higher and the neck bent like a "big shrimp", but the chest and abdomen are still flat. This not only fails to resist stomach acid, but also affects the cervical spine. The correct way to raise the "bed" is to form an "uphill" trend from the stomach to the esophagus, using gravity to "press" stomach acid down. How to lift it? Raise the headboard! You can use solid wood blocks of 15-20 centimeters, specialized bed mats, or an electric bed to raise the head of the bed by 10-15 degrees (about 15-20 centimeters). How to choose a pillow? The height of the pillow only needs to adapt to the width of one side of the shoulder when lying on the side (8-12 centimeters), and the key is to keep the "head neck chest" in a straight line, without folding and compressing. Key point of one sentence: Raise the "headboard", not the "head"; It's reliable to tilt your whole body like a slide. The "four piece set" for protecting the stomach in winter for gastroesophageal reflux disease is ultimately an art of "eating" and "lying down". Control your mouth and adjust the angle of the bed to prevent stomach acid from flowing back. Finally, in order to help everyone survive the winter safely, we have summarized a set of "four piece anti reflux set". Please check it out: 70% full dinner, less oil and less spicy, try to finish before 19:30. After meals, take a walk for more than half an hour and don't just sit on the sofa after finishing. Shut your mouth before bedtime, don't eat anything within 3 hours before bedtime, and late night snacks are a big taboo. Sleeping requires attention to detail. Raise the head of the bed by 15 centimeters and try to stay on the left side of the bed. Of course, if you adjust your lifestyle but your symptoms still don't improve, don't force yourself and seek medical attention at the gastroenterology department in a timely manner. We will help you fix the "valve" of your stomach, so that your health can accompany you through the winter. Wen/Guo Xiaojuan (Beijing Tsinghua Chang Gung Hospital) (News Agency)