Functional Nutrition Intervention Protocols
GASTROESOPHAGEAL REFLUX DISEASE
SSESSMENT
Anthropometrics Height, weight, BMI
Waist circumference, hip circumference, waist-
to-hip ratio
% body fat, % lean body mass
Biomarkers/Labs
Conventional CMP, CBC, R/O Helicobacter pylori, parasites;
methylmalonic acid (MMA)
Functional IgG/IgG4 food sensitivity or MRT testing; consider
stool testing to rule out underlying infection
Nutrigenetic None
Clinical Indicators Nutrition-focused physical exam
Diet/Lifestyle Histories Comprehensive intake form
Medical Symptoms Questionnaire
IAGNOSIS Gastroesophageal reflux disease
NTERVENTION
Core Food Plan Balanced core food plan; weight loss, if indicated
Food Plan Modifications Comprehensive Elimination Diet to R/O food
sensitivities
Avoid foods that relax the lower esophageal
sphincter: high
fat foods, chocolate, alcohol (especially white
wine); avoid
foods that may be irritating to the esophagus:
carbonated
beverages, citrus fruit/juice, coffee, onions,
garlic, pepper,
spicy foods, peppermint, tomatoes/products,
very hot or
very cold foods; choose foods that dont relax
the lower
esophageal sphincter: low-fat protein foods,
low-fat
carbohydrate foods; 5-6 small, frequent meals,
drink fluids
30 min before or 60 min after meals
Anti-inflammatory foods: cold water fish; dark
red, black, or
blue fruits/juices; green tea; dark chocolate;
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Functional Nutrition Intervention Protocols
fruits and
vegetables in general
Medical Foods Anti-inflammatory food, if indicated
Dietary Supplements
High quality daily multivitamin with chelated
minerals
If using acid blocker, replenish vitamin B12,
folate, minerals
(replace, as indicated: Ca, Cr, Fe, I, Mg, Mn, Se,
Zn; zinc
carnosine recommended)
Transit time modulators: enteric peppermint oil,
probiotics,
also ginger as a modulator
Omega-3s, ~2g/d for inflammation
Melatonin, 0.5 mg 10 mg 1 hr before bed
Aloe vera juice (aloes-free), 50 ml (~6 oz) tid
DGL (deglycyrrhizinated licorice) may be helpful,
200 mg
tid
Ginger root (Zingiber officinale Roscoe), 1-4 g
fresh
(maximum 4g/d) or supplement standardized
to gingerol
content; root can also be steeped in hot water
and enjoyed
as a tea
Food/Medication/Dietary Aloe vera may cause hypoglycemia
Supplement
Interactions
Lifestyle
Recommendations
Physical Activity Daily activity, as tolerated, preferably outdoors
(sunshine)
Sleep Full complement, as determined for individual
patient
Elevation of head of the bed; wait at least 2-3 hr
after eating before lying down; avoid sleeping in
the left decubitus position
Psycho-social Encourage social connections, activities that are
meaningful
and pleasurable for the individual
Smoking cessation
Potential transit time modulators: acupuncture,
hypnosis, music therapy
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Functional Nutrition Intervention Protocols
ONITORING and VALUATING
Follow-up Plan Periodic contact by functional nutrition
practitioner
Return to clinic in 3 weeks to begin food
reintroduction
Key Resources:
Natural Standard Database or Natural Medicine Comprehensive Database for
supplement information
Kaltenbach T, Crockett S, Gerson LB. Are lifestyle measures effective in patients
with gastroesophageal reflux disease? An evidence-based approach. Arch Intern
Med. 2006;166:965-71.
Li Y, Foundation and clinical research on the effect of traditional Chinese herbs on
gastrointestinal motility. Chin J Integr Med. 2009;15:86-8.
Werbach MR. Melatonin for the treatment of gastroesophageal reflux disease. Altern
Ther Health Med. 2008;14:54-8.
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