With Mayo Clinic nutritionists Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.

I was just looking through a recent issue of the journal "Nutrition in Clinical Practice" and came across a review article on "Diet and Lifestyle Modifications in the Management of Gastroesophageal Reflux Disease" — or GERD. The article listed some statistics:

• GERD is the most common gastrointestinal related diagnosis given by U.S. physicians.
• 44 percent of the population has bothersome symptoms at least once monthly.
• 17 percent have weekly occurrence, 7 percent are bothered daily.
• In 2004 medication to treat GERD was among the top 5 selling drugs — costing in excess of $10 billion dollars.

Long-standing or inadequately treated GERD can lead to adenocarcinoma among other conditions that can affect swallowing — pretty serious.

Why my interest? My husband has GERD. But rather than go into detail about what this condition is, I thought I'd approach it from the perspective of a spouse. (See the links below for a full description and a neat video.)

About 10 years ago, my husband would suddenly sit upright in bed in the middle of the night gasping. Since I began my practice in gastroenterology we quickly determined that it was probably acid reflux and got over-the-counter antacids. We also implemented several lifestyle changes such as smaller meals and avoiding foods he knew were aggravating like garlic and caffeine. We don't smoke, and he's skinny so his weight is not an issue.

Some time later, we were having dinner (complete with guests) and he again gasped, clutched his chest (heart attack?) and off to the ER we went. He was diagnosed with esophageal stricture with spasms (due to reflux) — a very painful condition that mimics a heart attack. OK, time to get really serious. He had a procedure that stretched his narrowed esophagus, and was put on stronger prescription medication. It was a certainty that we needed further lifestyle changes.

We've found we need to eat early — no later than 6:30 pm in order to control symptoms so we can get to bed at a decent hour. We get off work at 5 p.m. So things get really hectic in order to get dinner served and eaten. We have also found that our evening glass of wine needed to be eliminated. Our friends have learned that our dinner parties start at 5 and end early. For elevating the head of the bed we tried the typical 6-inch blocks you can get at the home improvement center. Not good enough. Finally we got an 8-inch by 6-inch railroad type tie. He also supplements this with a foam wedge that elevates his upper torso about another 4 inches for a total of 1 foot. Perfect! We've also implemented all of the other recommended lifestyle changes listed in the links below.

My point is that when medical problems occur, they impact the lives of family members and friends. My husband appreciates that I've improved his quality of life by changing many things in our diet and being a partner in his care. (He also appreciates that I must put up with clinging to the head of the bed to keep from sliding down and off!)

Seriously, I fully recognize that there are other medical conditions that are considered more grave. These include cancer, heart disease, diabetes, trauma and end of life maladies that require many changes in diet and life style. But common conditions like GERD are also important and they need the help of a spouse, family member or friend. (My husband also has celiac disease — but that will be another blog.)

I'd like to hear from you if you have a spouse, family member or friend with special dietary needs and how you help make their lives a bit better.

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