By Alex Bridges -- Daily Staff Writer

WINCHESTER- Holiday spreads can bring out "mmmms" and "ahhs," but some people just think "uggh."

With Thanksgiving coming in a few days, many doctors warn against overeating — and drinking alcoholic beverages — especially for people who suffer from eating-related disorders such as Gastroesophageal Reflux Disease, also known as GERD.

The ailment, described by many as feeling worse than heartburn, results when stomach acid enters the esophagus.

Dr. Nicholas Snow, a gastroenterologist at Winchester Medical Center, performed an endoscopy on a patient at the hospital recently. Snow works often with patients suffering from ailments affecting the gastrointestinal tract, and warns that holiday dining can exacerbate those problems.

"Obviously the later [and] more you eat, combining alcohol with large, fatty foods, each of which are independent risk factors for reflux," Snow said. "So a large meal, a fatty meal, eating late and alcohol, are independent risk factors."

"So in other words, reflux, while very common, is worse when you do those things," Snow said.

As the tiny camera attached to the end of the endoscope moves down the patient's throat, esophagus and stomach, Snow points out that the unidentified woman suffers from diabetes. That disease also can be affected if a person with it doesn't stick to a strict diet even during the holidays.

Studies show heavier people tend to gain more weight from eating during the holidays while lighter people do not, Snow said. Weight also plays a factor with people who may suffer from reflux because it puts more pressure on the stomach.

Many people take a Thanksgiving Day nap after sitting down and eating a large, holiday meal. They may also hunker down on the couch or in the recliner to watch a football game.

But Snow warned against that.

"One of the things we recommend for people with GERD is not to lie down for two hours or longer after, and mainly that's because gravity can play a big role in exacerbating reflux," he said.

While not a disease, doctors also see some increase in cases of food bolus, in which food becomes trapped in the esophagus and can cause problems. Snow said this can happen from eating too much too fast and to people with poor teeth or stricture in their esophagus.

"They will get a chunk of food down their that won't pass and I suspect we see more of that in the holidays though I'm not certain," Snow said.

On the liquid side, carbonated and alcoholic beverages are well known to cause trouble for people already suffering from digestive problems.

Alcohol can cause what is called "holiday heart syndrome," Snow said, or a heart arrhythmia.

Holiday indulging also can lead to pancreatitis, an inflammation of the pancreas.

"Almost any time you eat richer foods you stimulate more acid secretion and hormones in the GI tract that can exacerbate reflux and irritable bowel," Snow said. "One of the less common is probably pancreatitis which is sometimes [caused by] acute alcohol, sometimes chronic alcohol [consumption]. Fatty foods sometimes tend to stimulate more hormones and aggravate pancreatitis."

But is there a magic amount of food and drink a person must abide by to avoid problems? Snow said that all depends on the person. Weight does play a factor.

"Since heavy people are more likely to gain more weight during the holidays, they should pay more attention, unfortunately, to eating during that time," Snow said.

Susan Lessar, a dietitian working at Winchester Medical Center, explained that foods don't cause heartburn but rather aggravate the condition that stimulates acid production in the stomach. Some food and drink that do this include black pepper, coffee, tea, chocolate, alcohol and mint.

"There may be individual food intolerance, like tomato sauce may aggravate my heartburn," Lessar said.

Another ailment, gout, once was assumed to be linked to eating protein-rich foods. But Lessar explained that more recent studies are showing that gout has less to do with diet and people with the disease need to rely on their medications.

Lessar concurred that napping or sitting down for a long time right after the meal isn't a good idea.

"It's important to sit upright or stand for at least an hour after eating — that can help with reflux," she said.

The dietitian suggested people try to eat smaller meals more frequently rather than one large meal.

"Unfortunately, Thanksgiving dinner is not a small meal," Lessar said.

People with reflux or other diseases may already take medicine to treat their condition. Doctors don't usually see many people come to the hospital with acute symptoms around the holidays, Snow said.

"People are gonna feel bad because they have reflux and so, again, it's gonna be with richer foods, people tend to eat more desserts, more protein," he said.

Timing of the holiday dinner helps.

"I think maybe that's why Thanksgiving traditionally is earlier in the afternoon than most meals because it is so much bigger," Snow said. "It gives you a chance to digest some of the food before it causes reflux."

But Snow emphasized that even people with reflux or other ailments still should enjoy themselves at the holidays.

"The other thing to realize is you're not going to ruin yourself by one meal," Snow said. "Enjoy Thanksgiving. Enjoy the Christmas dinner. It's what you do throughout the year, if you're prone to reflux, you can prevent things but just enjoy it because we don't want people worried about all this."

Contact Alex Bridges at abridges@nvdaily.com