You may spend mealtime avoiding certain foods and drinks if you have acid reflux or gastroesophageal reflux disease (GERD). This is a condition where stomach acid leaks back into the esophagus. Symptoms can include coughing, nausea, hoarseness, belching, sore throat, and regurgitation.
GERD symptoms are affected by what you choose to eat. What you decide to incorporate or avoid in your diet can help relieve some of your symptoms.
Beverages such as coffee, colas, alcohol, carbonated drinks, and tomato and citrus juices often top the list of “don’ts.” Some research suggests that these beverages increase risk for GERD symptoms.
Herbal teas help improve digestion and soothe many stomach problems, such as gas and nausea. The American Dietetic Association recommends caffeine-free herbal tea for acid reflux, with the exception of spearmint or peppermint teas.
The Mayo Clinic suggests chamomile, licorice, slippery elm, and marshmallow as herbal remedies to soothe GERD symptoms.
Licorice helps increase the mucus coating of the esophageal lining, which helps calm the effects of stomach acid. However, there is insufficient evidence to confirm the effectiveness of fennel, marshmallow root, and papaya tea.
When using dried herbs as extracts in tea, you should use 1 teaspoon of herb per cup of hot water, says the National Gardening Association. Steep leaves or flowers covered for five to 10 minutes. Steep roots 10 to 20 minutes. For best results, drink two to four cups per day.
Be aware that some herbs can interfere with certain prescription medications, so talk to your doctor before trying an herbal remedy.
Cow’s milk contains a significant amount of fat and is hard to digest. Like all high-fat foods, full-fat cow’s milk may relax the lower esophageal sphincter, which can cause or worsen reflux symptoms.
Opt for the lowest fat options possible if you have to go with cow’s milk products. The McKinley Health Center at the University of Illinois includes skim milk as part of its recommended GERD diet.
For those who are lactose intolerant or just experience an increase of acid reflux symptoms from dairy, plant-based milks are a good solution. Today there are a variety of these products available, including soy milk, almond milk, cashew milk, and coconut milk. Carrageenan is a common additive in non-dairy beverages, which may contribute to digestive symptoms. Avoid this additive if you have GERD.
Almond milk, for example, has an alkaline composition which can actually help to neutralize stomach acidity and can relieve acid reflux symptoms. Soy milk contains less fat than most dairy products, making it a safer choice for people with GERD.
Citrus drinks such as orange, tangerine, grapefruit, and other drinks like pineapple juice and apple juice are very acidic and may cause acid reflux. Other types of juices are less acidic and thus less likely to trigger GERD symptoms in most people. Options include carrot, aloe vera, cabbage juice, or freshly juiced drinks made with less acidic foods like beet, watermelon, spinach, or cucumber. Because tomato-based foods can trigger reflux symptoms, avoiding tomato juice may also reduce GERD.
Sometimes, the simplest solutions make the most sense. Tufts Medical Center recommends drinking eight glasses of water per day to help reduce GERD symptoms. Some doctors also recommend alkaline water to reduce stomach acidity and to control acid reflux.
Drinks to avoid
Just as some drinks are more easily tolerated by those with acid reflux, there are drinks that can aggravate the condition. These should be avoided as much as possible for those with GERD. Examples include fruit juices, caffeinated beverages, and carbonated beverages.
Citrus juices are naturally highly acidic, and thus can aggravate acid reflux. Examples of citrus juices include lemon juice, orange juice, lime juice, and grapefruit juice. The citric acid that is naturally present in citrus can irritate the esophagus. While the stomach is made to withstand higher acidic foods, the esophagus is not.
When buying juice drinks, check for citric acid. It’s sometimes used as a flavoring.
Morning coffee is a daily habit for many, but those with acid reflux should avoid it when possible. Coffee can stimulate excess gastric acid secretions that may rise up to your esophagus (particularly when a large amount of coffee is consumed), which results in heightened acid reflux symptoms.
Other caffeinated beverages, like sodas or teas with a lot of caffeine, can have similar effects and should be avoided as much as possible.
Alcohol can negatively affect those who have acid reflux, regardless of whether you’re drinking a glass of wine or downing a margarita. Hard liquor is more likely to quickly aggravate reflux conditions, though a glass of wine with an otherwise large or acidic meal can cause discomfort, too.
Heavy consumption of alcohol may be a risk factor for developing GERD, and it could potentially cause mucosal damage in the stomach and esophagus.
Acid reflux and pregnancy
Some women who have never experienced acid reflux before will develop acid reflux or heartburn symptoms for the duration of their pregnancy. This is normal, and many women will experience a decrease or cessation in symptoms after the pregnancy is over.
In addition to the guidelines discussed above, sipping liquids instead of drinking them quickly can help prevent acid reflux symptoms. Keeping a food diary to help track what is aggravating your symptoms and when can help you to prevent symptoms throughout your pregnancy.
If your GERD or acid reflux hasn’t responded to purely dietary changes, there are other remedies and medications that may offer relief.
Over-the-counter treatments include:
- temporary use of antacids, like Tums or Gaviscon
- proton pump inhibitors, like omezaprole or Prevacid
- H2 receptor blockers like Pepcid AC
- deglyccerhized licorice
Prescription medications include:
- prescription-strength proton pump inhibitors
- prescription-strength H2 receptor blockers
- medications like Baclofen, which strengthen the esophageal sphincter
In extreme cases, surgery may be in an option. Surgery can reinforce or strengthen the lower esophageal sphincter.
As with eating, when and how you drink beverages can make a difference in GERD symptoms.
The following tips can help keep symptoms at bay:
- Avoid skipping breakfast or lunch, which can lead to overeating (and overdrinking) late in the day.
- Give up late-night snacks, including beverages that may cause heartburn (carbonated and caffeinated drinks).
- Maintain an upright posture during and after eating and drinking. Don’t eat for at least three hours before bedtime.
- Moderate alcohol consumption. Drinking too much alcohol can cause reflux symptoms in some people.
- Reduce or eliminate spicy foods and fried foods.
By practicing healthy drinking habits as a part of your overall plan for managing GERD, and taking note of how your individual symptoms respond to specific foods and drinks, you can reduce your reflux symptoms and improve your quality of life.