Symptoms of acid reflux occur when acid moves backward from the stomach into the esophagus. This occurs because of a weakened or damaged lower esophageal sphincter (LES). Under normal conditions, the LES typically closes to keep food from coming back up after it enters your stomach.
The foods you eat affect the amount of acid your stomach produces. They can also be directly irritating to the esophagus. Diet and nutrition are key considerations for those who suffer from acid reflux or gastroesophageal reflux disease (GERD), a severe, chronic form of acid reflux.
Many people with GERD find that certain foods trigger their symptoms. These foods may irritate the esophagus. They may also cause problems with the LES. Discovering which foods make your symptoms worse can help you deal with your GERD.
No single diet can prevent all symptoms of GERD. Triggers are different for different people. In order to figure out your triggers, it helps to keep a food diary. This diary should track:
- what food you eat
- what time of day you eat
- any symptoms that you experience
Keep the diary for at least a week. You may want to go longer if you eat a varied diet. You can then use the diary to identify the specific foods and drinks that affect your GERD.
The following diet and nutrition guide is a starting point to plan your meals. Use this guide in conjunction with your food journal and recommendations from your doctor. The goal is to minimize and control your symptoms and to find a diet that works for you.
Doctors debate which foods actually cause reflux symptoms. However, certain foods have been shown to cause problems in large numbers of people. These foods are good ones to try eliminating from your diet.
Fried and fatty foods can cause the LES to relax, allowing more stomach acid to back up into the esophagus. They also delay stomach emptying. Eating such foods puts you at greater risk for reflux symptoms. Reducing your total daily fat intake can help.
The following foods have high fat content. Avoid them or eat them only sparingly.
- french fries and onion rings
- full-fat dairy products like butter, whole milk, regular cheese, and sour cream
- fatty or fried cuts of beef, pork, or lamb
- bacon fat, ham fat, and lard
- high-fat desserts or snacks like ice cream and potato chips
- cream sauces, gravies, and creamy salad dressings
Tomatoes and Citrus Fruit
Fruits and vegetables are important to a healthy diet. However, certain fruits can cause or worsen GERD symptoms. Specifically, highly acidic fruits are more likely to make your symptoms worse. If you suffer from frequent acid reflux, you may want to reduce or eliminate your intake of:
- tomato sauce (or foods where tomato sauce or paste is a main ingredient, such as pizza or chili)
Chocolate contains an ingredient called methylxanthine. It has been shown to relax the smooth muscle in the LES. This can increase reflux.
Garlic, Onions, and Spicy Foods
Spicy and tangy foods trigger heartburn symptoms in many people. This includes foods such as onions and garlic.
These foods won’t be triggers for everyone. If they’re a big component of your diet, make certain to track them carefully in your diary. Some spices may bother you more than others.
No diet has been proven to prevent GERD. However, certain foods may help ease symptoms in some people.
Talk to your doctor if you have questions about whether certain foods should be part of your diet. What helps improve acid reflux for one person may be problematic for another. Working with your doctor can help you develop a diet that works for you.
Yogurt and Probiotics
Probiotics are “good” bacteria. They are commonly found in yogurt. According to the Mayo Clinic, eating probiotic foods may aid digestion. It may also offer some protection from harmful bacteria.
Preliminary studies have shown that probiotics can help treat specific digestive problems such as:
- diarrhea (particularly when it is caused by antibiotics)
- irritable bowel syndrome
- certain intestinal infections
There is not enough research on how probiotics affect GERD symptoms. However, there is reason to believe they may be helpful in some people.
Research shows that increased fiber intake, specifically in the form of fruits and vegetables, may help protect against a number of digestive woes, including GERD. Scientists are not yet certain how fiber prevents GERD symptoms. However, increasing your dietary fiber is generally a good idea. In addition to helping with your GERD, fiber also reduces the risk of:
- high cholesterol
- uncontrolled blood sugar
- hemorrhoids and other bowel problems
- Allen, M.L., et al. (1990). The effect of raw onions on acid reflux and reflux symptoms. Am J Gastroenterol , 85, 377-380. (http://www.ncbi.nlm.nih.gov/pubmed/2327378)
- Asthma and Allergy Foundation of America. (2012). Allergic asthma. Retrieved from Asthma and Allergy Foundation of America: http://www.aafa.org/display.cfm?id=8&sub=16
- Cleveland Clinic. (2008). Diseases & conditions: GERD and asthma. Retrieved from Cleveland Clinic: http://my.clevelandclinic.org/disorders/gastroesophageal_reflux_gerd/hic_gerd_and_asthma.aspx
- El-Serag, H.B., et al. (2005). Dietary intake and the risk of gastro-oesophageal reflux disease: a cross sectional study in volunteers. (http://www.ncbi.nlm.nih.gov/pubmed/15591498, Ed.) Gut , 54, 11-17.
- Harvard Medical School. (2012). More than just heartburn. Retrieved from Harvard Medical School: http://getima.com/Documents/GERD.pdf
- Johns Hopkins Medicine. (2011). Johns Hopkins health alert: the benefits of fiber. Retrieved from Johns Hopkins Medicine: http://www.johnshopkinshealthalerts.com/alerts/digestive_health/JohnsHopkinsHealthAlertsDigestiveDisorders_1447-1.html
- Mayo Clinic. (2011). Basics: GERD: lifestyle and home remedies. Retrieved from Mayo Clinic: http://www.mayoclinic.com/health/gerd/DS00967/DSECTION=lifestyle-and-home-remedies
- McKinley Health Center. (2008). The GERD diet (gastroesophageal feflux disease). Retrieved from University of Illinois, McKinley Health Center: http://www.mckinley.illinois.edu/handouts/gerd_diet.html
- National Institutes of Health. (2007). Heartburn, gastroesophageal reflux (GER), and gastroesophageal reflux disease (GERD). Retrieved from National Digestive Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health: http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/index.aspx
- University of Maryland Medical Center. (2012). Food allergy. Retrieved from University of Maryland Medical Center: http://www.umm.edu/altmed/articles/food-allergy-000063.htm
- University of Maryland Medical Center. (2011). Garlic. Retrieved from University of Maryland Medical Center: http://www.umm.edu/altmed/articles/garlic-000245.htm
- University of Pittsburgh Medical Center. (2011). Patient education materials: GERD: gastroesophageal reflux disease. Retrieved from University of Pittsburgh Medical Center: http://www.upmc.com/HealthAtoZ/patienteducation/G/Pages/gerdgastroesophagealrefluxdisease.aspx
- Zeratsky, K. (2011). Consumer health: are probiotics and prebiotics important for health? Retrieved from Mayo Clinic: http://www.mayoclinic.com/health/probiotics/AN00389