If you live with gastroesophageal reflux disease (GERD), then you’re probably familiar with the burning sensation in your chest that occurs after consuming certain foods or beverages. You may even already know some of your heartburn triggers. For example, you might know that you’ll pay the price later if you indulge in chili dogs or orange juice.

However, sometimes your GERD symptoms may occur when you least expect them, making you feel frustrated and discouraged. You avoided the orange juice, yet you still experienced heartburn after breakfast. You didn’t eat the chili dogs at your parents’ barbeque, but you drove home clutching your chest anyway.

What else could be triggering your discomfort? The best way to find out is to keep a “trigger log” for at least one week. You should take note of all the foods and beverages you consume, as well as all the activities you participate in each day. When you look back, you’re likely to discover subtle triggers that you can avoid in the future.

A trigger journal can be as simple as a notebook you carry with you, or as complex as a spreadsheet file you create on your computer. It doesn’t matter how you track your triggers. The important thing is that you record what you eat, drink, and do each day, and note whether or not you experience GERD symptoms. It’s also important that you record the time of day of each meal and activity, to help determine if there are any patterns that you can avoid in the future.

There is no specific diet that will prevent all symptoms associated with GERD. The only way you can create a diet and lifestyle that will help you feel better is to create a trigger journal. Keeping a log of all meals, drinks, and activities throughout your day will allow you to determine which foods and activities aggravate your reflux and which ones help alleviate recurrences. A sample entry in your trigger journal may look like this:

You should continue keeping this journal every day for at least one week. Recording your consumption and behavior for an additional one to two weeks will allow you to experiment with a wide variety of food, drinks, and activities at different times. This can help you identify your potential triggers more easily.

Once you’ve completed the journal, look over your daily logs and note when you experienced symptoms. Try to find similarities in the columns throughout your entries to determine possible triggers.

For example, you may want to list orange juice as one of your triggers if you had it for breakfast three times, and you experienced heartburn after drinking it each time. However, you may want to look more closely if you had heartburn only one of the three times. Perhaps it was the coffee instead of the juice that caused your heartburn.

As you identify the culprits that aggravate your symptoms, write them down at the bottom of your journal. This will serve as a good starting point for eliminating the triggers that cause you discomfort. You are likely to determine which activities and foods are causing you to experience symptoms of heartburn within the first week of keeping your journal. However, don’t be discouraged if you don’t immediately identify any triggers. Instead, continue making journal entries as GERD is a complex condition with many causes that may not be easily identifiable in all individuals.

The best way to narrow down your list of potential triggers is to continue taking notes in your journal for another couple of weeks. Avoid your suspected triggers and see if symptoms improve. Most of this process involves trial and error.

As you continue to experiment, it helps to know which foods, beverages, and activities commonly trigger heartburn and other GERD symptoms. Remember that each person is different. What may trigger symptoms in one person may not bother you, and vice versa.

It should also be noted that GERD symptoms are related not only to what you eat, but how much you eat. Eating smaller portions more often (as opposed to two or three big meals a day) will help keep your stomach from bloating and producing too much acid, which is one cause of reflux symptoms

The following foods have been identified as common culprits:

  • chocolate
  • spicy foods
  • high-fat foods
  • fried foods
  • citrus fruits
  • tomatoes and tomato-based products
  • onions
  • garlic
  • peppermint

Some of these foods may stimulate the production of stomach acid, making GERD symptoms more severe. Others may relax the muscle that separates the esophagus and stomach, allowing acidic stomach contents to flow back up into the esophagus. This flow can cause symptoms such as lower chest burning and pain.

Steer clear of these beverages if you want to prevent symptoms:

  • carbonated drinks
  • caffeinated drinks
  • citrus and tomato juices
  • Coffee, both regular and decaf
  • alcohol

These beverages can increase the amount of acid in the stomach and aggravate the esophagus, triggering GERD symptoms.

Finally, remember that doing certain activities after eating can also prompt the onset of symptoms. The following activities are common triggers:

  • eating late at night
  • lying down within one hour after eating
  • lying on your right side, which puts the stomach higher than the esophagus and can increase the risk for acid flowing back up into the esophagus
  • wearing tight clothing
  • smoking

Try these activities instead:

  • Stay upright or take a walk after meals.
  • Refrain from eating at least two hours before bedtime.
  • Use wedge pillows to elevate your head while you sleep. These special pillows may be available at medical supply stores.
  • Chew non-mint gum, which can cut down on stomach acid.
  • Consider stopping use of all forms of nicotine. If you are struggling with addiction to cigarettes or smokeless tobacco, you can ask your doctor for help.

Some potential triggers that you may not have considered include weight gain and certain medications, including those used to treat:

  • high blood pressure
  • asthma
  • osteoporosis
  • arthritis
  • Parkinson’s disease
  • anxiety
  • depression
  • insomnia

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, break down the protective barrier in your stomach. This allows acid to irritate the lining of your stomach and worsen symptoms of GERD. To determine whether your medication is contributing to your symptoms, check the drug label for a list of possible side effects. Talk to your doctor if you suspect your medication is triggering GERD symptoms. Your doctor may be able to lower your dosage or switch you over to another medication altogether.

Other possible triggers for heartburn include:

  • fish oil supplements
  • stress
  • pregnancy

The key to finding your triggers is getting to know your body and its reactions. After you identify what is causing your symptoms, you can work to create a diet and lifestyle that prevents recurrence of your symptoms of GERD and allows you to live a much more comfortable lifestyle.