The GERD Diet: Acid-Reducing Foods
Everyone experiences heartburn now and then. But if you experience that burning sensation in your chest or throat regularly, some changes to your diet and eating habits may provide some relief.
“Your food should be moving one way — from your mouth to your stomach — and it should be digested in your stomach within a certain period of time,” says Sarah Andrus, MS, RD, LDN, a Mass General Brigham outpatient dietitian in the Newton-Wellesley Hospital GERD and Heartburn Clinic. “For people with chronic acid reflux or GERD (gastroesophageal reflux disease), that process does not work perfectly."
In people with GERD, acidic contents leak from the stomach up into the esophagus (the tube that connects your mouth to your stomach). Acid reflux and GERD can cause uncomfortable symptoms. They also can irritate the lining of your esophagus and cause health problems down the road. Knowing what to eat — and what to avoid — when you have GERD can help you get relief and prevent damage to the esophageal lining.
Symptoms of acid reflux
Acid reflux and GERD often cause one or more of the following symptoms:
Burning sensation in your throat or chest, called heartburn
Cough or sore throat
Feeling that food is stuck in your throat
Regurgitation, when food comes back up into your mouth from your esophagus
Trouble swallowing (dysphagia)
Voice changes or hoarseness
However, “silent GERD” involves frequent acid reflux that damages the esophagus but doesn’t cause symptoms. The condition is often discovered during endoscopy, a test that uses a tiny camera to explore your esophagus.
What foods cause acid reflux?
The foods you eat and the way you eat them can contribute to acid reflux.
“No foods are the cause of GERD, but certain foods and habits can worsen GERD symptoms. We have a fairly well-defined list of foods and behaviors that are most likely to be culprits,” Andrus says. “However, everyone’s food triggers are different. So it’s not a great idea to just omit the full list of these foods. They might not be problems for you, and not eating them can eliminate many good nutrients in your diet.”
She suggests keeping a record of what you eat and when you experience symptoms. This can help you identify what items affect you personally.
Foods that irritate the lining of the esophagus
Certain foods are more acidic and can irritate the lining of the esophagus. Acidic foods that many people with GERD avoid include:
Citrus products, such as lemons and orange juice
Spicy foods
Tomato products, such as red sauce
Foods that relax the esophageal valve
There are two valves (sphincters) in your esophagus. The upper valve connects your mouth to your esophagus. The lower one connects your esophagus to your stomach. They should remain closed until they need to open to allow food to come in. They also open when we throw up.
“But certain foods and drinks can relax that valve at the end of your esophagus, allowing acidic stomach contents to come back up into the esophagus,” Andrus explains. Those foods include:
Chocolate
Coffee
Mint, particularly peppermint
Foods that cause pressure in the digestive system
Other foods, including carbonated beverages such as sodas and seltzers can cause distention (pressure) in the stomach that forces the lower esophageal sphincter open. Large meals and late-night eating can also have this effect. When that lower sphincter opens, stomach acid can wash backward.
Foods that help with acid reflux
Very few foods have been shown to stop or fully resolve reflux, and there is no perfect diet for GERD. But some foods and habits can be protective against the condition or ease symptoms, Andrus says.
“When you look at map of the world that displays where people have more GERD, it tends to be areas where our diets are much more processed and lower in fiber or whole foods,” she says. “The regions with less acid reflux tend to consume more plants.”
If you have symptoms of GERD, reflect on your diet and look at every meal for a source of fiber. If you find your diet lacking, try to start replacing simple carbs with complex forms of fiber. Andrus recommends a diet rich in certain foods to avoid acid reflux:
Fruits
Vegetables
Whole grains
For active GERD symptoms, foods that are alkaline (the opposite of acidic) can help neutralize stomach acid. Dairy products are a reliable source of alkaline foods. If you can tolerate dairy, try the following foods to reduce stomach acid on the spot:
Cottage cheese
Kefir (a fermented milk)
Milk
Yogurt
Some resources suggest that ginger, peppermint products and lemon water can help. However, Andrus says they can actually worsen GERD, so try them with caution.
Other tips to prevent acid reflux
Eating habits can also trigger symptoms of acid reflux. Andrus recommends that people make some easy changes to alleviate GERD:
Don’t drink a lot of water during meals. Water can fill up the stomach and put more pressure on the esophageal valve.
Chew gum to increase saliva production. Saliva helps break down and digest foods.
Don’t eat late at night, as lying down soon after eating can trigger heartburn.
Eat slowly to prevent swallowing air. This also makes you chew your food more thoroughly and exposes food to more saliva, aiding in digestion.
Eat small meals every few hours. This will prevent you from skipping meals and then eating very large meals, which aggravates GERD.
Quit smoking. The habit is linked with an increased risk of acid reflux and other gastrointestinal conditions.
When to call your doctor for GERD
Andrus suggests that you talk to your primary care physician or a gastroenterologist if:
Medications are no longer as effective as they once were.
You have to use antacids more than once or twice a week.
You have to change your diet to prevent symptoms, especially if you’re cutting out important food groups.
GERD and cancer
While frequent heartburn is the most common GERD symptom, some people don’t experience it. They may notice other signs or symptoms that are related to GERD or could be potential signs of cancer, such as:
Anemia
Difficulty or pain during swallowing
Tooth decay
Unexpected weight loss
Voice changes such as hoarseness
If you have any of these symptoms and they are severe or long-lasting, talk to your doctor about GERD and cancer. They can help rule out more serious conditions, like esophageal cancer, before treating your GERD.
Managing GERD symptoms
Gastroenterologists can offer medications and surgical procedures that can help even severe GERD. For example, the GERD and Heartburn Clinic at Newton-Wellesley Hospital is one of only a few interdisciplinary GERD clinics in the country. It includes gastroenterologists, surgeons, physician assistants, nurses and dietitians who specialize in the condition.
A dietitian can be particularly effective by helping you evaluate your overall diet and identify what triggers acid reflux for you. A dietitian also can recommend dietary supplements to ensure proper nutrition and maintain a healthy weight.
