Everyone needs to eat, but for people who have gastroesophageal reflux disease (GERD), eating the wrong thing can have painful consequences. GERD symptoms include heartburn, or a burning sensation in the chest or throat. Additional symptoms are difficulty swallowing or constant coughing.

However, eating the right foods can also help relieve GERD symptoms. In this article, we will dive into the following foods that affect acid reflux and GERD:

WHAT CAUSES ACID REFLUX?

Acid reflux occurs when stomach acid reaches the esophagus and causes irritation. Normally, the ring of muscle that connects the esophagus and stomach, called the lower esophageal sphincter (LES), closes to prevent stomach acid from reaching the esophagus. A damaged or weakened LES, however, relaxes and opens when it should be closed and allows stomach acids to reach the esophagus.

Multiple factors can contribute to acid reflux, including:

  • Activities before and after eating
  • What time of day you eat
  • Position of your body
  • The amount of food you eat
  • What food you eat

Those who experience acid reflux more than twice a week may have GERD and should visit a doctor for diagnosis and treatment.

If you’re just starting to experience GERD symptoms and you’re not sure what’s causing your symptoms, read this list of foods that may worsen your GERD symptoms, as well as foods that may provide GERD relief.

Foods that Worsen GERD

Pinning down which foods to avoid and which foods to eat for GERD is not always clear. It is best to keep a food diary to track what foods, the amount of food, and what meal times trigger acid reflux. Though, the list of foods below may be a good place to start.

1. DAIRY

People often think dairy, like whole milk, will soothe a burning throat or upset stomach. However, milk and dairy products are high in fat and tend to make heartburn worse. When you have frequent GERD symptoms, like heartburn, eating high-fat dairy products like cheese can aggravate your symptoms.

Furthermore, cold dairy products like ice cream can actually numb and inhibit the lower esophageal sphincter’s function. As a result, stomach acid can backwash up into the esophagus much easier. If you insist on keeping dairy in your diet, stick to low-fat dairy or foods made with plant-based milk.

Dairy to avoid:

  • Cream
  • Whole milk
  • Cheese
  • Ice cream
  • Full fat yogurt

2. CITRUS Fruits and Juices

Lemons, oranges, limes, and grapefruit are all foods that can make your GERD symptoms worse because of their citric acid content. Pineapple is another fruit high in citric acid you might want to avoid in order to manage your symptoms.

Why Does Citrus Give Me Heartburn?

Because citrus fruits contain high amounts of citric acid, they cause your stomach to produce more stomach acid. As a result, your stomach is more full and the chances for reflux increase. You may not experience heartburn every time you eat citrus fruits, but if you enjoy a glass of orange juice every day,  you might want to moderate your citrus intake if you notice a connection between your symptoms.

Citrus to avoid:

  • Grapefruit
  • Oranges
  • Limes
  • Lemons
  • Pineapple

3. TOMATOES

These red, ripe fruits grow quickly and are a staple in many foods. Their umami or savory flavor makes many favorite foods tasty. Pasta with marinara sauce, pizza, lasagna, stew and more benefit from tomatoes. They’re also nutritious, packing antioxidants, vitamin C, and potassium.

However, tomatoes are also highly acidic. Just like citrus, the acids in tomatoes will increase your stomach’s acid levels. Furthermore, tomato sauces often contain onion and garlic, which can also trigger acid reflux.

4. SPICY FOODS

Chili peppers, hot sauce, paprika, salsa, wasabi, and other spicy additives make food delicious. However, spicy foods contain a substance called capsaicin, which is a chemical compound that gives them their spice. Capsaicin also causes a burning sensation on the mucous membranes in the digestive tract and increases stomach acid production.

However, a 2010 study on the Asian diet has some evidence that people who regularly eat spicy foods may have a tolerance to their effects. Though, there is no concrete evidence that is true.

Spicy foods to avoid:

  • Chili powder
  • chili oil
  • cayenne pepper
  • white pepper
  • black pepper

5. COFFEE and Caffeinated Drinks

An almost essential part of everyone’s day, the caffeine in coffee helps many people get their day started and maintain their energy throughout the day. However, the caffeine in coffee also impairs the contractions of the LES. A cup of coffee a day may not be enough to cause problems. However, the answer may be in how much caffeine you’re taking in.

If you drink coffee with high caffeine content and have recurring heartburn, try decreasing the amount of caffeine you drink.

6. SODA

There are two factors from soda and soft drinks that aggravate acid reflux symptoms. One, just like coffee, is caffeine content. The second is carbonation.

Energy drinks, cola, and even some citrus sodas all have caffeine. If you drink multiple caffeinated sugary drinks per day, the greater the chances are that your LES will have a hard time functioning properly.

The carbonation from sodas inflates the stomach while also increasing its internal pressure. Combining the increase of pressure and the relaxant effect of caffeine on the LES, reflux becomes more likely.

7. High Fat and FRIED FOODS

Naturally, fried foods are high in saturated fats, which take much longer to break down in the stomach. Fatty fried foods also slow down the digestion process. In order to break down these complex fats, your stomach will produce more acid. As a result, your stomach will become more full and increase the likelihood of reflux.

Fried and high fat foods to avoid:

  • French fries
  • Potato chips
  • Onion rings
  • High fat red meats
  • Peanut butter​

8. CHOCOLATE

Like coffee, chocolate contains some amounts of caffeine, which relaxes the LES. Additionally, cocoa powder is another acidic substance that can increase stomach acid. Chocolate also releases serotonin when eaten. Serotonin is a mood-regulating hormone that calms stress. However, serotonin can also cause the LES to relax and increase the likelihood of acid reflux.

WHAT ELSE CAN CAUSE GERD SYMPTOMS?

As you might have noticed, the common factor through most of the above foods is how they make symptoms worse. Most cause a combination of either relaxing the LES, increasing stomach acid production or keeping the stomach full for too long. The above foods are not the only foods and drinks that can aggravate GERD symptoms. Additional items include the following:

  • Alcohol
  • Mints
  • Nitrates
  • Iron or potassium supplements
  • Processed Foods
  • Pain relievers such as ibuprofen, acetaminophen and aspirin
  • Antibiotics
  • Bisphosphonates (osteoporosis medications)
  • Alpha-blockers and calcium channel blockers (high blood pressure medications)
  • Tricyclics (antidepressants)
  • Theophylline (bronchodilator to treat asthma and chronic obstructive pulmonary disease)

Some medications such as alpha-blockers and calcium channel blockers can make symptoms worse. If you suspect that one of your medications is the reason for your GERD symptoms, talk to your doctor before stopping your medication. Your doctor may recommend alternative medications or treatments.

Additionally, the foods listed above may be hard to cut out completely. Instead of eliminating foods that trigger acid reflux, try eating them in moderation. Also try eating smaller meals more frequently as opposed to larger meals two or three times a day.

FOODS THAT HELP REDUCE ACID REFLUX SYMPTOMS

There are plenty of foods that can nullify or even just help you manage your GERD symptoms. Keep in mind that eating these foods is not a permanent cure. However, these foods will help you reduce your symptoms and prevent them from getting worse.

The first thing to note about foods that make GERD worse is their high-fat content, their relaxant properties, and their difficulty to digest. Once you know this, consider the foods that might be the opposite. Remember to record foods that alleviate heartburn in a food diary. Some of these foods may even help you instantly relieve symptoms.

1. VEGETABLES

Low in calories, low in fat, and low in sugar, vegetables are an excellent source of key nutrients and fiber. Additionally, vegetables have a high satiating factor, meaning they will leave you full and satisfied after a big meal without regrets. Vegetables are also easy to digest, which reduces the risk of a flare-up.

Vegetables to eat:

  • Green beans
  • Broccoli
  • Asparagus
  • Cauliflower
  • Leafy greens (though these may trigger some)
  • Potatoes
  • Cucumbers
  • Fennel
  • Celery
  • Sweet peppers
  • Sweet potatoes
  • Carrots
  • Beets

2. Whole Grains

A high-fiber food that can be flavored with any mix-ins and accompany any meal, whole grains are a good choice for any diet. Fiber promotes healthy digestion and reduces acid reflux as a result. Whole grain also provides healthy energy levels throughout the day.

Whole grains to eat:

  • Oatmeal
  • Whole grain rice
  • Whole grain bread (not whole wheat)
  • Couscous
  • Quinoa

3. GINGER

This spicy root actually helps soothe upset stomachs and reduce inflammation. For most people, ginger is too strong to be eaten raw. Brewing ginger tea, drinking ginger ale, or adding sliced or grated ginger to a salad can help you manage painful reflux symptoms.​

4. HEALTHY FATS

Saturated and processed fats take much longer to digest. On the flip side, your body does need healthy fats that can be found in tree nuts, avocados, olive oil and flaxseed. These are healthy unsaturated fats found in plants.

Fats to eat:

  • Avocados
  • Walnuts
  • Flaxseed
  • Olive oil
  • Chia seeds
  • Sesame oil
  • Sunflower oil

5. Lean Meats

Lean meats and seafood are a great source of protein while containing a low amount of fat. Instead of frying lean meats, keep them healthy by baking, broiling, grilling, or air frying them. Use healthy oils like olive oil, sunflower oil, or avocado oil when cooking.

Lean meats to eat:

  • Chicken breast
  • Turkey, white meat
  • Fish
  • Other seafood

6. Non-Citrus Fruits

In comparison to citrus fruits, non-citrus fruits contain valuable vitamins and minerals as well as fiber to aid in digestion. Plus, alkaline fruits (fruits with a high pH) can neutralize stomach acids (pH between 1 and 2) and relieve acid reflux. Bananas are a great choice to relieve acid reflux only if they are ripe and have a few brown spots. Underripe, green bananas contain more starches, which can trigger acid reflux.

Fruits to eat:

  • Ripe Bananas
  • Melons
  • Apples
  • Pears

7. Legumes

A great source of protein and fiber, legumes are a healthy addition to any diet. Legumes are satiating, meaning they help you feel full for longer, but without the negative effects of acid reflux.

Legumes to eat:

  • Beans
  • Peas
  • Lentils

8. Yogurt

While whole fat dairy can trigger acid reflux, low-fat and sugar-free yogurt can soothe an irritated esophagus. Additionally, the probiotics in yogurt help aid in digestion and promote gut health.

DIAGNOSING GERD


If you experience chronic acid reflux and suspect you have GERD, you should see your doctor. Only a trained physician can diagnose GERD. To determine a diagnosis, the physician will look at family history, assess symptoms, and potentially run diagnostic tests, like an endoscopy, pH monitoring, and esophageal manometry.

Here’s a more detailed look at the diagnostic process:

  1. Medical History: The doctor will ask about your medical history, including any symptoms, their frequency, and severity. They may also ask about potential risk factors for GERD, including medications.
  2. Physical Examination: The physician may perform a physical exam to check for signs of GERD or other related conditions. This exam may include checking for weight loss, abdominal tenderness, or other biological indicators.
  3. Symptom Assessment: Your doctor will want to know about any potential symptoms. GERD symptoms often include heartburn, regurgitation, chest pain, difficulty swallowing, and coughing. Describing your symptoms in detail will help the doctor understand your condition.
  4. Dietary and Lifestyle Assessment: Your doctor will look at your diet, eating habits, and additional lifestyle factors, like smoking, that could contribute to GERD. Let your doctor know if you frequently eat foods that are bad for GERD, like the ones mentioned above.
  5. Reactions to Medication: In some cases, doctors may prescribe medications called proton pump inhibitors (PPIs) to see if there’s an improvement in symptoms. If symptoms respond positively to the medication, it may support a GERD diagnosis.
  6. Endoscopy: If symptoms persist or are severe, your physician may recommend an endoscopy. During an endoscopy, the physician inserts a thin, flexible tube with a light and camera (endoscope) through the mouth into the esophagus to inspect the lining for signs of inflammation or damage. They may also take a biopsy.
  7. pH Monitoring: This test measures the acidity (pH level) in the esophagus over 24 hours. The test can help confirm abnormal acid levels and determine the frequency and duration of acid exposure in the esophagus.
  8. Esophageal Manometry: This test measures the lower esophageal sphincter (LES) strength and function of the esophageal muscles. It can identify issues with food and stomach acid movement.

The specific diagnostic approach may vary from person to person, and not all individuals with suspected GERD will undergo every test. The choice of diagnostic tests depends on the severity and nature of symptoms, response to initial treatment, and the doctor’s clinical judgment. Always consult a healthcare professional for an accurate diagnosis and appropriate treatment plan.

GERD TREATMENT IN NASHVILLE

Remember that no single diet can cure GERD or prevent all acid reflux symptoms. Trigger foods will vary from person to person, so write them down in a diary. However, effective diet changes can help you avoid other needed treatments.

When you need immediate acid reflux relief, antacids work, though they are a short-term solution. The calcium carbonate and other ingredients in antacids neutralize stomach acids and prevent painful symptoms. But remember that antacids do not treat or heal an inflamed esophagus. You will need long-term treatment for chronic acid reflux to prevent esophageal cancer.

If you need long-term treatment for acid reflux and GERD in Middle Tennessee, the surgeons and doctors at The Surgical Clinics can help. We want you to know that surgery is the last resort when treating GERD. Many cases can be adequately treated with medications, like pantoprazole, that reduce stomach acid production and help the esophagus heal, in combination with an acid reflux-friendly diet.

However, if these approaches do not work, we can perform surgery that strengthens the LES with either implants or surgical modification. With our access to advanced surgical techniques and resources, we also offer groundbreaking GERD treatments that many patients have benefited from.

Contact the Surgical Clinic to schedule your GERD consultation today.