GERD Diet and Acid Reflux Management

There is no universal diet that works for everyone with gastroesophageal reflux disease (GERD).

While it does not sound promising, many people diagnosed with GERD do find certain things to be helpful in managing their symptoms. Often, it is a matter of trial and error to figure out which foods work and which don’t.

Although this article does not provide strict instructions, it may give you ideas about what to consider in your diet if you are experiencing acid reflux. My aim was to collect and summarize information from scientific journals, experts, and real individuals to prepare a guideline on the GERD diet.

Understanding GERD and acid reflux

To better understand what GERD is, it is best to start with acid reflux.

Acid reflux is defined as the backflow of stomach content to the esophagus. The feeling created by this backflow is called heartburn because the burning sensation happens in the chest area, leading some people to mistakenly believe that they are experiencing heart problems.

While most people have experienced heartburn at some point in their lives, a large population struggles with it regularly. When someone has chronic acid reflux, they can get diagnosed with GERD — gastroesophageal reflux disease. It is estimated that around 20% of the U.S. population has GERD, making it one of the most common conditions affecting the digestive system.

Acid reflux occurs when the lower esophageal sphincter, the muscle between the esophagus and stomach, opens at the wrong time. This muscle normally opens when we consume food or drinks, so the contents from the mouth can reach the stomach. It remains closed at other times, the stomach contents moving only forward, not backward. If it relaxes at the wrong time, acid from the stomach can flow into the esophagus.

Besides heartburn, GERD patients may also have these symptoms:

• Regurgitation
• Sour taste in the mouth
• Burping
• Sore throat
• Problems swallowing

How diet impacts GERD symptoms

Although diet cannot reduce the root cause of GERD, your food choices may impact the severity of the symptoms. By identifying patterns, you could potentially manage your symptoms more effectively.

What may trigger symptoms will differ from person to person, thus, dietary changes should be tailored for each individual.

A food diary is sometimes used to help people identify their triggers. For the best results, you should work together with a registered dietitian who would not only be able to help you identify your triggers but also ensure you are not restricting your diet too much. If not properly executed, elimination diets may lead to nutritional deficiencies.

Foods that can worsen GERD

As explained by Dr. Michael Chichak, a general practitioner based in California, most triggers for acid reflux often include foods that are either inflammatory or those that, for some reason, relax the lower esophageal sphincter.

Although each person might react to certain foods differently, the following foods have been identified as potential GERD triggers. These triggers are also often mentioned in various GERD communities, such as those found on Reddit. Keep in mind that the triggers mentioned in these communities are only subjective opinions and experiences, thus, not evidence-based; however, they show a wide variety of possible triggers.

Acidic foods

Foods such as citrus fruits and tomatoes may worsen GERD symptoms by increasing stomach acidity. This decrease in pH (or, in other words, an increase in acidity) may even create acid reflux in people without GERD.

Fatty foods

Reactions to high-fat foods such as fatty meats and deep-fried foods should also be monitored. It is proposed that fatty foods may trigger reflux symptoms because they slow emptying from one’s stomach. Fat type (unsaturated vs. saturated fats), however, was not found to be influential for GERD.

Dairy products

Although currently available studies have shown no significant relationship between dairy and GERD, some people identify dairy as potentially triggering. This could be due to high-fat content or lactose intolerance.

Spicy foods

As mentioned by Kristin Draayer, a registered dietitian nutritionist, spicy foods can irritate the lining of the esophagus and intensify burning sensations

Moreover, capsaicin, the active component in chili peppers, has been linked to delayed gastric emptying, which may provoke reflux.

Coffee and tea

Some studies suggest that certain beverages, such as coffee, tea, and soda, may trigger heartburn symptoms. One study found that decaffeinated coffee was less likely to cause these symptoms, while decaffeinated tea still had the same negative effect, indicating that caffeine is most likely not the main culprit.

Carbonated drinks

Sparkling water, soft drinks, and other fizzy sodas may contribute to acid reflux. As added by Kristin Draayer, carbonated drinks can increase abdominal pressure, which may cause the lower esophageal sphincter to open and allow acid to escape into the esophagus.

Chocolate

Similarly, some people find that chocolate triggers acid reflux flare-ups by decreasing esophageal sphincter pressure. Moreover, chocolate, especially milk or white chocolate, is generally high in fat, which could also contribute to reflux.

Ginger

Although ginger is sometimes suggested as a quick solution to potentially reduce heartburn, it may actually make it worse. As indicated in the academic literature, ginger can cause the relaxation of the lower esophageal sphincter. If you choose to try ginger, consume it together with food.

Lastly, you should not eliminate certain food groups from your diet completely if not specifically instructed by an RD or healthcare provider. It is more productive to monitor your intake of potential trigger foods and see how they affect your symptoms.

Foods that can help reduce the risk of acid reflux

Although there is no one-fits-all diet when it comes to GERD management, certain dietary choices may help you to reduce heartburn symptoms.

High-fiber foods

If your diet is low in fiber, you may experience more severe acid reflux symptoms. As shown in one study, people who previously ate a low-fiber diet (less than 20 grams per day) saw a reduction in GERD symptoms after incorporating psyllium into their routine.

It is estimated that, on average, Americans get around 16 grams of fiber per day. As proposed by the Dietary Guidelines for Americans, you should get 14 grams of fiber per every 1,000 calories per day, meaning a person who consumes around 2,000 calories a day should have an intake of 28 grams of fiber.

Vegetables, fruits, and whole grain products are high-fiber foods. Try these positive dietary changes to boost your fiber intake: switch to whole-grain bread and brown rice, and include a serving of fruit as a snack.

However, dietary fiber, depending on its type, may also worsen the symptoms for some people, especially those with severe GERD cases. Some fibers, especially insoluble ones, also found in these natural sources, can, in fact, be hard to digest, slow the digestion process, potentially exacerbating symptoms in sensitive individuals.

Low-acid foods

Some low-acid foods are suggested for people experiencing GERD because they may counteract stomach acid. These would include non-citrus fruits (e.g., apples and bananas), nuts (walnuts, almonds), and green vegetables (leafy greens, broccoli). Keep in mind that even alkaline foods cannot fully neutralize stomach acid, and some may still trigger symptoms in certain individuals.

Bananas, for instance, are often proposed to be helpful not only because they are low in acid but also because fresh bananas may create a barrier on the esophageal mucous lining, which, in turn, may provide soothing and protective effects against acid reflux irritation. Some people in GERD communities, however, report bananas to be one of their trigger foods.

Neutralizing stomach acid may provide short-term relief; this is what GERD medications usually do, too. However, it also comes with risks, for instance, disruptions in normal digestion, and even rebound. If you continuously focus solely on neutralizing the stomach acid without taking into consideration the triggers, this can end up in the stomach producing even more acid to maintain digestion, which means potentially more severe symptoms.

Probiotic-rich foods

Some studies also indicate that probiotics may reduce the severity of heartburn, regurgitation, and dyspepsia. Their efficacy is still not clear, and it depends on the sources and strains. More studies are needed to assess the potential impact of probiotics specifically on GERD symptom management.

If you choose to incorporate yogurt with live cultures in it, opt for low-fat options.

Increasing water intake

As pointed out by Claudia Hleap-Knight, a registered dietitian in Philadelphia, staying hydrated is also an important factor to consider when dealing with GERD symptoms.

Water can also provide temporary relief by diluting stomach acid and easing the irritation in the esophagus.

Lifestyle and eating habits

For those with GERD, it is important to consider certain lifestyle changes that could ease the symptoms. Below, we have collected some of the most commonly advised adjustments and considerations.

• Eat small meals. Opting to have smaller meals more frequently may help to manage your symptoms since delayed stomach emptying due to large food portions may worsen heartburn symptoms.
• Avoid eating late at night. If you eat close to bedtime, your stomach remains full. Once you lie down, the likelihood of stomach acid rising into the esophagus increases due to acid production after eating. In general, it is advised not to lie down after eating for at least 2–3 hours.
• Consider sleeping inclined. Some people, especially those who suffer from morning flare-ups, might find sleeping inclined less triggering for their heartburn symptoms. You can purchase a specialized pillow for that.
• Eat slowly and chew food thoroughly. Mindful eating practices can be helpful as they will help you to assess your fullness cues in order to avoid excessive intake of products that may trigger the symptoms.
• Avoid alcohol and smoking. Alcohol and smoking are associated with worsened acid reflux symptoms.
• Maintain a healthy weight. Excess weight has been identified as a risk factor for GERD. Studies show an association between obesity and a higher prevalence of GERD and its complications as well.
• Practice stress management techniques. Meditation, yoga, dedicating time to hobbies and friends, you name it — anything that lowers your stress may also help manage GERD symptoms.
• Consider your exercise routine. Although exercise is undoubtedly great for your health, certain workouts might exaggerate GERD symptoms. Monitor your symptoms to determine if high-impact exercises, such as running or jumping, trigger discomfort. Keep in mind that exercise, in general, is important for GERD patients as it helps to maintain a healthy weight and may also contribute to better digestion.

When to seek medical advice

While occasional heartburn or acid reflux can usually be managed easily, Dr. Michael Chichak advises you to seek medical help if you are experiencing frequent acid reflux for a more personalized way of dealing with the symptoms.

Moreover, do not hesitate to contact your doctor if you are experiencing any of the following:

• Persistent reflux symptoms despite dietary changes
• Over-the-counter medications are no longer effective
• Severe symptoms such as difficulty swallowing, unexpected weight loss, or voice changes

If left untreated, GERD may lead to complications.

Bottom line

Managing GERD involves understanding your triggers, making mindful dietary choices, and adopting lifestyle changes that work for you. Since everyone’s experience with GERD is different, a personalized approach is key. Keeping a food diary and seeking guidance from a registered dietitian can make a significant difference.