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Acid reflux is a disease of the esophagus, the muscular and tubular organ that connects your throat to your stomach. The medical term for the chronic condition is gastroesophageal reflux disease (or GERD), but it is informally referred to as acid reflux, gastric reflux or heartburn. Many people experience mild cases of acid reflux from time to time, but people who have it chronically (more than twice a week) likely have GERD, the more serious condition. Symptoms of GERD can be uncomfortable and scary, including pain and tightness in the chest. Other symptoms include frequent belching, bad breath, difficulty swallowing, abdominal pain, nausea and vomiting. Not everyone sees a healthcare provider when they have occasional or frequent acid reflux, so it’s estimated that 15 to 30% of the population has GERD.
GERD is caused by a weakening of the lower esophageal sphincter, which is the valve that prevents food and contents from the stomach from moving back up the esophagus after it has been swallowed. In people with GERD, the sphincter opens or leaks, allowing stomach acid into the esophagus, which is problematic if it happens chronically. Anyone can get GERD, including children, but women are hospitalized for it the most. GERD occurs more often in people who:
- Are overweight or obese
- Eat large meals
- Take certain medications, including antihistamines, antidepressants and painkillers
- Smoke or frequently are exposed to secondhand smoke
- Are pregnant (symptoms usually subside after the baby is born)
Acid reflux and GERD are often treatable by some lifestyle changes, including what you eat and drink. What you eat affects how much acid your stomach produces. By making some mindful food choices and eating changes, you can reduce backward flow of stomach acid, even if your esophageal sphincter is weakened.
What foods to eat to help reduce acid reflux
High-fiber foods and meals have been linked to lower risk of acid reflux. High-fiber choices include all types of beans, whole grains like oats and quinoa, avocado, nuts, seeds, berries and vegetables of all types.
Fruits are nutrient-dense choices, so don’t avoid them. Rather, opt for those that have a low probability of triggering acid reflux, such as melons, bananas and apples.
Eating small to mid-size portions of foods that contain a lot of water can help dilute stomach acid. Lettuce, cucumber, melons, celery and broth-based soups can be good choices.
Foods that have a higher pH are more alkaline than they are acidic. These foods could reduce the acidity of stomach acid and the pain associated with acid reflux. Foods like ginger, broccoli, cauliflower, mushrooms, green beans, leafy greens, watermelon, root vegetables, ripe bananas and nuts are higher on the pH scale.
Foods to avoid when you have acid reflux
For many, acid reflux and heartburn is connected to too-high alcohol consumption, which also creates more inflammation in the body. People diagnosed with GERD should limit alcohol to one drink or less per day, which is equivalent to 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof spirits. Research also shows acid reflux can be reduced by avoiding alcohol 2 to 3 hours before bedtime.
Meals and single foods that are high in fat are a double whammy for GERD sufferers. They stay in the stomach longer and create more stomach acid while also causing the esophageal sphincter to relax and open. High-fat animal-based foods, such as fatty cuts of beef and lamb and full-fat dairy, as well as fried foods should be eaten in small amounts. Also, cream sauces and gravies, pork and bacon, lard- and butter-based sauces, ice cream and oily snacks tend to be high in fat.
Everyone should avoid trans fats, but people with acid reflux have special reason to, so as to reduce bodily inflammation that can exacerbate symptoms. Artificial trans fats have been banned by the FDA, but despite this, foods that contain less than 0.5 grams of trans fat per serving can list 0 grams trans fat on the Nutrition Facts label. While this amount is small, it can add up quickly. Trans fats exist mostly in packaged baked goods, some margarine and vegetable shortenings, some microwave popcorns, fried fast food, non-dairy creamers, and refrigerated doughs and biscuits. If a product contains “partially hydrogenated oil” that’s a good indication it has trans fats.
Some people with GERD experience more symptoms after eating the highest acidic fruits, such as all forms of citrus, tomatoes and pineapple, especially when a dish contains a lot of these foods.
Foods high in methylxanthine
This natural compound in things like chocolate and coffee can have a relaxing effect on the esophageal sphincter, leading to backward flow of stomach acid. Foods and beverages made from black tea, yerba mate, coffee beans, cocoa beans, kola nuts and guarana berries could increase acid reflux.
Spicy and tangy foods
Spicy foods and tangy foods are often implicated in acid reflux, but they affect everyone differently. In some people, heavily spiced dishes or dishes with a lot of onions, garlic, or spicy/tangy sauces may trigger heartburn.
Mint-flavored foods, breath mints and chewing gum have been known to trigger acid reflux in some people.
Supplements that can help with acid reflux
Additional support from certain supplements could help reduce GERD symptoms. Always consult your doctor before starting a new supplement.
Multivitamin with minerals
A high-quality multivitamin with minerals could be effective at preventing inflammation and improving overall health in people with GERD, especially if your diet is lacking in a variety of food groups and plant-based foods.
Taking a ginger supplement, brewing ginger tea or chewing on a ginger candy has been a strategy to reduce a range of gastrointestinal ailments for many years. Ginger has an anti-inflammatory effect that could have a healing effect on the esophagus.
This compound, often associated with sleep benefits, has been connected to long-term relief from GERD in some studies, when combined with an over-the-counter proton-pump inhibitor, such as omeprazole (Prilosec).
Have acid reflux? Do this first.
If you are overweight, consider trying to lose 15 to 20 pounds. Research shows this will have the biggest health impact on reducing acid reflux. If you are in a normal weight range, the most impactful thing you can do is eat smaller portions of food at a time and start a food journal to help you identify foods and situations that increase acid reflux in you.
What else to know about acid reflux
For people with chronic acid reflux, there are several things that can make symptoms better or worse. Consider the above recommended dietary approaches with the following in mind:
Many people can find relief from acid reflux with lifestyle modifications, including the above diet changes. But some GERD sufferers find relief from over-the-counter medications. Over the counter options include antacids to neutralize stomach acid (Mylanta, Tums, Rolaids), H-2 receptor blocks to reduce stomach acid (such as Pepcid AC), and proton-pump inhibitors that block acid production and heal the esophagus (Prevacid 24 Hr, Prilosec OTC). For persistent GERD, your healthcare provider may recommend prescription-strength medication.
Consider moving away from three large meals per day and instead space out your eating into more and smaller occasions. Avoid large meals consumed all in one sitting, especially within 2 hours of going to bed.
Gravity works against GERD sufferers at night. As best you can, avoid sleeping flat on your back or right side, which can cause stomach acid to rest in the esophagus. Studies show that sleeping on your left side is associated with fewer and less severe symptoms. Also, sleeping on your left side at an incline can reduce stomach acid flowing into the esophagus. Use a bed wedge or put blocks under your bed frame to achieve an incline where your entire torso (not just your head and neck) is elevated above your lower body.
Avoid slouching or laying down after meals and try to keep your upper body upright for at least 2 hours after a meal. Taking a leisure walk or standing after meals can help.
Nicotine from tobacco smoke is known to provoke acid reflux by relaxing the smooth muscle inside the body, including the esophageal sphincter. GERD is a prevalent condition of frequent tobacco users (including users of cigarettes, cigars, pipes, chew and snuff), as well as adults and children who are frequently exposed to secondhand smoke.
Keeping a journal to track daily food intake, as well as portion size, time of day, medication, sleep, movement and more can be one of your most helpful tools in identifying foods that trigger acid reflux symptoms in you.
In some people, lifestyle modifications are not enough to manage GERD. Scar tissue in the esophagus, from repeated exposure to stomach acid, can make swallowing very painful and increase esophageal cancer risk. In these people, surgery to strengthen or assist the closure of the esophageal sphincter is an option.