In April 2020, the
Gastroesophageal reflux disease (GERD) is a condition where the contents of the stomach move back up the food pipe regularly. People can improve symptoms of GERD by including certain foods in their diet and avoiding others.
This regurgitation is usually long term and can result in uncomfortable symptoms, including heartburn and pain in the upper abdomen. The severity of the condition often relates to a person’s diet and lifestyle.
Avoiding trigger foods and following other dietary tips may relieve the symptoms of GERD. This article explores the foods that people with GERD may wish to exclude from their diet. It also discusses foods to include.
Although no specific foods can cure GERD, some might actively improve symptoms.
Until recently, researchers did not understand GERD fully, and there was a lack of scientific evidence to suggest changing the diet could improve symptoms. However, an older 2013 study of more than 500 people found some foods, such as those high in fiber, can help reduce GERD symptoms.
Similarly, a 2016 study found that following the Mediterranean diet, which is rich in fruits, vegetables, whole grains, and unsaturated fats, could help ease symptoms of GERD.
Here are some examples of foods to eat to help relieve the condition.
Vegetables are low in fat and sugar. They are also a suitable source of fiber, a beneficial carbohydrate. Suitable options include:
- Brussel sprouts
- green beans
Include lean protein from low-cholesterol sources, such as:
- lean poultry
And while egg whites are also a suitable option, egg yolks are rich in fat, which may trigger GERD symptoms.
Additionally, when cooking proteins, try using methods, such as grilling, broiling, baking, or poaching, instead of frying.
A general rule for GERD is to avoid or reduce saturated fats from meat and dairy and trans fat from processed foods and replace them with foods featuring healthy fats. These include:
- avocado oil
- olive oil
- nut butter
- fatty fish
- nuts and seeds
Whole grains are suitable sources of fiber. Research
- brown rice
- whole grain bread
Certain foods can trigger GERD symptoms.
GERD is a digestive disorder, so diet can often affect the symptoms of the condition. With this in mind, making dietary and lifestyle changes can go a long way toward treating many instances of GERD.
Foods that might worsen GERD or reflux esophagitis symptoms include:
- meat, which tends to be high in cholesterol and fatty acids
- oils and high fat foods, which may cause the sphincter in the stomach to relax
- high quantities of salt
- calcium-rich foods, such as milk and cheese, which are sources of saturated fats
The researchers found that children with CMA often experienced symptoms of GERD after consuming cow’s milk. Ongoing research is examining whether this also applies to adults.
People who experience regular discomfort or bloating after eating dairy products with cow’s milk may find that eliminating them from their diet reduces these symptoms.
The trigger-food diet
The trigger-food diet involves eliminating common trigger foods, such as coffee and chocolate, to alleviate GERD symptoms. However, this approach has little clinical backing, while results vary between individuals.
In 2013 guidelines on diagnosing and managing GERD, the American College of Gastroenterology states it does not recommend eliminating trigger foods because the dietary connection to the condition is not straightforward.
Instead, it believes the primary aim of treatment should be to heal the digestive system.
Other food flare-ups
There are additional foods that often cause GERD flare-ups. Doctors often recommend that people with this condition avoid them. These include:
- carbonated beverages
- acidic drinks, such as orange juice and coffee
- acidic foods, including tomato sauce
While there is little clinical evidence linking these foods to GERD symptoms, anecdotal experiences of some people with the condition suggest these foods may worsen symptoms.
However, trigger foods can vary from person to person. Therefore, people with GERD should try eliminating each food type from their diet to see if their symptoms improve. If these foods do not worsen symptoms, they can incorporate them back into their diet.
Experts recommend following a Mediterranean diet or a similar diet program rich in fruit, vegetables, and whole grains to reduce GERD symptoms. Some sample meal ideas include:
- poached eggs on whole grain toast
- avocado on whole grain toast
- mixed salad greens with whole grain pita bread and hummus
- brown rice with steamed vegetables and salmon
- whole grain bread sandwich with tuna and grilled vegetables
- whole grain pizza with tomato sauce, vegetables, and low fat cheese
- baked chicken with whole grain pasta with tomato sauce and grilled vegetables
- grilled vegetable skewers with hummus dip and salad
When a person swallows, food passes down the food pipe to the stomach. A ring of muscle tissue called the lower esophageal sphincter contracts after allowing food into the stomach. This prevents the food from returning up the food pipe.
If the esophageal sphincter does not close correctly, the contents of the stomach can leak back up into the food pipe, causing GERD.
If GERD symptoms occur more than twice a week for a period longer than 3 weeks, doctors will define the condition as chronic.
People sometimes refer to GERD as acid reflux or heartburn, but these are symptoms of the disease rather than separate conditions.
Without treatment, GERD can lead to severe health problems, such as Barrett’s esophagus. In this condition, abnormalities develop in the cells lining the food pipe. In some cases, this may lead to cancer.
The primary symptom of GERD is heartburn, a painful sensation that ranges from a burning feeling in the chest to a sensation of food sticking in the throat. It is also relatively common to experience nausea after eating.
Some less common symptoms of GERD include:
- wheezing or weak coughing
- a sore throat
- changes to the voice, including hoarseness
- food regurgitation
Lying down immediately after eating can worsen symptoms. People sometimes find their symptoms also get worse during the night. If this is the case, they may often find relief by elevating the head as they sleep and avoiding eating at least 2 hours before going to bed.
The symptoms of GERD are highly treatable.
People can purchase over-the-counter (OTC) medications to treat GERD. These include antacids, such as Gaviscon, which neutralize stomach acid.
People can also buy H2-receptor blockers, which may decrease the production of stomach acid for up to 12 hours. OTC proton-pump inhibitors (PPIs) have a similar effect.
Prescription medications might include stronger antacid, or acid-blocking, drugs. Although these are generally effective, they only reduce stomach acid levels. This acid is responsible for most vitamin B12 absorption from food during digestion, so the frequent use of antacids, PPIs, or H2-receptor inhibitors can lead to vitamin B12 deficiency.
Baclofen is a drug that can help control symptoms by reducing the relaxation of the lower esophageal sphincter. However, baclofen can cause adverse effects, including fatigue and confusion.
Holistic dietary strategies for GERD
A comprehensive GERD treatment plan needs to consider additional factors beyond basic dietary changes.
For many people with digestive issues, restoring balance to the bacterial flora in the intestines may be beneficial. Eating fermented and prebiotic foods might also help achieve this.
People call the bacteria in these foods probiotics, which may reduce digestive issues by balancing the digestive system as a whole. Prebiotics are foods rich in fibers that grow beneficial bacteria selectively.
Foods containing natural probiotics include:
- raw sauerkraut
- raw kimchi
- raw fermented pickles and vegetables
- kombucha, a fermented tea drink
Prebiotic-rich foods include:
- Jerusalem artichokes
- chicory root fiber or inulin
- greener bananas
People with GERD might find that probiotic and prebiotic foods can reduce symptoms. Probiotics help fight a bacterial strain known as Helicobacter pylori, which some scientists believe
Slippery elm contains high levels of mucilage, which can coat and soothe the throat and stomach. It may also cause the stomach to secrete mucus, which helps
Research from 2018 suggests an oral melatonin supplement might also help treat GERD symptoms. However, the researchers only recommend this as one aspect of treatment, and further studies are necessary to confirm these results.
Additionally, maintaining a moderate weight and keeping the head raised during sleep can minimize the symptoms of GERD.
Although people typically consider GERD to be a chronic disorder, it does not have to be permanent.
Changes to the diet, lifestyle, and integrative treatments can help alongside medication. If these approaches are ineffective, surgery can be an option to strengthen the lower esophageal sphincter.
The appropriate treatment should prevent GERD from affecting a person’s quality of life. However, it is vital to always speak with a doctor before making any changes to a treatment plan.
GERD causes the contents of the stomach to move back up the throat regularly, causing uncomfortable burning symptoms.
Although no specific diet can prevent the condition, eating and avoiding certain foods may ease symptoms for some individuals. People with GERD can often manage their symptoms with dietary and lifestyle changes and OTC medications.