Foods to eat, and foods to avoid with GERD and acid reflux

Foods to eat

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. Although more evidence is needed, a 2021 review suggests that certain foods, such as fruits and vegetables, are associated with lower risk of GERD.

Similarly, a 2016 study found that following the Mediterranean diet, which is rich in fruits, vegetables, whole grains, and unsaturated fats, was linked with a lower risk of GERD.

Here are some examples of foods to eat that may help relieve the condition.

Vegetables

Vegetables are low in fat and sugar. They are also a suitable source of fiber, a beneficial carbohydrate. Suitable options include:

• asparagus
• broccoli
• Brussel sprouts
• cauliflower
• cucumbers
• green beans
• kale
• potatoes
• spinach

Fruits

Eating non-citrus fruits is less likely to trigger GERD symptoms. Fruit is also a suitable source of vitamin C, fiber, magnesium, and potassium.

Options include:

• apples
• bananas
• berries
• melons
• peaches
• pears

Proteins

Include lean protein from sources low in saturated fat, such as:

• beans
• skinless chicken
• fish
• lentils
• seafood
• skinless turkey

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 lower-fat methods, such as grilling, broiling, baking, or poaching, instead of frying.

Fats

A general rule for GERD is to avoid high-fat meals. While all types of fat are linked with increased GERD symptoms, it’s recommended that people avoid or reduce saturated and trans fat for overall health.

Saturated and trans fats can be replaced with healthy unsaturated fats in moderation. These include:

• avocado oil
• olive oil
• nut butter
• fatty fish
• nuts and seeds

Whole grains

Whole grains are suitable sources of fiber. Research links diets high in fiber with a reduced risk of heartburn symptoms. Some whole grain foods include:

• oatmeal
• brown rice
• whole grain bread

Foods to avoid

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 symptoms include:

Meat and eggs

Because animal products like fatty meats and eggs tends to be high in saturated fats, they can trigger GERD symptoms. Examples include:

• red meat
• lamb
• pork belly
• bacon
• sausages
• processed meats

Oils and high fat foods

These can cause the sphincter at the bottom of the esophagus to relax, exacerbating GERD symptoms. They also slow down digestion.

Examples include:

• oils
• fatty meat
• butter
• baked goods
• cheese
• cream
• potato chips

High glycemic foods

High glycemic index foods, which are typically high in refined sugars, are linked with GERD symptoms. Examples include:

• white rice
• white bread
• baked goods
• potato chips
• sweet fruits
• breakfast cereal
• fruit juice
• soda

Milk and dairy

A 2021 review examined the relationship between cow’s milk allergy (CMA) and GERD symptoms in children.

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. However, CMA is rare in adults because many allergic children develop a tolerance for cow’s milk by the age of 6 years.

The evidence for a link between reflux symptoms and milk is mixed. Some studies even suggest consuming milk is associated with lower rates of nonerosive reflux disease.

However, 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.

Trigger foods

Some people choose to avoid common trigger foods, such as coffee and chocolate, to alleviate GERD symptoms. However, this approach has little clinical backing, while results vary between individuals.

Some common trigger foods may include:

• chocolate
• mint
• carbonated beverages
• acidic drinks, such as orange juice and coffee
• caffeine
• acidic foods, such as tomato sauce and citrus fruits
• spicy foods
• alcohol

People with GERD may choose to try eliminating each food type from their diet to see if their symptoms improve. If symptoms do not improve, they can incorporate the food type back into their diet.

In 2022 guidelines for diagnosing and managing GERD, the American College of Gastroenterology suggests avoiding trigger foods to help manage GERD symptoms. However, they also state that there is little evidence to support this recommendation.

Diet plan

Experts recommend following a Mediterranean diet or a similar dietary pattern rich in fruit, vegetables, and whole grains to reduce GERD symptoms. Some sample meal ideas include:

• oatmeal with berries
• 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 pesto sauce, vegetables, and low fat cheese
• baked skinless chicken with grilled vegetables and baby potatoes
• grilled vegetable skewers with hummus dip and salad

What is GERD?

When a person swallows, food passes down the food pipe to the stomach. At the bottom of the food pipe, a ring of muscle tissue called the lower esophageal sphincter opens to allow food into the stomach. It then closes up, to prevent 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.

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.

Symptoms

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:

• hiccups
• burping
• 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.

Treatments

The symptoms of GERD are highly treatable.

Medications

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 fermented foods “probiotics.” They may reduce digestive issues by supporting a healthy balance of microorganisms in the gut. Prebiotics are foods rich in fibers that grow beneficial bacteria selectively.

Foods that naturally contain probiotics include:

• yogurt
• kefir
• 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
• onions
• garlic
• leeks
• apples

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 might relate to GERD. However, more research is necessary to confirm this.

Natural remedies

Natural treatments that are thought to relieve GERD symptoms include licorice, ginger, and slippery elm bark. Some believe that these remedies may reduce symptoms, ease nausea, and improve gastric emptying. However, there is currently little research evidence to support their use.

Slippery elm contains high levels of mucilage, which is thought to coat and soothe the throat and stomach. It may also cause the stomach to secrete mucus, which helps protect it from acid damage.

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. Other lifestyle changes that may reduce symptoms include:

• quitting smoking
• eating smaller meals
• not lying down for at least 2-3 hours after a meal

Outlook

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.

Summary

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.