8 Foods to Avoid in Heartburn and GERD

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Gastroesophageal reflux disease (GERD) is a health problem where the stomach acid and other contents flow back into the tube that carries food from the mouth to the stomach.

This happens because a muscle at the bottom of the tube doesn’t close properly. When the acid flows back, it can irritate and inflame the lining of the tube, causing symptoms like heartburn and chest pain.

Symptoms

Common symptoms of GERD include:

Heartburn (a burning feeling in the chest)
Regurgitation (a sour or bitter taste in the mouth)
Difficulty swallowing
Chest pain or discomfort
Belching
Nausea

Less common symptoms of GERD may include:

Hoarseness or a sore throat
Chronic cough
Asthma symptoms
Dental problems (e.g., erosion of tooth enamel)
Bad breath
Laryngitis (inflammation of the voice box)
Sinus problems

In rare cases, GERD can cause more serious complications such as Barrett’s esophagus (a precancerous condition), esophageal strictures (narrowing of the esophagus), and esophageal cancer.

Does diet affect GERD?

Certain foods can potentially worsen GERD symptoms by increasing the amount of stomach acid or relaxing the lower esophageal sphincter (LES), the muscular ring that separates the esophagus from the stomach.

When the LES is relaxed or weakened, stomach acid and other stomach contents can flow back up into the esophagus, leading to symptoms such as heartburn, regurgitation, and chest pain.

Additionally, eating large meals or lying down after eating can increase the likelihood of GERD symptoms because it allows more time for stomach acid to flow back up into the esophagus.

Everyone with GERD may have different trigger foods, so it’s important to pay attention to your own symptoms and identify which foods and behaviors may be exacerbating your symptoms. Your doctor can also help you create a personalized plan for managing your GERD symptoms.

Foods to avoid

Dietary and lifestyle changes are often central to the management of GERD. Some foods that research has identified as possible trigger foods include:

Fatty foods – There is some evidence that increased fattier or fried meals, especially cholesterol-heavy foods, are associated with worsening GERD symptoms. However, larger studies suggest that this association may be overshadowed by the fact that increasing high caloric fatty foods also increases the risk of obesity, which in itself a strong risk factor for GERD.
Spicy foods – There is some evidence that spicy foods or the active ingredient, capsaicin, may worsen symptoms of acid reflux by directly causing a burning sensation. Interestingly enough, the chronic consumption (5-6 weeks) of low amounts of spice appears to reduce symptoms of heartburn in GERD, likely primarily due to pain receptor desensitization.
Animal meat – There is some evidence a diet high in animal meats, especially barbecued and well-done meats can increase symptoms of GERD and a diet low in meat reduced the risk of GERD; although not all studies agree. Additionally, excessive consumption of red meat is associated with an increased risk of esophageal cancers.
Carbonated drinks – There is some evidence that carbonated drinks may worsen symptoms by relaxing the LES. Additionally, many carbonated beverages are highly acidic. Consumption of acidic drinks increased acidity of stomach contents, with orange juice and pop being the biggest culprits. However, this increase appears to be temporary and clinically insignificant. Because studies are inconsistent in what they use as a carbonated beverage, using everything from pop to beer to carbonated water, it can be difficult to draw strong conclusions.
Alcohol – Studies are mixed, with some suggesting alcohol is an independent risk factor for GERD, and some suggesting no effect. However, due to alcohol’s negative impact on the esophagus, with even light amounts increasing risk of esophageal cancers, it is routinely avoided.
Coffee – Studies are mixed, with some suggesting coffee may worsen symptoms of GERD, and others suggesting no effect. Higher qualities studies did reveal that drinking coffee did not seem to increase the risk of GERD attacks or developing GERD. Thus, it appears that while it is possible coffee could aggravate active symptoms of GERD, drinking coffee itself will not likely worsen GERD.
Tea – Studies generally show no association between GERD symptoms and tea consumption. However, some studies suggest consumption of strong green tea may increase GERD symptoms by protecting and preserving the function of gastric acid producing cells. Thus moderate tea consumption does not appear to be an issue in most people with GERD, and may even exert beneficial protective effects.
Mint – Although peppermint and spearmint have been reported to relax smooth muscle contractions, and may be useful in reducing esophageal spasms, there is no evidence to suggest mint consumption could weaken the LES enough to cause acid reflux. Furthermore, menthol, an active ingredient in mint, causes cold sensations on contact, which could easily be mistaken for a burning sensation in heartburn.
Onions – There is some weak evidence to suggest eating raw onions may worsen heartburn in GERD.

Other dietary changes

Although the research is more unclear with these dietary recommendations, they have been shown to be helpful in certain people. These tips include:

Reducing glycemic load – Lower glycemic index diets are useful in weight loss and reducing obesity, a risk factor in GERD.
Avoiding citrus – Citrus beverages are acidic, and appear to increase the acidity of stomach contents.
Avoiding milk or cheese – These foods can be high in fat. Milk may also neutralize some stomach acid content.
Avoiding chocolate – Many chocolate products are also high in fat.
Avoiding tomatoes – Tomato juices are mildly acidic. It is also a common food sensitivity.
Avoiding garlic or ginger – Both have mild irritant effects on mucosal membranes.

Foods to have

While certain foods and drinks can potentially trigger or worsen GERD symptoms, there are also some foods that can help improve symptoms or provide relief. These include:

Non-citrus fruits: Fruits such as bananas, apples, and melons are generally well-tolerated by people with GERD and can provide a source of vitamins and fiber.
Vegetables: Leafy greens, broccoli, cauliflower, and other non-acidic vegetables can help provide important nutrients without triggering reflux.
Whole grains: Oatmeal, brown rice, and other whole grains can provide fiber and complex carbohydrates without exacerbating GERD symptoms.
Lean protein: Skinless poultry, fish, and tofu are good sources of protein that are less likely to cause reflux than fatty meats.
Low-fat dairy: Skim milk, yogurt, and low-fat cheese are generally well-tolerated by people with GERD.

Supplements for GERD

While there is no single supplement that can cure GERD, there are some supplements that may be helpful in managing symptoms or addressing underlying factors that contribute to reflux. Some supplements that may be helpful for GERD include:

Probiotics: These “good” bacteria can help improve gut health and promote digestion, potentially reducing reflux symptoms.
Melatonin: This natural sleep aid has been shown to help reduce acid secretion in the stomach and may help improve sleep quality in people with GERD.
Licorice: Deglycyrrhizinated licorice (DGL) may help soothe inflammation in the esophagus and promote healing of the mucous membrane.
Magnesium: This mineral can help relax the muscles in the digestive tract and may help improve symptoms of reflux.
Vitamin D: This vitamin is important for bone health and immune function, and may also play a role in reducing inflammation in the esophagus.
Betaine HCl: This supplement may be helpful for people with low stomach acid levels, which can contribute to reflux.

Antacids

These over-the-counter medications, work by neutralizing the acid that is already present in the stomach. While antacids can provide rapid relief of symptoms, their effects are short-lived and they do not promote healing of the esophagus. Here are some popular examples of commercial antacids:

Tums: Tums contain calcium carbonate and are available in various flavors. They work by neutralizing stomach acid and can provide quick relief of heartburn and indigestion.
Rolaids: Rolaids contain a combination of calcium carbonate and magnesium hydroxide. They work by neutralizing stomach acid and can provide relief of heartburn and indigestion.
Maalox: Maalox contains a combination of aluminum hydroxide and magnesium hydroxide. It works by neutralizing stomach acid and can provide relief of heartburn, acid indigestion, and sour stomach.
Mylanta: Mylanta contains a combination of aluminum hydroxide, magnesium hydroxide, and simethicone. It works by neutralizing stomach acid and reducing gas in the digestive system. Mylanta can provide relief of heartburn, acid indigestion, and sour stomach.
Alka-Seltzer: Alka-Seltzer contains a combination of aspirin, sodium bicarbonate, and citric acid. It works by neutralizing stomach acid and can provide relief of heartburn and indigestion.
Gaviscon: Gaviscon contains a combination of sodium alginate, calcium carbonate, and sodium bicarbonate. It forms a foam barrier over the stomach contents, which can help prevent acid reflux. Gaviscon can provide relief of heartburn and acid indigestion.
Pepto-Bismol: Pepto-Bismol contains bismuth subsalicylate, which can help relieve symptoms of indigestion, nausea, and upset stomach. It also has a mild antibacterial effect and can help reduce diarrhea. Pepto-Bismol should not be used for long-term treatment of GERD without consulting a healthcare provider.

Lifestyle changes for GERD

Certain lifestyle changes can also affect your GERD symptoms. Here are some lifestyle changes that can help manage GERD:

Maintain a healthy weight: Being overweight or obese can increase pressure on the stomach, leading to reflux symptoms. Losing weight through diet and exercise can help reduce symptoms.
Eat smaller, more frequent meals: Eating large meals can put pressure on the stomach and increase the likelihood of reflux. Eating smaller meals more frequently can help reduce symptoms.
Don’t eat before bedtime: Lying down after eating can increase the likelihood of reflux symptoms. It’s important to wait at least 3 hours after eating before lying down.
Elevate the head of the bed: Raising the head of the bed by 6-8 inches can help reduce reflux symptoms during sleep.
Quit smoking: Smoking can increase acid production and weaken the muscles that prevent reflux, making symptoms worse.
Manage stress: Stress can increase stomach acid production and exacerbate GERD symptoms. Techniques such as deep breathing, meditation, and yoga can help reduce stress and improve symptoms.

Medications and GERD

Certain medications can affect your GERD symptoms. Because their use and disuse should be monitored by a physician, you should always ask your doctor about it first before starting or stopping any medication.

Medications that help

There are several medications that are commonly used to treat GERD, and they work in different ways to reduce the amount of stomach acid produced or neutralize the acid that is already present in the stomach. These medications include:

Proton pump inhibitors (PPIs): These drugs, such as omeprazole, esomeprazole, and lansoprazole, work by blocking the enzyme in the stomach wall that produces acid. By reducing the amount of acid in the stomach, PPIs can help relieve symptoms of GERD and promote healing of the esophagus.
H2 receptor blockers: These medications, such as ranitidine and famotidine, work by blocking the action of histamine, a chemical in the stomach that stimulates acid secretion. By reducing the amount of acid in the stomach, H2 blockers can help relieve symptoms of GERD and promote healing of the esophagus.
Prokinetics: These medications, such as metoclopramide, work by helping the stomach empty more quickly, which can reduce the amount of acid that flows back into the esophagus. However, prokinetics have limited effectiveness and can cause side effects such as drowsiness and restlessness.

Medications that hurt

There are several medications that can cause or aggravate GERD symptoms. Here are some examples:

Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs, such as ibuprofen and aspirin, can irritate the lining of the stomach and increase the likelihood of reflux symptoms.
Calcium channel blockers: These medications, which are used to treat high blood pressure, can relax the lower esophageal sphincter (LES) and increase the likelihood of reflux.
Anticholinergic medications: These medications, which are used to treat conditions such as overactive bladder and COPD, can slow down the movement of food through the digestive system, leading to increased pressure on the stomach and increased likelihood of reflux.
Bisphosphonates: Bisphosphonates, which are used to treat osteoporosis, can irritate the lining of the esophagus and increase the likelihood of reflux symptoms.
Iron supplements: Iron supplements can irritate the lining of the stomach and increase the likelihood of reflux.
Potassium supplements: Potassium supplements can be irritating to the stomach and increase the likelihood of reflux symptoms.
Antibiotics: Some antibiotics, such as tetracycline and clindamycin, can irritate the lining of the stomach and increase the likelihood of reflux symptoms.
Corticosteroids: Corticosteroids, which are used to treat a variety of conditions such as asthma and arthritis, can weaken the muscles that prevent reflux and increase the likelihood of symptoms.
Benzodiazepines: These medications, which are used to treat anxiety and insomnia, can weaken the muscles that prevent reflux and increase the likelihood of symptoms.
Antidepressants: Some antidepressants, such as tricyclic antidepressants, can slow down the digestive system and increase the likelihood of reflux.