The best diet for GERD: What foods to eat and avoid if you suffer from frequent acid reflux

Slippery elm bark may help reduce acid reflux.Hakat/Getty Images
  • The best diet for GERD includes alkaline foods like bananas and cauliflower.
  • An eating plan like the Mediterranian Diet has also been found to benefit people with GERD.
  • You should also be sure to avoid carbohydrates, spicy foods, and fatty foods.
  • This article was medically reviewed by Atif Iqbal, MD, FACS, FASMBS, board-certified general surgeon and medical director of the Digestive Care Center at MemorialCare Orange Coast Medical Center in Fountain Valley, California.
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Gastroesophageal reflux disease (GERD) is a condition defined by having persistent and frequent bouts of acid reflux. The condition is common and affects about 20% of Americans. Though these episodes can be uncomfortable, changing your diet can help ease some of the most troublesome symptoms.

Normally, the lower esophageal sphincter (LES), a valve that connects your stomach and throat, , closes while you are not swallowing. This keeps the contents of your stomach from moving back up your esophagus.

However, in those with GERD, the LES frequently relaxes and opens up, even when you aren't swallowing. This allows the flow of stomach acid, digestive enzymes, and other stomach contents to come back up — leading to poor digestion and acid reflux
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If you are experiencing severe GERD symptoms, a doctor may prescribe you medication, but making changes to your diet is an important step in controlling GERD.

Foods to avoid

One of the first suggestions doctors will make for managing GERD symptoms is a change in diet.

While there are a number of potential trigger foods, and they can be highly individualized, here are a few common culprits:
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Fatty foods

High-fat foods, like fried or greasy foods, have been linked to increased GERD symptoms. Studies have found that consuming high-fat foods decreases the pressure of the LES, causing it to relax and open up more often. A relaxed LES means that stomach acid can flow upwards into your esophagus, causing acid reflux.

Consuming fatty foods also delays the emptying of the stomach, meaning food sits in the stomach longer before moving to the next stage of digestion. When food remains in the stomach for long periods of time, you are more likely to experience GERD symptoms. Fatty foods that may cause acid reflux include:
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  • Processed meats
  • Fast food
  • Processed snacks
  • Sweets

Carbohydrates

According to a 2019 study published in the Journal of Thoracic Disease, carbohydrates are particularly bad for GERD.

This is because certain starches and carbohydrates are only partially absorbed by the small intestine. As a result, they move into the large intestine, where they will be fermented by bacteria in the colon. This fermentation process releases various neurohormones that have been linked to the relaxation of the LES, which can lead to heartburn symptoms.

Some examples of carbohydrates you should avoid are:
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  • Potatoes
  • Wheat
  • Corn

Spicy foods

While spicy food, like hot curries or anything with hot peppers, doesn't affect the LES in the way that other foods do, many patients with GERD are recommended to cut spicy foods out of their diet.

That's because those hot spices can irritate the lining of the esophagus, which can mimic the symptoms of acid reflux. For those experiencing discomfort, reducing how much spicy food you eat may help reduce symptoms.

Foods that may help reduce acid reflux

To manage acid reflux, you need to do more than just eliminate foods from your diet. There are also other foods and herbs you can add to your diet to help.
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Alkaline foods

All foods fall on a pH scale. Foods with lower pH levels are more acidic, and those with higher pH levels are more alkaline.

For people with GERD, acidic foods like citrus fruits or soft drinks have been shown to increase the acidity in the stomach, therefore increasing GERD symptoms. Alkaline foods can offset some of the acidity by neutralizing the acid.

Some examples of very alkaline foods are:
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  • Bananas have a pH of 4.5-5.2
  • Cauliflower have a pH of 6.0-7.0
  • Fennel have a pH of 7.2-7.4
  • Nuts have a pH of 6.0-6.9

The Mediterranean diet

The Mediterranian diet, an eating plan that consists of mostly vegetables and limited animal products, has been found to help reduce GERD symptoms, according to a study published in 2017 in JAMA Otolaryngology Head & Neck Surgery.

The study compared the symptoms of 85 GERD patients who were prescribed proton pump inhibitors, which are medications designed to reduce stomach acid, and 99 patients who altered their diet to eat a Mediterranean diet and only drink alkaline water. The results found that the dietary changes were more effective than proton — 62.6% of people in the Mediterannean diet group saw a reduction in acid reflux symptoms, compared to 54.1% of the group using the medication.
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Some of the tenants of the Mediterranian Diet include:

  • Eating a primarily plant-based diet
  • Eating whole grains
  • Avoiding red meat

Herbal Remedies

"There are many herbal remedies, called demulcent herbs, that have been used to reduce acid reflux symptoms," says Sonya Angelone, MS, RDN, CLT who is a Registered Dietician Nutritionist at the Academy of Nutrition and Dietetics.

Demulcent herbs are recommended because they are thought to reduce inflammation in the esophagus and control symptoms of GERD.
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"Acid reflux is not always a condition of excess stomach acid production," says Angelone, sometimes it is an "inflammatory reaction."

Some demulcent herbs include:

  • Licorice root
  • Slippery elm bark
  • Marshmallow root
  • Gentle bitters
To incorporate these into your diet, you can brew them in hot water and turn them into tea. You can drink this tea 1-2 hours after meals.
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Tips for managing your diet

When you're making changes to your diet and lifestyle to prevent acid reflux, you'll want to make sure you can keep track of what is making a difference.

"Sometimes common foods are the culprit and other times it is additives or other ingredients," says Angelone. "It is important to keep a food/symptom record to look for any correlations between the consumption of any particular food or chemical and a symptom."

But diets alone are not enough to manage even infrequent acid reflux symptoms. Angelone also says certain lifestyle interventions can help, including:
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  • Don't eat for at least 3 hours before bed
  • Avoid large meals, especially late at night
  • Elevate the head of your bed at night with pillows
  • Eat smaller meals
  • Quit smoking, if needed
  • Lose weight, if needed.

Overall, it's best to talk to your doctor or a nutritionist to supervise changes in your diet and personalize recommendations that are best for you.

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