Can Fruit Make Your Acid Reflux Worse?

Sour burps and heartburn can be more than just unpleasant. When symptoms are frequent or severe, you may have acid reflux and will need to avoid foods that can trigger it. Because many fruits are acidic, does that mean you should skip them? Here's a handy guide.

First, it's helpful to understand how acid reflux works. To kick off the digestion process, you have an esophageal sphincter, which is a muscular tube that allows food you swallow to pass through to the stomach and then cinches closed to keep it from coming back up. From there, your stomach works to break down food as it comes into your system by using acid and enzymes that create smaller parts, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

But if your esophageal sphincter doesn't cinch all the way shut, those digestive juices can push back up through the opening. When this happens frequently, perhaps even every time you eat, it's a chronic acid reflux condition called gastroesophageal reflux disease (GERD). About 20 percent of the population have it, according to Johns Hopkins Medicine.

​Read more:​ The 10 Worst Foods for Acid Reflux

Even though GERD may be a kind of mechanical issue with your digestive process, what you eat also plays a major part in whether there's a flare-up. According to Johns Hopkins Medicine, foods that are high in fat, salt or spices tend to be the worst culprits, such as pizza, fast food, fatty meats and cheese.

"Eating the right types of foods when you have acid reflux or heartburn can be key to controlling symptoms," says Katrina Hartog, RD, CND, assistant director of clinical nutrition at Lenox Hill Hospital in New York City. "There's no food that can cure reflux, but it's helpful to avoid certain foods that trigger symptoms."

Some foods can cause a problem, she adds, because of the amount of acid in the food itself. Examples include tomato-based sauces, chocolate (sorry!) and, yes, some types of fruit. But it's important to keep in mind that not all fruits are a problem.

​Read more:​ Signs of Too Much Acid in the Stomach

Most fruits do contain natural acids, though some are more acidic than others, Hartog says, adding that eating fruit that is only weakly acidic is unlikely to trigger reflux symptoms.

Some of the least acidic fruits include:

• Watermelon
• Casaba melon
• Honeydew melon
• Cantaloupe
• Yellow bananas
• Papaya
• Figs

Some fruits have slightly more acidity, but can be eaten in moderation, Hartog says. The key is to keep track of what you're eating, and whether it bothers you. Consider adding these into your diet and pay attention to how you feel a few hours after eating them:

• Apples
• Pears
• Berries
• Cherries
• Peaches
• Apricots

Keep in mind that canned fruit and prepackaged fruit juice may be more acidic than fresh fruit because of acids added as preservatives.

According to Hartog, citrus fruits tend to be the most problematic for those with acid reflux and GERD. That's because they contain natural acids, including citric acid and ascorbic acid, also known as vitamin C.

"These types of fruits often cause more symptoms, so avoiding them in general can be helpful," she says. They include:

• Grapefruit
• Oranges
• Lemons
• Limes
• Tangerines

Tomatoes, which are classified as a fruit, also have natural acids, and Hartog says they tend to be a trigger food for many people. That includes fresh tomatoes as well as tomato products like pasta sauce or salsa. According to a 2015 study in ​Chemine Technologija​​,​ the more ripe the tomato, the higher the vitamin C (ascorbic acid) content.

Hartog suggests that it may be helpful to keep a food journal to determine what fruits you can eat without experiencing symptoms. She also recommends eating small meals more frequently, as a way to control GERD effects.

See your doctor if you have frequent reflux to determine the cause and appropriate treatment. Seek medical attention right away if you have difficulty swallowing, bloody or tarry stools, unintended weight loss, frequent vomiting or bloody vomit.