Gastroesophageal reflux disease, or GERD, is a condition in which the contents of the stomach move backward into the esophagus. Normally, according to MedlinePlus, a group of special muscle fibers called the lower esophageal sphincter, or LES, squeeze together to keep this from happening. In those with GERD, acidic stomach contents eat away at the esophagus, causing irritation and, in some cases, bleeding. Management of GERD begins with a low acid diet.
Definition
In the 2004 edition of "Heartburn and Reflux for Dummies," author Carol Ann Rinzler and gastroenterologist Ken DeVault explain that foods contain acids and also cause the stomach to secrete acid of its own. The acid the stomach produces is stronger than the acids in most foods, so some of the worst GERD culprits are not acidic foods in their own right. Therefore, according to Rinzler and DeVault, a low acid diet for GERD means avoiding highly acidic foods, as well as foods that promote acid secretion by the stomach.
Foods to Enjoy
Rinzler and DeVault suggest eating bananas, apples, baked potatoes, broccoli, peas, cabbage, carrots and green beans as fruit and vegetable choices. Grains that are good for GERD include multi-grain bread, corn bread, white or brown rice, couscous, crackers, pretzels, oatmeal and most cereals. For dairy products, GERD sufferers should select low-fat or fat-free cream cheese and sour cream or regular versions of feta and goat cheese. Low-fat soy cheese also is fine. Finally, Rinzler and Devault also endorse lean cuts of fresh or frozen meat, poultry, fish and eggs.
Foods to Limit
Rinzler and DeVault suggest proceeding with caution with other foods. They say low-acid orange juice, apple cider, peaches, berries, grapes, dried cranberries, garlic, cooked onions, leeks, sauerkraut and scallions work well for some people with GERD, but not others. Most dairy products fall into this category, including milk, low-fat cottage cheese, yogurt or frozen yogurt, cheddar cheese and mozzarella cheese. Granola, garlic bread and muffins are some of the few grains that cause problems. Proteins that Rinzler and DeVault list are nuts or nut butters, baked beans, scrambled or fried eggs,chicken or tuna salad, ham and luncheon meats.
Foods to Avoid
Fruits and vegetables that you should absolutely avoid include citrus juices, fresh cranberries or cranberry juice, tomato products and raw onions. Chocolate, alcohol and caffeine also cause your stomach to secrete large amounts of acids, as do fried foods or fatty versions of any food. Rinzler and DeVault specifically warn against french fries, ice cream, spaghetti with tomato sauce, chicken wings and marbled meats.
Timing
Rinzler and DeVault also emphasize the importance of timing. They say large meals -- even large meals composed of "safe" foods -- trigger more acid secretion than small ones. The solution, the authors say, is to consume frequent small meals. MedlinePlus says that GERD symptoms are often worse at night, so you should save large meals for the middle of the day and avoid eating anything less than three hours before you go to bed.
Considerations
GERD triggers can vary from person to person and it can be hard to build a balanced diet when your options are limited. As a result, Rinzler and DeVault recommend keeping a heartburn food diary to identify your own triggers. The diary should identify the day, time, food or beverage consumed and a rating of your GERD symptoms from 0 to 3. Look for your patterns and bring the diary with you when you see your doctor or dietitian.
References
- MedlinePlus: Gastroesophageal Reflux Disease
- "Heartburn and Reflux for Dummies"; Carol Ann Rinzler, M.A. and Ken DeVault, M.D.; 2004
- MedlinePlus: GERD
