You know the feeling all too well. It's that burning sensation in your throat or chest, otherwise known as your old friend, heartburn. Or it could be a dry cough that won't stop, trouble swallowing, bad breath, a sour taste in your mouth or excessive burping.
These are all symptoms of gastroesophageal reflux disease, or GERD. GERD happens when the muscular part of your lower esophagus that should close (called the lower esophageal sphincter) doesn't, causing food and acids to travel up from your stomach into your throat. This leads to burning and other problems from repeat acid exposure.
It's the more serious version of acid reflux, and besides being uncomfortable, it can damage your esophagus over time if left untreated, according to the National Institutes of Health (NIH).
If you have GERD, you probably know a thing or two about over-the-counter antacid treatments, and possibly other prescription medications, too. But one of the key GERD treatments revolves around diet and lifestyle modifications, says David M. Poppers, MD, PhD, a board-certified gastroenterologist at NYU Langone Health in New York.
And while diet doesn't cause the condition, it can make your symptoms worse. So here's a roundup of the top six drinks and foods to avoid with GERD, as well as what you can eat and drink for acid reflux.
1. Fried and Fast Foods
These two often go hand-in-hand — think: french fries, fried chicken, donuts, convenience foods that are cheap and tasty (and often get handed to you through a take-out window).
None of these are great for GERD: One October 2014 study in Przegląd Gastroenterologiczny found an association between the severity of GERD symptoms and diet, including fried foods.
More research is needed to understand why fried foods spark symptoms, according to a 2019 review in Current Medicinal Chemistry, but they're still known to aggravate GERD, says Alicia A. Romano, RD, a registered dietitian at Tufts Medical Center and national media spokesperson for the Academy of Nutrition & Dietetics.
Eat This Instead: High-Fiber Foods
Foods high in fiber are great for overall health and digestion, but they're especially good for heartburn relief, Romano says.
"Research shows that high-fiber diets play an important role in managing GERD symptoms," she says. That's why "a balanced, plant-oriented, high-fiber diet is a great starting point for GERD management."
A June 2018 study in the World Journal of Gastroenterology found that adding 12.5 g of soluble fiber a day to the diets of people with GERD decreased their weekly frequency of heartburn. The reason might be that dietary fibers bind to the nitric oxide in food, which could "diminish its negative effect onto low esophageal sphincter pressure," according to study authors. More research is needed, but the hypothesis is a start.
High-fiber foods don’t have to be slow, inconvenient or tasteless. Consider things like hot oatmeal with diced apple, cooked barley and greens sautéed in a little olive oil with chicken or warm lentil stew with a vegetable soup base. Just leave out the tomato and spices to make it GERD-friendly.
2. Fatty Meats
Foods like bologna, bacon and sausage are big instigators of GERD symptoms, Romano says.
Saturated fat-rich foods are notorious GERD offenders because they likely decrease the tension in the part of our esophagus that fails to close as it should, allowing acid to flow up. Fatty foods also take longer to leave the stomach, unlike more easily digested foods, which can lead to food regurgitation, according to the 2014 study in Przegląd Gastroenterologiczny.
Eat This Instead: Fish and Unsaturated Fats
While there's no one right diet to avoid GERD completely ("It's avoiding the triggers," Dr. Poppers points out), research has shown that a Mediterranean diet and/or a very low-carbohydrate diet protect against GERD, according to the Current Medicinal Chemistry article.
Another study, published October 2016 in Diseases of the Esophagus, looked at the association of a Mediterranean diet and GERD in 817 adults in Albania. It found a "beneficial effect" in the reduction of GERD from the diet type, which emphasizes fish (not fried!), unsaturated fats like olive oil and fresh fruits and vegetables.
3. Spicy Foods
Spicy foods might cause esophageal mucosal irritation, according to an August 2019 report in Thoracic Disease, mimicking classic heartburn. Spices like chili powder and pepper (white, black, cayenne) are common culprits, Romano says. Garlic can be an offender here too.
Eat This Instead: Mild Foods
One bonus with blander foods: They tend to be higher in fiber (think: grains, fruits, veggies), Romano says.
"Bland" sounds pretty unexciting, but it doesn't have to be. The list of foods you can eat on a bland diet isn't short, according to the U.S. National Library of Medicine:
- Steamed, baked or grilled lean meats (poultry, whitefish, shellfish)
- Low-fat or fat-free dairy
- White bread, pasta and crackers
- Fruit and vegetable juices (avoid citrus and tomato)
- Creamy peanut butter
- Desserts like custard, pudding, popsicles and gelatin
Tomato-based sauces and other tomato products, like tomato juice, have been shown to cause GERD symptoms, Dr. Poppers says, and this could be related to the acidic nature of the fruit (yes, tomatoes are a fruit!).
Eat This Instead: Other Fruits, Veggies and Herbs
Search the internet and you'll find a host of substitutes for tomato, including peaches, beets and basil. The easiest way to adjust certain recipes is to skip the tomatoes and move on, or get creative with pesto-based or low-fat dairy white sauces.
Experimentation — and moderation — can help with all of these foods substitutes, Romano says.
"For some, eliminating some of the triggers and then slowly reintroducing them back may allow you to identify if one of the foods above worsens your GERD symptoms," she says.
As tough as it may be to cut caffeine from your life, both the NIH and the American College of Gastroenterology recommend that people with GERD limit how much chocolate, coffee and caffeinated tea they eat or drink. It's yet another suspected irritant that provokes GERD symptoms.
Drink This Instead: Water
H2O is probably the best thing to drink for acid reflux.
Many of us are chronically dehydrated in our fast-paced lifestyles, Dr. Poppers says. Drinking enough water can help reduce GERD symptoms and benefit your overall wellbeing.
Another major GERD offender, alcohol causes numerous issues, including tampering with the lower esophageal sphincter, increasing acid and impairing how the stomach empties, according to an August 2014 study in BMC Gastroenterology. It's better to avoid it, if you can, or drink in moderation to see if it affects your symptoms, Dr. Poppers says.
Drink This Instead: Mocktails Without Citrus
There are plenty of ways to bring fun drinks into your life without booze. You'll want to skip orange juice, lime juice and lemon juice, too, as these are also possible triggers for GERD symptoms.
How to Figure Out Your GERD Triggers
There are other foods and drinks that might cause issues with GERD, including mint and carbonated beverages. Some people may have their own specific GERD trigger foods that are less common, so be mindful that something not listed here may be causing your discomfort, Dr. Poppers says.
To determine what bothers you the most, it's a good idea to keep a diary in which you record what you eat and when you have GERD symptoms.
"It's always better to try to identify and mitigate or minimize triggers rather than to jump to therapies, medications and otherwise," Dr. Popper says. He advises patients to work with a registered dietitian to develop the best diet for GERD and beyond.
There are many foods you can eat with the condition, so don't despair that so many of life's pleasurable foods and drinks might be on your don't-eat-for-now GERD list, Dr. Popper says. By modifying your lifestyle and getting effective treatment, you might be able to one day return to your trigger foods, possibly in moderation.
Romano agrees: "I always like to suggest to my patients experiencing GERD, rather than thinking about everything you have to take away from your diet, think about what you can add to your diet and lifestyle to make your condition better. In many cases, adopting healthier dietary patterns — including high-fiber fruits, veggies, legumes, nuts, seeds, whole grains — and lifestyle patterns can play a significant role in managing or preventing symptoms."
How and When You Eat Matters, Too
It's not just the type of foods and drinks you consume, but how you do so that can affect GERD symptoms, both Dr. Poppers and Romano emphasize. They share some tips below that can help you better understand the best practices for living and eating with GERD:
- Avoid large meals. Eat smaller portions, more frequently throughout the day.
- Chew your food well.
- Eat as slowly as you can, trying not to suck in too much air while eating.
- Sit upright after meals to help the digestion process.
- Try to eat at least two to three hours before going to sleep at night.
- If you do have to go to bed soon after eating, raise the head of your bed with risers to help prevent GERD symptoms.
Is This an Emergency?
- National Health Institute: “Acid reflux, Heartburn, and GERD: What’s the difference?”
- Przegląd Gastroenterologiczny: "Risk factors for gastroesophageal reflux disease: the role of diet"
- Current Medicinal Chemistry: "Food and Gastroesophageal Reflux Disease"
- World Journal of Gastroenterology: "Fiber-enriched diet helps to control symptoms and improves esophageal motility in patients with non-erosive gastroesophageal reflux disease"
- Diseases of the Esophagus: “Adherence to a predominantly Mediterranean diet decreases the risk of gastroesophageal reflux disease: a cross-sectional study in a South Eastern European population”
- Journal of Thoracic Disease: “The role of diet in the development and management of gastroesophageal reflux disease: why we feel the burn”
- U.S. National Library of Medicine: “Bland diet”
- University of Missouri System: “How to calculate how much water you should drink”
- BMC Gastroenterology: “Dietary guideline adherence for gastroesophageal reflux disease”
- Centers for Disease Control and Prevention: “Dietary Guidelines for Alcohol”