An episode of acid reflux commonly causes symptoms such as heartburn and sour burps. When reflux produces frequent or severe symptoms, it is defined as gastroesophageal reflux disease (GERD), which can lead to serious complications. Approximately 18 to 28 percent of Americans are affected by GERD, according to the authors of a research study published in June 2014 in the journal "Gut." Some people find that certain foods, such as acidic fruits, trigger reflux symptoms. While there is no specific diet recommended for reflux, if acidic fruits trigger your symptoms, replacing it with less acidic fruit may help.
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Acidic Foods and Reflux Symptoms
The stomach produces acid and enzymes that begin the process of food digestion. The pH of the foods you eat can make the contents of your stomach more or less acidic after a meal. Therefore, acidic foods might make your stomach contents more acidic. When acidic stomach contents leak into the esophagus, they can irritate the delicate tissue there, causing heartburn. Long-term irritation from reflux can lead to permanent damage. Avoiding acidic fruits that increase the acidity of stomach contents may help reduce reflux symptoms.
Cause of Reflux
A muscular band between the esophagus and stomach normally remains closed, other than to allow food or liquids into the stomach after swallowing. Reflux occurs when this band opens abnormally, allowing stomach contents to rise up into the esophagus. While the acidity of the foods you eat does not influence the function of the band at the opening of the stomach, highly acidic foods may increase the likelihood of heartburn and other symptoms if stomach contents reflux into the esophagus. Foods that are high in acid, such as certain acidic fruits, may make the stomach contents more acidic and irritating to the esophagus.
Fruits to Eat
Most fruits do contain natural acids, though some are more acidic than others. 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.
Many other slightly more acidic fruits are also unlikely to trigger reflux symptoms and are healthy options -- as long as they don't bother you. Examples of these generally well tolerated fruits include berries, cherries, apples, peaches, nectarines, apricots and pears. Canned fruit and prepackaged fruit juice may be more acidic than fresh fruit because of acids added as preservatives.
Fruits to Avoid
Citrus fruits contain a variety of natural acids, including citric acid and ascorbic acid, or vitamin C. Citric acid predominates, giving citrus fruits their tart and tangy taste. Citrus fruits, including grapefruit, oranges, lemons, limes and tangerines, are among the most acidic of all fruits. Some people find citrus fruits and juices trigger reflux symptoms. This may be from their natural acids increasing the acidity of the stomach contents. Cranberries are also highly acidic and may be a trigger food for some people with reflux. Fresh tomatoes, which are scientifically categorized as fruit, are not typically highly acidic. However, canned tomatoes and other prepacked tomato products are often very acidic because of acids added as preservatives.
Considerations and Precautions
The American College of Gastroenterology and American Gastroenterological Association recommend an individualized approach to diet for people with GERD. This means it isn't necessary to eliminate any particular food from your diet, unless it triggers reflux symptoms for you. Fruit is an important part of a healthy diet, so it may be helpful to keep a food journal to determine what fruits you can eat without experiencing symptoms.
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.
Medical advisor: Jonathan E. Aviv, M.D., FACS
REFERENCES & RESOURCES
- Gut: Update on the Epidemiology of Gastro-oesophageal Reflux Disease: A Systematic Review
- Gastroenterology: American Gastroenterological Association Medical Position Statement on the Management of Gastroesophageal Reflux Disease
- Gastroesophageal Reflux Disease, Gastroenterology Clinics of North America Review Articles; Joel E. Richter, M.D.
- American College of Gastroenterology: Diagnosis and Management of Gastroesophageal Reflux Disease
- University of Wisconsin Madison: pH Values of Common Foods and Ingredients
- U.S. Food and Drug Administration: Approximate pH of Foods and Food Products
- Microorganisms in Foods 6, Second Edition: Microbial Ecology of Food Commodities; International Commission on Microbiological Specifications for Foods
- National Institute of Diabetes and Digestive and Kidney Diseases: Gastroesophageal Reflux (GER) and Gastroesophageal Reflux Disease (GERD) in Adults
- FamilyDoctor.org: Heartburn