Is Pineapple Good or Bad If You Have Acid Reflux?

Acid reflux occurs when your acidic stomach contents travel up into your esophagus -- the tube that connects your stomach and mouth. Typical symptoms of acid reflux include heartburn or a burning feeling in your chest, as well as a sensation of food coming back into your esophagus after swallowing. Pineapple is on a list of foods commonly thought to worsen reflux symptoms, on the belief that this acidic fruit -- if regurgitated up from your stomach -- can irritate your esophagus and throat. However, there is a lack of research showing that avoiding acidic foods improves symptoms, according to the American College of Gastroenterology's 2013 clinical practice guidelines. Instead of a blanket restriction on acidic fruits such as pineapple, these guidelines support an individualized approach of avoiding foods that worsen your symptoms.

Pineapple contains bromelain, an enzyme that helps in digestion. Credit: Westend61/Brand X Pictures/Getty Images

Lifestyle and Acid Reflux

Acid reflux is traditionally managed with medications and lifestyle changes. The American College of Gastroenterology, or ACG, guidelines outline the lifestyle recommendations most supported by research -- weight loss if overweight, elevating the head of the bed while you sleep and avoiding meals 2 to 3 hours before bedtime. While ACG does not recommend that everyone with acid reflux avoid the same foods, these guidelines do clarify that those affected by acid reflux will have varying levels of food tolerance. So if you find that pineapple or other acidic foods such as oranges and tomatoes aggravate your acid reflux symptoms, you can improve your symptoms by avoiding or limiting these foods.

Pineapple Benefits

Pineapple is a nutritious fruit used in cuisines throughout the world. It is low in fat, a good source of fiber and high in vitamin C. Incorporating more fruits and vegetables is a positive dietary change that can help if you are trying to lose weight -- and weight loss can improve your acid reflux. Pineapple also contains bromelain, an enzyme that helps in digestion. Because of bromelain's touted benefits, pineapple has long been considered a food helpful for managing digestive complaints such as reflux. However, little data is available on bromelain, in the amounts naturally found in pineapple, and its role in managing acid reflux.

Pineapple and Acid Reflux

While most foods are considered acidic, defined by having a pH below 7, pineapple -- with its pH of 3.2 to 4.1 -- is more acidic than many other foods. Historically, the avoidance of high acid foods has been recommended to help control heartburn symptoms. However, research has not yet confirmed the benefits of this dietary approach, according to the 2013 ACG clinical practice guidelines. If pineapple does aggravate your symptoms, you may need to avoid this fruit for symptom relief. Alternatively, you can assess tolerance of small amounts with meals or try pairing this fruit with a lower-acid or neutralizing food. For example, Dr. Jonathan Aviv, in his book "Killing Me Softly From Inside," recommends that pineapple only be consumed if mixed with neutralizing foods, such as soy, almond or coconut milk. In summary, it's helpful to do your own detective work to determine if pineapple improves or worsens your acid reflux.

Acid Reflux Management

Aside from managing the discomfort of this condition, acid reflux can pose serious health consequences. Uncontrolled or severe acid reflux can lead to a precancerous condition that can contribute to the development of esophageal cancer. Effective management of your acid reflux is important. In addition to lifestyle changes, which include avoiding or limiting foods that worsen your symptoms, see your doctor if you experience more than occasional heartburn symptoms. Your doctor can prescribe certain medications to relieve reflux and provide recommendations to help you manage this condition.

Medical advisor: Jonathan E. Aviv, M.D., FACS

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