Foods to Avoid in GERD: How to Control Reflux?

Foods to avoid in GERD play a crucial role in controlling the symptoms of gastroesophageal reflux disease (GERD). This common condition is characterized by acid reflux and heartburn.
Certain foods can trigger or worsen GERD symptoms, primarily by decreasing lower esophageal sphincter (LES) pressure or irritating the esophageal lining.
However, dietary recommendations should be individualized, as not all patients react the same to certain foods.

Common Trigger Foods in GERD

Current evidence suggests that certain foods or habits may have a triggering effect on GERD-related symptoms, being:

Acidic and Irritating Foods

Foods to avoid in GERD include citrus fruits, tomato-based sauces, and spicy foods.
These foods can directly irritate the esophageal lining, causing discomfort even if they do not necessarily increase acid production. While some individuals may tolerate them in moderation, others may experience worsened reflux.

Caffeinated and carbonated beverages

Coffee, tea and soft drinks may contribute to symptoms by increasing gastric acid production and causing esophageal irritation. In addition, carbonated beverages can cause bloating, which puts pressure on the stomach and promotes acid reflux.
However, if well tolerated, it may not be necessary to eliminate moderate consumption of coffee and tea.

High-Fat and Fried Foods

Among the foods to avoid in GERD, fatty foods, including fried foods and full-fat dairy products, can relax the LES and delay stomach emptying, increasing the likelihood of acid reflux.
Reducing intake of these foods and preferring low-fat dairy may help minimize symptoms, especially in people with frequent episodes of heartburn.

Chocolate and Peppermint

Chocolate contains methylxanthines, which can relax the LES and trigger acid reflux. Similarly, peppermint, often used to soothe digestive issues, may actually worsen GERD symptoms in some individuals by relaxing the LES further.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Common NSAIDs, such as ibuprofen and aspirin, can irritate the stomach lining and exacerbate GERD symptoms. Patients with GERD should avoid taking NSAIDs without medical supervision and opt for alternatives when necessary.

Diet and lifestyle modifications

In addition to identifying foods to avoid in GERD, there are several diet and lifestyle changes that can help effectively manage symptoms:

• Meal size and timing: eating smaller, more frequent meals rather than large portions can reduce stomach pressure and minimize reflux episodes.
• Body fat percentage: Obesity is a risk factor for GERD, as excess abdominal fat can put pressure on the stomach and promote reflux. Decreasing fat percentage can significantly improve symptoms.
• Avoid eating late at night: Going to bed too soon after eating can worsen reflux symptoms. It is recommended to wait at least 2-3 hours before going to bed.
• Elevate the head of the bed: Elevating the upper body while sleeping can prevent acid from backing up into the esophagus during the night.

Foods to Avoid in GERD: Personalized Approach

The relationship between diet and GERD symptoms varies from person to person. While some people may experience relief by eliminating acidic foods, others may tolerate them without problems.
Therefore, it is critical to take a personalized approach. Keeping a food diary can help identify specific triggers and tailor dietary recommendations accordingly.

In conclusion:

In my experience as a nutritionist, eliminating foods high in salt and added sugars and unnecessary use of NSAIDs may be more beneficial for some patients than strictly avoiding citrus fruits, coffee or chocolate.
Instead of total restriction, the focus should be on balanced eating habits and portion control.

Written by: Nutritionist Andrés Izurieta

Bibliographic citations:

Fox M, Gyawali CP. Dietary factors involved in GERD management. Best Pract Res Clin Gastroenterol. 2023.

Surdea-Blaga T, Negrutiu DE, Palage M, Dumitrascu DL. Food and Gastroesophageal Reflux Disease. Curr Med Chem. 2019.

Tosetti C, Savarino E, Benedetto E, De Bastiani R, Study Group for the Evaluation of GERD Triggering Foods. Elimination of Dietary Triggers Is Successful in Treating Symptoms of Gastroesophageal Reflux Disease. Dig Dis Sci. 2021.