The National Institutes of Health estimates that over 60 million Americans experience the sensation we call heartburn on a monthly basis. This makes heartburn, also known as acid reflux, one of the most common gastrointestinal symptoms, and the reason for a significant number of hospital and gastroenterology clinic visits. While there may be some genetic components of acid reflux, many of our food choices and eating habits can play a major role in whether or how often we get it.1

Overview of Acid Reflux and GERD

Acid reflux is the term for the backflow of stomach acid and other stomach contents into the esophagus. When this happens, the acidity of the stomach contents can irritate the lining of the esophagus and cause a variety of symptoms, including heartburn, the burning sensation in the chest or throat that many people are familiar with. Occasionally experiencing acid reflux is normal for most people, usually triggered by diet or lifestyle habits, but it typically resolves on its own after a day.

Sometimes the acid reflux becomes persistent or recurring, and it can eventually lead to its chronic form, gastroesophageal reflux disease (GERD). GERD is a more severe form of acid reflux, and it is generally diagnosed when incidence of acid reflux occurs more than twice a week or causes inflammation in the esophagus. Apart from the unwelcome symptoms associated with GERD, it can also lead to other complications if left untreated. Examples include esophagitis (inflammation of the esophagus), esophageal strictures (narrowing), Barrett's esophagus (precancerous changes), and an increased risk of esophageal cancer.

There are a number of factors involved in the development of GERD; for example, habits like smoking and drinking alcohol regularly can exacerbate reflux symptoms or make GERD more likely. One of the main causes, however, is related to weakening or damage of the lower esophageal sphincter (LES), the ring of muscle that acts as a valve between the esophagus and stomach. Conditions like obesity or a hiatal hernia, for instance, can put pressure on the abdominal cavity and disrupt the normal function of the LES, leading to backflow from the stomach.2

What Are the Symptoms of GERD?

Naturally the primary symptom of GERD is heartburn, the painful feeling that follows acid backing up into the esophagus. It isn’t the only symptom, however; people with GERD are also prone to general chest pain or discomfort as well as a sore throat and coughing. Another

common symptom is regurgitation, when the backflow reaches the back of the throat or mouth and leaves a bitter taste. Less commonly, GERD can also lead to nausea, vomiting, erosion of tooth enamel, or a sensation of having something stuck in the throat.

Foods to Avoid

As noted, there are some conditions and life habits that make GERD more likely, and there are also some medications that can worsen reflux. For most people, though, preventing and/or treating GERD will revolve around making diet changes and determining which foods will trigger symptoms. The following foods are examples of what to avoid in order to reduce the chances of causing acid reflux:

    • Fatty foods: High-fat foods like fried foods, fatty meats, and full-fat dairy products (like ice cream or whole milk) are a common trigger of acid reflux in part because they take longer to digest; this means they sit in the stomach for longer, leaving more time to back up into the esophagus.
    • Spicy foods: Spicy foods, especially peppers that are rich in the compound capsaicin, can also be a trigger of heartburn. Compounds like capsaicin that make a food spicy can similarly cause food to stay in the stomach longer, but they can also directly irritate the lining of the esophagus.
    • Tomato products: Tomato sauce and other tomato-based products are examples of acidic foods that can irritate the esophagus or actually relax the lower esophageal sphincter. Vinegar has a similar effect.
    • Citrus fruits: Another example of an acidic food that can trigger heartburn is citrus fruits like lemons, limes, and grapefruit. By relaxing the LES, they make it easier for other acids in the stomach to flow back up into the esophagus.
    • Chocolate: Unfortunately for chocolate lovers everywhere, chocolate is another common trigger food. Chocolate contains a category of stimulants called methylxanthines (primarily caffeine) that can cause the LES to relax or weaken.
    • Carbonated beverages: Carbonated beverages like soda and sparkling water can be a problem for different reasons; the carbonation introduces excess air into the digestive tract, and this can cause pressure in the abdominal cavity that pushes on the LES. Chewing gum can have a similar impact as the chewing action can cause excess air to be swallowed.

    Foods to Emphasize

    Managing the symptoms of GERD isn’t just about what you have to cut out, however; there are also a variety of foods that are reliably non-triggering. The good news is that many GERD-friendly foods are also regarded as good for general health:

    • Whole grains: Whole grains are so named because they include the entire grain of a cereal and thus have more nutrients. Whole grains also have more fiber, which is beneficial for preventing acid reflux because of how it can neutralize some stomach acid. Examples of whole grains include brown rice, oats, quinoa, barley, and whole grain bread.
    • Lean proteins: Both fish and lean meats like chicken and turkey are a good low-fat alternative to beef and pork. These lean proteins have a higher proportion of unsaturated fat, and that makes them less likely to trigger heartburn or related symptoms.
    • Non-citrus fruits: There are a wide range of fruits that don’t have the kind of acidity of citrus fruits; examples include melons, bananas, apples, and berries.
    • Vegetables: Eating a variety of vegetables is crucial for good health, and it’s also a way to decrease the likelihood of acid reflux and GERD. Examples include leafy greens, broccoli, cauliflower, green beans, and carrots.
    • Healthy fats: For the same reason as lean meats, it’s also important to switch to healthier fats used in moderation. Nuts, seeds, and avocados are all examples of healthy fats, but it can also include olive oil and other plant-based oils.
    • Herbal tea: Non-caffeinated herbal tea can be a great addition to a GERD diet; with the exception of peppermint or spearmint (which can actually trigger heartburn) classic types like ginger and chamomile are safe to drink.

      Besides changing the composition of one’s diet, there are some other ways to improve the symptoms related to GERD. Eating smaller meals, for instance, can help simply by having less food in the stomach and thus reducing the pressure on the LES. There is also some evidence that probiotic foods can improve digestion and generally make acid reflux less likely.

      Make an Appointment With Cary Gastroenterology

      Acid reflux and GERD are unfortunately common in the United States, in large part because of the high-fat diets we are accustomed to. With a few changes, though, you can reduce the chances of acid reflux and the chances of it becoming a chronic condition. If you’ve been experiencing any of the symptoms noted above, you may want to get medical advice from one of our expert physicians at Cary Gastro. Contact us today to request an appointment.

      1https://magazine.medlineplus.gov/article/heartburn-what-you-need-to-know
      2      https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/definition-facts