See Your Doctor
If you experience frequent heartburn (more than twice weekly), difficulty swallowing, persistent cough, or unexplained weight loss, see your GP. These could indicate GERD or other conditions requiring medical evaluation. Dietary changes complement but don't replace medical treatment when needed.
Gastroesophageal reflux disease (GERD) occurs when stomach acid frequently flows back into the oesophagus. Occasional heartburn is common, but chronic reflux can damage the oesophageal lining and significantly impact quality of life.
Diet plays a major role - certain foods relax the lower oesophageal sphincter (the muscle that normally keeps acid in the stomach), while others increase acid production or irritate an already inflamed oesophagus.
How Foods Trigger Reflux
Sphincter relaxation - Fat, chocolate, caffeine, and alcohol relax the lower oesophageal sphincter, allowing acid to escape upward.
Increased acid production - Some foods stimulate more stomach acid production.
Direct irritation - Acidic or spicy foods may irritate an already inflamed oesophagus even if they don't cause reflux.
Delayed gastric emptying - High-fat meals stay in the stomach longer, increasing reflux opportunity.
Common Trigger Foods
Frequently Problematic
- Fatty or fried foods
- Chocolate
- Coffee (regular and decaf)
- Alcohol
- Citrus fruits and juices
- Tomatoes and tomato-based foods
- Peppermint and spearmint
- Carbonated drinks
Often Problematic
- Spicy foods
- Onions and garlic
- Very acidic foods
- Large portions of any food
- Very hot or very cold foods
- High-sodium foods
Triggers are highly individual. Chocolate devastates some people; others tolerate it fine. The conventional wisdom to avoid all these foods isn't necessary - identify YOUR specific triggers through careful observation.
Foods That May Help
Generally Well Tolerated
- Lean proteins (chicken, fish, turkey)
- Vegetables (non-acidic)
- Whole grains (oats, brown rice)
- Bananas
- Melons
- Ginger
- Low-fat dairy
- Eggs
May Have Protective Effects
- High-fibre foods
- Alkaline foods (most vegetables)
- Watery foods (cucumber, lettuce)
- Oatmeal
- Non-citrus fruits
- Fennel
- Herbal teas (not peppermint)
How You Eat Matters as Much as What
Eating Habits That Reduce Reflux
- Smaller, more frequent meals - Large meals distend the stomach and increase pressure on the sphincter
- Don't lie down after eating - Wait at least 3 hours before bed; gravity helps keep acid down
- Eat slowly - Rushing meals leads to swallowing air and overeating
- Avoid late-night eating - Finish dinner well before bedtime
- Elevate head of bed - Raising the head 6-8 inches (blocks under bedposts, not just pillows) helps nighttime reflux
- Wear loose clothing - Tight belts and waistbands increase abdominal pressure
Weight and Reflux
Excess abdominal weight increases pressure on the stomach and is one of the strongest risk factors for GERD. Even modest weight loss often improves symptoms significantly. Studies show that a 10% weight loss can reduce reflux episodes by 40%.
This is particularly relevant because many "GERD diets" focus on specific food avoidance while overlooking the more impactful factor of overall eating patterns that support healthy weight.
Finding Your Triggers
Rather than eliminating everything on the "avoid" list, try a systematic approach:
- Keep a food diary - Record what you eat and when symptoms occur
- Look for patterns - After 2 weeks, review for consistent triggers
- Test one food at a time - Remove suspected trigger for a week, then reintroduce
- Note context - Same food might be fine at lunch but problematic at dinner
You might find you can enjoy coffee in the morning but not after dinner, or that small amounts of chocolate are fine but larger portions aren't. This personalised approach prevents unnecessary dietary restriction.
Beyond Diet
Lifestyle factors also significantly affect reflux:
- Smoking - Weakens the oesophageal sphincter; quitting helps
- Stress - Increases stomach acid and symptom perception
- Medications - Some drugs worsen reflux (NSAIDs, certain blood pressure medications)
- Exercise - Helps weight management but avoid vigorous exercise right after eating
When Diet Isn't Enough
If dietary changes don't adequately control symptoms, medication may be needed. Antacids provide quick relief; H2 blockers and proton pump inhibitors (PPIs) reduce acid production more effectively. Long-term PPI use has some concerns, so work with your doctor to find the lowest effective dose and explore whether dietary management can reduce medication needs.
The Bottom Line
Managing acid reflux through diet involves both what you eat and how you eat. Common triggers include fatty foods, caffeine, alcohol, citrus, tomatoes, and chocolate - but triggers are individual, so identify yours through careful observation rather than blanket avoidance. Eating smaller meals, not eating close to bedtime, and maintaining a healthy weight are often more impactful than specific food elimination. If you have frequent symptoms, see your GP to rule out complications and discuss whether medication might help alongside dietary changes.
References
- NHS. (2023). Heartburn and acid reflux. nhs.uk
- Ness-Jensen, E., et al. (2016). Lifestyle intervention in gastroesophageal reflux disease. Clinical Gastroenterology and Hepatology, 14(2), 175-182. doi:10.1016/j.cgh.2015.04.176
- NICE. (2014). Gastro-oesophageal reflux disease and dyspepsia in adults. Clinical guideline CG184. nice.org.uk/guidance/cg184
- Sethi, S., & Richter, J.E. (2017). Diet and gastroesophageal reflux disease: role in pathogenesis and management. Current Opinion in Gastroenterology, 33(2), 107-111. doi:10.1097/MOG.0000000000000337
