Reduce GERD Symptoms One Bite at a Time

Wednesday, March 17, 2021

Stephanie Moore, RD, LD

Gastroesophageal reflux disease (GERD) is a chronic condition characterized by acid flowing back up the esophagus from the stomach. It affects an estimated 18-28 percent of adults in North America.

Common Symptoms of GERD

  • Heartburn
  • Chest pain
  • Regurgitation or sour taste in mouth
  • Globus sensation in throat
  • Chronic cough
  • Difficulty swallowing
  • Hoarseness

What and how you eat can contribute to symptoms of GERD. Some foods may relax the lower esophageal sphincter (LES) allowing stomach contents to come back up the esophagus and even up to the throat. Other foods may result in delayed stomach emptying, which, combined with a relaxed LES, can lead to acid reflux. Some foods may even increase acid production in the stomach.

Foods that can lead to GERD symptoms:

  • Spicy foods
  • Black pepper
  • Garlic and onion
  • Tomatoes
  • Citrus fruits
  • Caffeine – including coffee and tea
  • Alcohol
  • Carbonated beverages
  • Vinegar
  • Peppermint
  • Chocolate
  • Fatty foods

Fatty foods can relax the LES and delay stomach emptying by triggering the release of the hormone cholecystokinin (CCK). CCK keeps fatty foods in the stomach for longer to aid in their digestion, but this increases the risk of acid reflux. Avoiding fried and greasy foods and focusing on healthier forms of fat can help reduce the total amount of fat a person eats while still including this important nutrient in their diet. Although these foods can worsen symptoms of GERD, they are not guaranteed triggers for everyone.

Lifestyle habits that contribute to GERD:

  • Smoking
  • Being overweight/obese
  • Eating fast or on the go
  • Eating within 2-3 hours of going to bed
  • Eating large meals
  • Wearing high-waisted tight-fitting pants
  • Stress!

Since there are many diet and lifestyle triggers for GERD symptoms, making changes can feel overwhelming for patients. Keeping a food and symptom journal can make it easier to spot likely triggers.

Other helpful changes to start with include:

  • Eat smaller, more frequent meals
  • Relax before meals by taking a few deep breaths
  • Take smaller bites and chew each bite well before swallowing
  • Sit upright after eating for at least 2 hours or go for a walk
  • Add more fiber to meals in the form of fruits, vegetables, whole grains, nuts/seeds and legumes – fiber can increase LES resting pressure and reduce episodes of reflux

Although the main treatment for GERD is taking acid-reducing medication, there are many non-medicine ways to reduce symptoms of GERD. Navigating these changes can be overwhelming for the patient and time consuming for the provider. The Oregon Clinic offers nutrition therapy by registered dietitians to work one on one with patients and help them improve their GERD symptoms, one bite at a time.