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Mikaela Millan
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Experiencing heartburn or acid reflux occasionally is completely normal. However, having this same experience every time you eat might be a sign of a more serious condition. Gastroesophageal Reflux Disease (GERD) is a chronic condition wherein stomach acid flows back up the esophagus1. This then leads to heartburn, an uncomfortable burning sensation felt in the chest that can rise up to the neck and make you cough. While it can negatively impact day-to-day life, thankfully there are several changes you can make to your diet that can effectively manage the symptoms of GERD. Here's how a GERD diet can look like.
GERD can be compounded by several factors2. Pregnancy, smoking, and being overweight or obese can increase your risk of GERD. Some medications can also worsen symptoms of GERD, such as:
It is important to have a conversation with your healthcare provider regarding the factors that increase the risk of GERD. While some of these cannot be modified, such as your age, sex, or race, other lifestyle factors such as diet, exercise, smoking, and alcohol cessation can be altered to manage the symptoms of GERD. Your doctor may also recommend alternative medications if your current ones compound your symptoms.
To determine your triggers, track GERD symptoms (dry cough, bloating, burping, sore throat, nausea, vomiting, etc.).
By answering these questions, you'll be able to determine which behaviors/foods trigger your GERD.
Being a condition affecting the esophagus and stomach, your diet ultimately plays a huge role in the occurrence of GERD. Here are just some of the foods that can trigger heartburn and ones you may want to avoid3:
While it may initially be difficult to eliminate all these foods from your diet, being deliberate and consistent are key factors in the effective management of GERD. Eating these in moderation, as opposed to complete elimination, may also contribute to greater success.
A healthy diet can work wonders to lessen heartburn associated with GERD. Here are some of the best foods to eat to manage GERD4:
Fiber helps you feel full longer, which lessens the chances of overeating and, ultimately, heartburn. High-fiber foods include whole grains, root vegetables, and green vegetables. Oatmeal, couscous, and brown rice are good examples of whole grains. Root vegetables, like sweet potatoes, carrots, and beets, are rich sources of fiber. Lastly, asparagus, broccoli, and green beans also are great to load up on.
The acidity in the stomach is very high, so counter that with alkaline food such as bananas, melons, cauliflower, fennel, and nuts. By offsetting the acidity in the stomach, you also decrease the occurrence of heartburn.
Fruits and vegetables that contain a high amount of water can help dilute the acidity in the stomach. Celery, cucumber, lettuce, watermelon, broth-based soups, and herbal tea are all great sources of water to help calm an aggravated stomach.
Other helpful tips include choosing baked, broiled, or grilled food over fried and fatty ones5. Opt for fruits to satisfy your sweet cravings rather than chocolate or sweets. Steep ginger in your tea or munch on dried ginger to tame any unrest in your stomach.
While fat is a vital nutrient that provides the body with energy and supports healthy bodily functions, not all fats are equal. Saturated fats, commonly found in meat and dairy, as well as trans fats present in processed foods, margarine, and shortenings, should be avoided or limited. Instead, consider replacing them with unsaturated fats from plant-based sources or fish, in moderation. Here are some examples of healthier fats:
While a healthy diet cannot be stressed enough in the management of GERD, making a few simple but effective modifications to your lifestyle can positively increase your chances of success. Here are some diet and lifestyle changes you can make to reduce heartburn6:
This is definitely not an exhaustive list, but the suggestions mentioned here have been found to effectively improve the chances of success in managing GERD.
Here's an example of a GERD diet plan containing 5 meals over the course of 3 days.
Note that this is just an example and may not suit your specific situation. GERD triggers vary from person to person and this meal plan does not address the unique needs of an individual. Additionally, this meal plan does not address other health conditions you may have.
For personalized dietary recommendations, consult a healthcare provider or registered dietitian.
| Meal Time | Day 1 | Day 2 | Day 3 |
|---|---|---|---|
| Breakfast | Steel-cut oats with sliced banana, walnuts, and cinnamon | Scrambled eggs with sautéed spinach and whole wheat toast | Greek yogurt with mixed berries, chopped nuts, and honey |
| Snack | Apple slices with almond butter | Carrot sticks with hummus | Hard-boiled egg with a handful of grapes |
| Lunch | Grilled chicken breast with mixed greens, cucumber, and avocado | Turkey and vegetable stir-fry with brown rice | Baked sweet potato with black beans, salsa, and Greek yogurt |
| Snack | Roasted almonds with dried apricots | Low-fat Greek yogurt with sliced strawberries | Celery sticks with almond butter |
| Dinner | Baked salmon with roasted asparagus and quinoa salad | Grilled chicken breast with roasted vegetables and quinoa | Vegetarian chili with mixed vegetables and brown rice |
You can put together your own 7-day GERD diet plan, or a even a monthly diet plan by combining foods that don't trigger your reflux.
To understand GERD, we first need to understand how the esophagus and stomach are related to each other. The lower esophageal sphincter at the end of the esophagus is a smooth muscle that usually remains contracted to make sure that food from the stomach does not flow backward, like a one-way valve. In healthy individuals, this sphincter relaxes just to let food pass through then contracts again to maintain a high-pressure zone. This makes sure that food flows in only one direction: toward the stomach.
However, people with GERD may have frequent relaxation of the esophageal sphincter, causing the backward flow of gastric stomach acid up the esophagus7. The exact reason why this happens is not yet fully understood, but the weakness of the lower esophageal sphincter accounts for about 48-73% of GERD symptoms7.
A hiatal hernia can als contribute to the occurrence of GERD2. This is a condition wherein an opening in the diaphragm, the muscle that separates the chest from the abdomen, allows the upper part of the stomach to enter the chest cavity.
Another mechanism that contributes to the presence of GERD is defective esophageal peristalsis8. Peristalsis is the squeezing movement of the esophagus that ensures that the food from the mouth flows in one direction down the esophagus into the stomach. When this is defective, it not only permits the contents of the stomach to move backward and enter the esophagus but also contributes to damage to the esophagus lining. Unlike the stomach, which is well equipped to handle highly acidic contents, the lining of the esophagus, being a passageway of food, is not suited for this.
A healthy diet and lifestyle modifications are the cornerstone of management in GERD. While there are options for medications such as proton pump inhibitors and antacids, nothing beats a well-rounded diet, regular exercise, adequate sleep, and good hydration. Medication and surgery may be options for those not responsive to conservative measures. Hopefully, the incorporation of the suggested foods into your diet as well as the lifestyle recommendations improves your GERD symptoms. For personalized dietary recommendations, consult a healthcare provider or registered dietitian.
Mikaela is a dentistry clinician at the University of the Philippines.
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