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Acid reflux, similar to gastroesophageal reflux disease (GERD), is a common digestive issue that can cause a burning sensation in the chest, known as heartburn. For those with food allergies, intolerances, IBS, or on a low FODMAP diet, managing acid reflux can be particularly challenging. Here, we’ll discuss common trigger foods and provide easy swaps for keeping your diet reflux-friendly.
Research shows [1] that many people with GERD continue to have symptoms even when taking medication such as proton pump inhibitors. This is often because lifestyle and dietary factors affect each person differently, with triggers varying from one individual to another.
Keep this in mind as you review the common triggers below – some may resonate with your own experience.
Common Acid Reflux Trigger Foods
1. Spicy Foods
Spicy foods that contain capsaicin such as hot peppers and chili, can irritate the esophagus and trigger reflux symptoms [2]. This includes curries, stews, hot sauces and other spicy foods.
Try this swap:
Instead of hot peppers or chilli, add a flavorful kick with these low FODMAP options like mustard powder, horseradish, fresh ginger, turmeric, and warming cinnamon. Fresh herbs such as basil, cilantro, dill, oregano, rosemary, and thyme also add depth without triggering acid reflux.
2. Citrus Fruits
Acidic fruits like oranges, lemons, limes, and grapefruits are highly acidic and can exacerbate acid reflux symptoms.
Try this swap:
Choose low-acid options like aloe vera juice, such as bananas, melons (cantaloupe, honeydew, watermelon), coconut, pears, and apples.
Low FODMAP: Bananas (1 serve), cantaloupe (low serve 3/4 cup), honeydew melon (low serve 1/2 cup), aloe vera juice (low serve 1/4 cup),
3. Tomato Products
Tomatoes and products made from tomatoes, like sauces and soups, are acidic and can trigger reflux.
Try this swap:
Try pumpkin puree, roasted red peppers (in moderation), or sauces made from herbs and olive oil.
Low FODMAP: Puree pumpkin, beetroot, cauliflower or carrots, or choose a flavoured olive or avocado oil to add flavour to your sauces.
4. Garlic and Onions
It’s unclear why alliums including garlic and onion may cause acid reflux, but they are staples in many dishes because they are so flavourful. It’s possible that their hugh fructan content is partially the cause for reflux. Likewise, the frucan content is often the cause for IBS symptoms in many people – that’s why for those on a low FODMAP diet, avoiding garlic and onions is already recommended due to their high FODMAP content.
Try this swap:
Use garlic and onion infused olive oil (safe low FODMAP alternative), chives, or asafoetida powder (used sparingly).
Low FODMAP: Garlic-infused olive oil, chives.
One study showed that coffee, in contrast to tea, can potentially cause symptoms of reflux for some people. The effect was said to be be less pronounced with decaffeinated drinks; though it was found that it was not necessarily caffeine itself that causes the issue [4].
On the other hand, another more recent study did not find a strong association between caffeine and reflux, but rather it drinking coffee with milk was potentially associated with reflux [5]. Perhaps this is unsurprising in light of dairy as a common food that people are may be allergic or sensitive to – and according to further studies, dairy can indeed also cause heatburn [6].
Try this swap:
Opt for these low FODMAP options like herbal teas(chamomile, lemongrass, or ginger tea). Try dairy alternatives like almond milk or rice milk.
5. Coffee & Milk
6. Chocolate
Chocolate has been shown to relax the lower esophagael sphincter (LES) increasing the risk of reflux, so is recommended to be avoided [7].
Try this swap:
Use carob powder or carob-based treats as a reflux-friendly and Low FODMAP (in serves up to 1 heaped teaspoon) sweet alternative. It’s a great low nickel option too!
7. Fatty and Fried Foods
Foods high in fat and fried foods both effect the LES and take longer to digest, increasing the risk of reflux. Avoid deep-frying, creamy sauces with high fat, and large servings of avocado or coconut cream. [8]
Try this swap:
Choose reflux-friendly, low FODMAP ingredients that still offer richness or crunch:
Lean meats like chicken, turkey, or firm fish (baked or grilled) – low FODMAP
Eggs (poached or boiled) – low FODMAP, a rich and satisfying protein
Pumpkin seeds (pepitas) – low FODMAP up to 2 tbsp, add great crunch
Walnuts – low FODMAP up to 15 halves, mild richness, softer crunch
Rice cakes or seed crackers – check ingredients, can add a crunchy base without frying
8. Alcohol
Alcohol is not only likely irritate the stomach lining directly, but also effect the function of the esophogus and stomach and peristalsis. This means that reducing or eliminating alcohol can significantly improve reflux symptoms [9].
Try this swap:
Swap for alcohol-free wines, or beverages like herbal tea or infused water. Though, if you’re really keen to drink alcohol, consider spirits with lower pH and higher ethanol content – such as tequila, whisky, gin, or cognac—as they tend not to stimulate gastric acid secretion and may be gentler on reflux than wine or beer.
9. Carbonated Drinks
Some studies show that drinking soda may be associated with increased reflux symptoms [10], but the majority of sources don’t show a clear relationship. The jury is still out on this one, so use your discernment on this one.
Try this swap:
Drink water, herbal teas, or unsweetened plant-based milks.
10. Black & Red Pepper
It’s extremely common to shake a little pepper to season a meal, but pepper is yet another ingredient considered an irritant and in one study, it was found to cause mucosal microbleeding [11]. It is generally considered best avoided for those who suffer from acid reflux.
Try this swap:
Season with mild, low FODMAP herbs and spices such as basil, oregano, thyme, rosemary, dill, and cilantro.
11. Sugary Processed Foods
Sugar along with many processed high-carbohydrate foods are often considered very acidic, and have been shown to have a negative effect on acid reflux [12]. These foods are best kept to a minimum or avoided completely for those with reflux.
Try this swap:
Focus on whole foods such as low-fat yogurt (lactose-free if needed), berries, seeds, nuts, and whole grains like oats.
Low FODMAP: Lactose-free yogurt, strawberries (Up to 5 berries), blueberries (Up to 1 cup), chia seeds, oats (1/2 cup serves).
How Else To Manage Acid Reflux
Timing of Meals. Eating large meals late in the evening can increase the risk of nighttime reflux. Aim to have your last meal at least 2-3 hours before bedtime to allow for proper digestion. If you feel hungry closer to bedtime, opt for a light snack that is low in fat and acidity.
Laying Down. Lying down immediately after eating can cause stomach acid to travel back up the esophagus. To minimize symptoms, try to remain upright for at least 2-3 hours post-meal. If you need to rest, consider elevating your upper body with pillows to prevent acid reflux.
Exercise and Acid Reflux. Regular physical activity can help maintain a healthy weight and promote digestion, but certain exercises can trigger reflux symptoms. High-impact activities like running or heavy lifting may worsen symptoms. Instead, opt for low-impact exercises like walking, swimming, or yoga, which can aid digestion without straining the abdomen.
Acid Reflux, Eosinophilic Esophagitis (EOE), and Other Health Issues.
- Eosinophilic esophagitis (EOE) is a chronic inflammatory condition that affects the esophagus and can cause symptoms similar to GERD. People with EOE often have food allergies, and certain foods can trigger inflammation. If you suspect EOE, working with a healthcare provider for proper diagnosis and management is essential.
- Acid reflux may also be linked to other gastrointestinal disorders, such as IBS and gastroparesis, where delayed stomach emptying can contribute to reflux symptoms. If you have other digestive issues, it’s crucial to address them with a healthcare professional to find a comprehensive management plan.
Tips for Managing Acid Reflux
- Eat Smaller Meals. Large meals can increase stomach pressure, leading to reflux. Aim for smaller, more frequent meals throughout the day.
- Stay Upright After Eating. Lying down immediately after eating can cause stomach acid to travel back up the esophagus. Try to stay upright for at least 2-3 hours after meals.
- Elevate Your Head While Sleeping. Using an extra pillow or a wedge pillow can help keep your head elevated and reduce nighttime reflux.
- Chew Gum. Chewing gum stimulates saliva production, which can help neutralize stomach acid. Choose non-mint flavors to avoid triggering reflux.
- Keep a Food Diary. Track what you eat and note when you experience reflux symptoms. This can help you identify and avoid personal trigger foods. Check out our downloadable food diary here.
- Stay Hydrated. Drinking water throughout the day can help dilute stomach acid and reduce symptoms. Avoid drinking large amounts of water with meals, as this can increase stomach pressure.
Managing acid reflux involves making mindful dietary choices and being aware of your body’s responses to different foods. By avoiding common trigger foods and incorporating reflux-friendly habits, you can enjoy a more comfortable and healthy eating experience.
Remember, everyone’s body is different. What triggers acid reflux for one person may not affect another. Listen to your body and work with a healthcare provider to develop a personalized plan that suits your needs.
References
[1] Don’t eat tomatoes: patient’s self-reported experiences of causes of symptoms in gastro-oesophageal reflux disease | National Library of Medicine
[2] Foods Inducing Typical Gastroesophageal Reflux Disease Symptoms in Korea | National Library of Medicine
[3] Functional Food in Relation to Gastroesophageal Reflux Disease (GERD) | National Library of Medicine
[4] Effect of decaffeination of coffee or tea on gastro-oesophageal reflux | National Library of Medicine
[5] The role of tea and coffee in the development of gastroesophageal reflux disease | National Library of Medicine
[6] The impact of low-fat and full-fat dairy foods on symptoms of gastroesophageal reflux disease: an exploratory analysis based on a randomized controlled trial | National Library of Medicine
[7] Chocolate and heartburn: evidence of increased esophageal acid exposure after chocolate ingestion | National Library of Medicine
[8] The role of diet in the development and management of gastroesophageal reflux disease: why we feel the burn | National Library of Medicine
[9] Is alcohol consumption associated with gastroesophageal reflux disease? | National Library of Medicine
[10] Association Between Beverage Intake and Incidence of Gastroesophageal Reflux Symptoms | National Library of Medicine
[11] Effect of red pepper and black pepper on the stomach | National Library of Medicine
[12] The Effects of Modifying Amount and Type of Dietary Carbohydrate on Esophageal Acid Exposure Time and Esophageal Reflux Symptoms: A Randomized Controlled Trial | National Library of Medicine
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