Gastroesophageal reflux disease (GERD) — also known as heartburn or acid reflux — is a condition that occurs when your stomach contents back up to your esophagus.

Your esophagus is the tube that connects your throat and stomach.

Diet plays an important role in both the prevention and treatment of GERD.

This article explains what to eat and avoid with GERD and provides a sample GERD diet menu.

GERD diet

Causes and risk factors

GERD is one of the most common digestive disorders worldwide, especially in America where up to 28% of Americans have the condition (1).

The condition is also common in Europe, the Middle East, and South America (1).

However, GERD may be underdiagnosed and affect even more people because of access to over-the-counter acid-reducing medications that can treat GERD symptoms.

There are several factors linked to the development of GERD.

These factors include (2):

  • overweight and obesity
  • smoking
  • gastroparesis
  • pregnancy
  • genetic factors
  • high-fat diet
  • excess alcohol use

Several medications have also been associated with GERD, including drugs that lower cholesterol and blood pressure and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (2).

Symptoms

GERD is a condition that occurs when stomach contents — acid, digestive enzymes, and bile salts — back up to your esophagus.

This reflux of stomach contents causes a burning sensation in your chest (heartburn) and may leave a sour or bitter taste in your throat and mouth.

Other symptoms of GERD include (2):

  • belching
  • nausea
  • bloating
  • upper stomach pain
  • dysphagia or difficulty swallowing

GERD symptoms tend to occur after meals and may worsen when lying down.

The frequency in which symptoms occur varies by person, but they can occur anywhere from twice a week to daily (3).

Diagnosis and treatment

To diagnosis GERD, your doctor will likely review your health history and any symptoms that you have been experiencing.

Based on your symptoms, your doctor may also perform additional tests to rule other conditions that present similar symptoms like eosinophilic esophagitis (EoE).

Tests include (4):

  • endoscopy to examine your digestive tract
  • X-rays to view your esophagus
  • pH monitoring to measure acid reflux

These tests can also help your doctor identify any complications from GERD.

GERD complications include (4):

  • Barrett’s esophagus: A condition where the normal tissue lining of your esophagus changes to tissue that resembles the lining of the intestine.
  • Esophageal stricture: A narrowing or tightening of the esophagus, which can cause swallowing difficulties.
  • Esophageal cancer: A form of cancer that occurs in the esophagus.

These complications develop slowly over time from the repeated reflux of stomach contents, which causes inflammation and damage to the lining of the esophagus.

Dietary changes and other treatment options for GERD aim to reduce symptoms and risk of complications.

GERD diet

Research on which diet is best for GERD remains limited.

However, some foods and drinks have been associated with a decrease in GERD symptoms, while others have been associated with an increase in them.

Still, the types of foods and beverages that may produce symptoms in one person may not produce them in another.

As such, you should identify which foods trigger GERD symptoms and remove or eliminate them from your diet.

Foods to avoid

Certain foods and beverages can relax the lower esophageal sphincter (LES) muscle, which acts as a gate between the esophagus and stomach.

When this muscle is relaxed at the wrong time, stomach acid can travel back up through the esophagus, causing heartburn.

Therefore, you may find symptom relief by avoiding or limiting foods and beverages that relax the LES muscle or irritate the esophagus lining.

These include (5, 6):

  • Spicy foods and condiments: Dishes, sauces, and seasonings made with hot peppers, such as habanero, cayenne, jalapeños, and chili peppers.
  • Citrus fruits: lemons, limes, grapefruits, mandarin oranges, tangerines
  • Fried foods: doughnuts, french fries, onion rings, funnel cake, etc.
  • Caffeine: coffee, tea, energy drinks
  • Other items: alcohol, chocolate, tomato juice, soda

Foods to eat

Eating a fiber-rich diet may protect against the development of GERD complications like Barrett’s esophagus and esophageal cancer (7).

A fiber-rich diet has also been associated with fewer and shorter episodes of acid reflux and heartburn in people with GERD (8).

However, these benefits cannot be attributed to fiber alone as fiber-rich foods — fruits, vegetables, and whole grains — also contain other healthy nutrients like vitamins, minerals, and antioxidants.

For example, one study showed that people who consumed more vitamins and minerals from fruits and vegetables were less likely to have GERD or develop related complications (9).

In either case, eating a diet rich in fruits and vegetables and other minimally processed foods may ease GERD symptoms.

Examples include:

  • Non-citrus fruits: apples, bananas, berries, cherries, grapes, melons, pomegranates, etc.
  • Vegetables: asparagus, beets, broccoli, carrots, green beans, mushrooms, spinach, etc.
  • Grains and starches: beans, brown rice, oats, peas, popcorn, potatoes, quinoa, whole-grain bread and pasta
  • Low-fat dairy: cottage cheese, Greek yogurt, milk
  • Seafood: cod, tuna, salmon, scallops, tilapia, trout, tuna
  • Lean proteins: chicken, cod, pork loin, turkey, sirloin and tenderloin steaks
  • Nuts and seeds: almonds, chia seeds, flaxseeds, pecans, walnuts

One-day sample GERD diet

Here is an example of a one-day GERD diet rich in fiber and other foods that may ease symptoms.

Breakfast

  • 1/2 cup (40 grams) oats
  • 1 cup (240 mL) milk
  • three egg whites and one whole egg scrambled
  • 1 cup (28 grams) spinach, cooked

Snack

  • 1 cup (227 grams) Greek yogurt
  • 1 cup (140 grams) blueberries

Lunch

  • a chicken avocado wrap made with:
    • 3 ounces (84 grams) grilled chicken breast, chopped
    • Avocado, cubed
    • Cucumber, chopped
    • Lettuce, shredded
    • Cheddar cheese, shredded
    • Ranch dressing
    • Whole-grain tortilla

Snack

  • 1 ounce (28 grams) almonds
  • banana

Dinner

  • 4 ounces (113 grams) salmon, baked
  • sweet potato, baked
  • asparagus

Other tips for managing GERD

Identifying which foods and drinks trigger your GERD symptoms and limiting or avoiding them can help you manage the condition.

In addition to diet, there are other ways to alleviate acid reflux and heartburn.

Weight loss

Overweight and obesity are risk factors for the development of GERD and its complications.

As such, losing excess body fat may help reduce or eliminate GERD symptoms (10).

Indeed, a study in 332 people who were obese found that a 5–10% decrease in body weight was associated with a reduction in GERD symptoms in 81% of the study participants, and 65% experienced a complete resolution of reflux symptoms (11).

A combination of a low-calorie diet and regular exercise can help you lose weight and keep it off in the long term (12).

Eating behavior

Not only can the types of foods you eat help you manage GERD, but so can your eating behaviors.

Here are some tips:

  • Eat more slowly. Eating quickly has been associated with an increase in acid reflux episodes (13).
  • Avoid late-night eating. Eating within three hours of bedtime compared with four has been linked with heartburn and acid reflux (14).
  • Consume small, frequent meals: While eating too much fat has been suggested to trigger heartburn and acid reflux, eating fewer calories at meals may be more effective for reducing symptoms (15).

The bottom line

GERD occurs when your stomach contents back up to your esophagus.

Diet plays an important role in treating GERD symptoms and preventing health complications from the condition.

However, the types of foods and beverages that produce symptoms can vary person-to-person.

Therefore, you should identify which foods trigger your symptoms and remove or eliminate them from your diet.


Gavin Van De Walle, MS, RD, LN
Gavin Van De Walle, MS, RD, LN

Gavin Van De Walle holds a master's degree in human nutrition and bioenergetics. He is a registered dietitian who aims to arm the public with evidence-based nutrition recommendations so they can make their own educated and informed health decisions.