Dispelling Common Misconceptions: Unraveling the Truth About Common GERD Food Triggers

Madelaine Morrish, RD

Written by: Madelaine Morrish, RD

Updated: November 8th, 2023

If you have been diagnosed with gastroesophageal reflux disease (GERD) and suspect that your diet is contributing to your uncomfortable heartburn, you may be searching for what foods you should avoid to manage your symptoms. You’re not alone! Gastroesophageal reflux disease is a chronic digestive health condition that impacts 1 in 6 Canadians. Common GERD food triggers that are often suggested to be avoided include spicy foods, citrus, chocolate, coffee, carbonated beverages, and high-fat foods. In this article, we will dive into common food triggers and other dietary factors you can try to relieve your symptoms! 

What is GERD?

Gastroesophageal reflux disease (GERD) is a chronic digestive condition that is caused by a dysfunction in the lower esophageal sphincter (LES), a valve between the esophagus and the stomach, which results in stomach contents entering the esophagus¹.  Normally when food is consumed, the LES opens to allow food to enter the stomach and then closes to prevent stomach contents from moving backward into the esophagus. When GERD is present and stomach contents enter the esophagus, it causes irritation and damage to the lining of the esophagus, and can result in rather unpleasant symptoms.

Symptoms of GERD

The most common symptom of GERD is heartburn¹, a burning sensation in the chest that is often associated with a sour taste in the back of the mouth (due to the regurgitation of stomach acid). Other symptoms that can be present include:

Foods that Trigger GERD

There are many foods that are suspected to trigger GERD; but you might be surprised to learn that the basis of some of these recommendations is backed by limited data3,5. Common foods that are suggested to trigger GERD include spicy foods, citrus fruits, chocolate, coffee, carbonated beverages, and high-fat foods. Let’s break down whether these foods should always be avoided to manage GERD.

Spicy Foods

If you enjoy foods with some heat, you might be saddened to learn that you need to avoid all spicy foods to tame GERD symptoms. Although spicy foods are suggested to trigger GERD, laboratory studies investigating the effect of spicy food on LES pressure showed that spicy foods had little to no effect on LES pressure6. This means that spicy foods have not been shown to cause stomach contents to enter the esophagus. Despite spicy foods not causing a physiological change known to contribute to reflux, these foods can cause direct irritation of the esophageal lining, which may explain why some individuals experience worsening heartburn when consuming these foods6.

Citrus Fruits

The recommendation to avoid citrus fruits does have some evidence to support it.7 The reason some people get heartburn from acidic foods is the irritation caused by their acidic pH. There are also some studies showing that acidic beverages like orange and grapefruit juice, tomatoes and tomato products can contribute to heartburn symptoms5.

Chocolate

It is still unclear whether avoiding chocolate will prevent GERD symptoms. Chocolate, which contains both caffeine and cacao, has been shown to relax the LES, which suggests that consuming chocolate should contribute to GERD symptoms5.  Although chocolate relaxes the LES, there are several observational studies that did not confirm the relationship between chocolate consumption and the onset of GERD symptoms6,7

Coffee

What about your morning cup of joe? Coffee, similar to chocolate, has also been shown to relax the LES due to its caffeine content5.  Coffee may also stimulate gastric acid secretion which could exacerbate heartburn symptoms2. Although the effects of coffee on the digestive tract would lead us to believe that it should trigger GERD, the evidence to back up this claim is mixed5.  A meta-analysis reviewing the association between coffee intake and GERD symptoms showed no significant association between coffee consumption and GERD symptoms even when comparing low coffee intake (<4 cups/day) to high coffee intake (>4 cups/day)6.

Carbonated Beverages

Unlike avoiding coffee, the recommendation to avoid carbonated beverages, like soda, may be warranted. According to a systematic review of 25 studies, the majority of research suggests that carbonated beverages do increase GERD symptoms4.  Carbonated beverages may relax the LES and contribute to increased gastric secretion leading to an increased risk of heartburn5.

High-Fat Foods

Foods high in fat that are often suggested to trigger GERD include:

There is evidence suggesting that there is a significant association between high-fat diets increasing the risk of GERD symptoms7. High-fat foods relax the LES and delay how quickly stomach contents move through the digestive tract which is likely the reason high intakes of fat, especially consumed in one sitting, can contribute to symptoms6.

Other Dietary Factors to Consider

Dietary recommendations to manage GERD should be individualized based on your own lived experience.  If you suspect that these common GERD food triggers are increasing your symptoms, continue to limit your consumption of them. If you have eliminated these foods and continue to experience no change or correlation in your symptoms, there are other dietary factors that can be explored to find some relief.

Instead of solely focusing on eliminating suspected trigger foods for GERD, research shows that increasing fibre intake, having smaller meals, and being mindful of meal timing may be more beneficial in managing GERD5,6.  Consuming irregular meals, including skipping breakfast frequently and snacking soon before bedtime may be a risk factor for experiencing GERD symptoms, increasing their occurrence by up to 20%6.  If you struggle with managing GERD, try:

Summary

The relationship between specific foods and GERD symptoms is complex and varies from person to person.  Instead of fixating on avoiding suspected trigger foods to manage GERD symptoms, it may be more beneficial to focus on increasing fibre intake, consuming regular meals throughout the day, paying attention to meal timing, and keeping the upper body elevated higher than the stomach when sleeping. The one-size-fits-all approach to dietary recommendations for GERD may not be effective for everyone, emphasizing the importance of personalized care. By making thoughtful dietary adjustments and adopting healthier eating habits, individuals can improve their quality of life and minimize the impact of GERD on their daily activities.

References

  1. Clarrett DM, Hachem C. Gastroesophageal Reflux Disease (GERD). Mo Med. 2018 May-Jun;115(3):214-218. PMID: 30228725; PMCID: PMC6140167.
  2. Iriondo-DeHond A, Uranga JA, Del Castillo MD, Abalo R. Effects of Coffee and Its Components on the Gastrointestinal Tract and the Brain-Gut Axis. Nutrients. 2020 Dec 29;13(1):88. doi: 10.3390/nu13010088. PMID: 33383958; PMCID: PMC7824117.
  3. Katz PO, Dunbar KB, Schnoll-Sussman FH, Greer KB, Yadlapati R, Spechler SJ. ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease. Am J Gastroenterol. 2022 Jan 1;117(1):27-56. doi: 10.14309/ajg.0000000000001538. PMID: 34807007; PMCID: PMC8754510.
  4. Heidarzadeh-Esfahani N, Soleimani D, Hajiahmadi S, Moradi S, Heidarzadeh N, Nachvak SM. Dietary Intake in Relation to the Risk of Reflux Disease: A Systematic Review. Prev Nutr Food Sci. 2021 Dec 31;26(4):367-379. doi: 10.3746/pnf.2021.26.4.367. PMID: 35047433; PMCID: PMC8747955.
  5. Newberry C, Lynch K. The role of diet in the development and management of gastroesophageal reflux disease: why we feel the burn. J Thorac Dis. 2019 Aug;11(Suppl 12):S1594-S1601. doi: 10.21037/jtd.2019.06.42. PMID: 31489226; PMCID: PMC6702398. 
  6. Taraszewska A. Risk factors for gastroesophageal reflux disease symptoms related to lifestyle and diet. Rocz Panstw Zakl Hig. 2021;72(1):21-28. doi: 10.32394/rpzh.2021.0145. PMID: 33882662.
  7. Zhang M, Hou ZK, Huang ZB, Chen XL, Liu FB. Dietary and Lifestyle Factors Related to Gastroesophageal Reflux Disease: A Systematic Review. Ther Clin Risk Manag. 2021 Apr 15;17:305-323. doi: 10.2147/TCRM.S296680. PMID: 33883899; PMCID: PMC8055252.

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