If you regularly suffer from acid reflux, you know that it can be both uncomfortable and hard to control. First of all, know that you're not alone: Approximately one in five adults in America suffer from gastroesophageal reflux disease (GERD), the medical condition commonly known as acid reflux, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Still, many people aren't sure what exactly the condition is, what causes it and how to best treat and manage symptoms. So, we asked a gastroenterologist to explain.
GERD happens when stomach acid mistakenly travels back up into the throat.
"Gastroesophageal Reflux Disease (GERD) occurs when the acid-containing contents of the stomach travel back up into the esophagus and cause the burning sensation more commonly known as heartburn," says Scott Gabbard, MD, a gastroenterologist at Cleveland Clinic. Clinically, this happens because "the bottom valve of the esophagus (called the lower esophageal sphincter) opens when it is not supposed to, which allows [stomach acid] to flow back up into the esophagus and cause problems."
No surprise, how we eat plays a huge part in GERD.
Because GERD is a digestive disorder, what and how we eat affects how symptoms manifest. "Large meals and meals that are high in fat trigger the lower esophageal sphincter to open after a meal," Gabbard says. Eating within three hours of bedtime (or laying down) can also trigger GERD, because "It generally takes the stomach 4-6 hours to empty after a meal," he says. For especially large or high-fat meals the emptying might take even longer.
High-fat, high-calorie and high-fiber foods are the worst offenders when it comes to GERD symptoms.
Because fat and fiber both slow the digestion of food in the stomach, they can trigger GERD and that hearburn sensation you might experience after a meal. You shouldn't fear fat or fiber (both are important to an overall healthy diet), but if you suffer from GERD, it's a good idea to only eat them in small portions. In fact, a study in the journal Clinical Gastroenterology and Hepatology found that eating smaller, lower-fat meals (less than 500 calories and less than 15 grams of fat) helped reduce GERD in people that commonly experience it.
If GERD is a problem for you, consider avoiding large amounts of fried foods, fatty cuts of meat and rich desserts, all of which are high in fat. Even healthy fats like nuts, nut butters, olive oil and avocado can trigger acid reflux if you eat too much at once—that's not to say you should avoid them, but stick to small portions. The same goes for high-fiber foods like fruits, vegetables, and whole grains—they're good for you and can actually help with digestion, but too much can overload your digestive symptoms and cause GERD.
While certain foods are easier on your digestive system and less likely to cause GERD, there's no magic diet that will totally prevent symptoms.
Opting for lean meats and proteins over fattier cuts can help reduce GERD symptoms, since protein isn't a trigger. Eating an overall balanced diet is another great way to reduce symptoms, Gabbard says. In fact, some foods that cause acid reflux in large quantities—fruits, vegetables and healthy fats—likely help reduce symptoms when eaten in smaller portions spread throughout the day. Foods rich in soluble fiber, like oatmeal, can also reduce symptoms because it absorbs acid in the stomach.
Gabbard also suggests drinking a glass of water before every meal, plus a glass of water between courses of an especially big meal. "Water helps fill up the top of the stomach called the fundus, which sends a fullness (satiation) signal to the brain," he says. "This may help to limit consumption of calories and fats," which in turn reduces GERD symptoms.
Bottom line: Managing GERD is about watching your portion sizes and not eating too soon before bed.
High-fat, high-calorie, and high-fiber foods can trigger GERD symptoms. But, the biggest things to be aware of are how much and when you eat, not what you eat. Try to keep meals below 500 calories and 15 grams of fat, especially meals eaten later in the day. And if you can help it, give your stomach ample time to empty by eating at least four hours before bedtime.