Managing Acid Reflux (GERD): What to Eat, What to Avoid, and Lifestyle Steps That Help

Acid reflux (GERD) happens when stomach acid and enzymes flow back into the esophagus because the lower esophageal sphincter relaxes or an anatomical problem exists. Reduce symptoms by avoiding known triggers (large/high-fat meals, alcohol, caffeine, citrus, tomato, chocolate, peppermint), waiting 2-3 hours before lying down, elevating the head of the bed 6-8 inches, losing excess weight, and quitting smoking. Sugar-free, nonmint gum after meals can help. Use antacids short-term and discuss H2-blockers or PPIs with a clinician for frequent symptoms; seek prompt care for alarm signs like difficulty swallowing or bleeding.

What is acid reflux (GERD)?

Acid reflux - commonly called heartburn - occurs when stomach contents flow back into the esophagus. In most cases this happens because the lower esophageal sphincter (LES), a valve at the base of the esophagus, relaxes inappropriately or is mechanically disrupted (for example, by a hiatal hernia). The stomach makes hydrochloric acid and enzymes such as pepsin to digest food. When these return to the esophagus they irritate its lining and cause burning, regurgitation, or a sour taste.

Why reflux happens (common triggers)

Many episodes are driven by transient lower esophageal sphincter relaxations (TLESRs), increased abdominal pressure (obesity, pregnancy), certain medications, or an anatomical problem such as a hiatal hernia. Lifestyle and dietary triggers include large high-fat meals, chocolate, peppermint, caffeine, alcohol, carbonated drinks, citrus, tomatoes, and spicy foods. Smoking weakens the LES and increases reflux risk.

Symptoms that need medical attention

Most people get occasional heartburn. See a clinician promptly if you have difficulty swallowing, persistent vomiting, unintended weight loss, gastrointestinal bleeding (black or bloody stools), or chest pain that could be cardiac in origin. Chronic reflux can lead to complications such as esophagitis, strictures, Barrett's esophagus, cough, or dental erosion.

Practical diet and lifestyle steps that reduce reflux

• Wait 2-3 hours after eating before lying down or sleeping. Avoid late-night meals.

• Raise the head of the bed 6-8 inches (15-20 cm) rather than propping up pillows; this uses gravity to reduce reflux.

• Lose weight if you are overweight; even modest weight loss often reduces symptoms.

• Stop smoking and limit alcohol.

• Eat smaller, more frequent meals and reduce high-fat and large portions.

• Avoid specific triggers you notice (common ones are citrus, tomato-based foods, chocolate, peppermint, coffee, and carbonated beverages).

• Chewing sugar-free gum (not mint-flavored) after meals may reduce symptoms by increasing saliva and swallowing.

Foods generally better tolerated

• Vegetables (non-acidic, prepared without heavy frying)

• Low-fat proteins: lean poultry, fish, legumes

• Whole grains and breads

• Low- or nonfat dairy if tolerated

• Fruits that are less acidic (bananas, melons, apples)

• Nonmint herbal teas and water

Medicines and when to use them

Short-term relief can come from antacids. H2-receptor blockers and proton pump inhibitors (PPIs) are effective for frequent or severe symptoms; use as directed by a clinician. Long-term PPI use is appropriate for many people but should be reviewed periodically because of potential risks and to confirm ongoing need.

Bottom line

GERD is usually manageable with a combination of targeted dietary choices, meal timing, weight loss, and simple sleep adjustments. Persistent or severe symptoms warrant medical evaluation to guide testing and treatment.