Experiencing acid reflux is not pleasant. In some cases, it’s downright painful. Although it is common to have occasional reflux, some people have it more regularly. Indeed, according to National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), approximately 20% of people in the United States suffer from gastroesophageal reflux disease (GERD). Reflux is also known as heartburn or indigestion.
While many acid reflux sufferers rely on over-the-counter and prescription medications to treat the condition, lifestyle changes can be just as effective.
Here, three medical experts explain the condition, its causes, and why small adjustments to your routine, including eating certain foods, can play a big role in reducing that dreaded heartburn.
What is acid reflux, exactly?
Acid reflux is the backflow of stomach acid into the esophagus, also known as the tube that connects the mouth to the stomach, says Peyton Berookim, MD, a dual board-certified gastroenterologist based in Los Angeles and director of the Gastroenterology Institute of Southern California. Each time you swallow, he explains, a circular band of muscle around the bottom of your esophagus, known as the lower esophageal sphincter, relaxes to allow food and liquids to flow into your stomach. From there, the sphincter usually closes, although if the sphincter relaxes abnormally or weakens for any reason, stomach acid can back up into the esophagus.
The acid in your stomach is particularly strong, explains the internist Sunit Srivastava, MD, a Florida-based internal medicine physician at Largo Medical Center, so when it leaks into other parts of your body it can cause a range of reactions, from irritation and inflammation to conditions precancerous and sometimes even cancerous. “Acid reflux can range from mild and bothersome to terminal, if left untreated and severe enough,” says Srivastava.
For many people, the illness will manifest as a bitter taste in the mouth or a burning sensation in the chest, better known as heartburn, says Berookim. Other signs and symptoms may include regurgitation of acidic food or liquid, coughing, wheezing, difficulty swallowing, hoarse voice and even chest pain, he adds.
What are the causes?
There are several things that can cause acid reflux. The first: what Srivastava describes as “a chemical phenomenon” that relaxes the valve at the top of the stomach, causing it to open and allowing acid to rise. The phenomenon can be triggered by nicotine, alcohol and “very large meals”, he specifies.
Two other causes are the result of “mechanical phenomena”, says Srivastava. The first is to push out part of the stomach into the chest cavity. “It looks a lot worse than it is,” he says. “A lot of people have it.” The second is due to excess weight, especially in the midsection. A larger midsection can increase pressure on the stomach, pushing acid up, Srivastava says.
Who is at risk?
People with certain conditions are at higher risk of developing acid reflux. These include obesity, hiatal hernia, pregnancy, connective tissue disorders and delayed stomach emptying, says Berookim. In addition to this, certain lifestyle factors can make acid reflux worse, including smoking, large meals (especially late at night), fatty or fried foods, tomatoes and citrus fruits, chocolate, peppermint and drinking alcohol or coffee, he adds. These high-acid foods add acid to the stomach and increase the risk of irritation, says Maya Feller, MS, RD, a New York-based dietician.
6 Best Foods for Acid Reflux
Just as certain foods can trigger acid reflux, others can soothe the condition. “What works for one may not work for all,” Feller cautions, “but in general, we encourage people to eat low-acid foods.” Foods with a higher pH are less acidic. Typically, a food’s pH isn’t listed on the label, so it can be difficult to determine. Feller and Berookim recommend the following options:
1. Oatmeal
This fiber-rich breakfast food can coat the sensitive lining of the esophagus, Berookim says, and isn’t an irritant for most people, Feller says. Try these make-ahead cinnamon oatmeal for healthy, fresh breakfasts without acid reflux all week long.
2. Aloe Vera
This plant not only soothes sunburn, it can also soothe your gastrointestinal system. Preliminary research suggests aloe vera may reduce acid reflux symptoms, according to a 2022 review in the journal Nutrients. Look for 100% aloe vera juice without any additives or anthraquinone (an organic compound in aloe that can be a laxative). Mix aloe vera juice with cucumber, spinach and celery for a drinkable solution, suggests Feller.
3. Fennel
This spicy-sweet vegetable can aid digestion, says Feller. Fennel teas “have a wonderful flavor and can usually be enjoyed daily,” she adds, and fennel bulb can be cooked with lentils and other root vegetables or sliced and eaten raw with greens. . Check out these healthy fennel recipes for inspiration.
4. Melons
Many fruits, such as oranges, cranberries, kiwis and pomegranates, are acidic. But melon, including cantaloupe and honeydew, are not, which means they’re probably good bets for those who suffer from acid reflux. Have a few slices for breakfast or as an afternoon snack.
5. Bananas
Another fruit that calms the stomach, bananas, especially ripe bananas, have a high pH. You can always eat them plain, add them to your oatmeal for a doubly good option, or try cooking with them in these Baked Banana Walnut Oatmeal Cups.
6. Green vegetables
As for vegetables, leafy greens like kale and spinach are healthy, low-acid options. Learn how to cook kale here and check out these healthy spinach recipes.
What to do if you have acid reflux
If you think you have acid reflux, go to your doctor for a formal evaluation, as the symptoms you’re experiencing may be the result of other conditions, like ulcers or even heart disease, Srivastava says. If you do have acid reflux, changing your lifestyle is your best bet to combat it, says Srivastava. This is because the prescription drugs used to treat acid reflux come with a range of side effects, including an increased risk of pneumonia, hip and spinal fractures, and C. diff (a disease life-threatening), vitamin malabsorption and the progression of osteoporosis. Certain medications may also have links to dementia, he says.
Helpful lifestyle changes include losing excess weight, eating smaller meals, and replacing foods that typically cause heartburn with the safer bets mentioned above. On top of that, you should stop eating at least three hours before bedtime, adds Berookim. Exercise is another great way to alleviate the condition, says Srivastava. He explains that regular physical activity helps your body release endorphins which can relieve pressure on your esophagus.
The essential
Acid reflux is a common condition, but lifestyle changes, including eating more certain foods like oatmeal, bananas, and green vegetables, can help calm the burn. As always, see your doctor for an evaluation if you experience acid reflux symptoms.