The esophagus is the tube that carries food from the throat to the stomach. However, it is not just a simple tube. The lower esophagus has a specialized muscle around it that usually stays tightly closed, opening only to allow food and liquid into the stomach. It acts to prevent the reflux of stomach acid into the esophagus.
Symptoms occur when this specialized muscle weakens and allows stomach acid to splash up into the esophagus. These symptoms include heartburn, chest discomfort, and bitter fluid flowing up into the mouth. Chest discomfort can occur. If the stomach juice trickles into the breathing tubes, hoarseness, cough, and even shortness of breath can occur. This entire problem is called GERD (Gastroesophageal Reflux Disease). A number of factors, including certain foods, may cause the lower esophageal muscle to relax, causing GERD.
Heartburn is that uncomfortable burning feeling in your chest, or the bitter or sour taste in the back of your throat.
For the 60 million Americans who get heartburnat least once a month, the pain isn’t just a small inconvenience. Heartburn can affect almost everything you do, keeping you from sleeping at night and functioning well during the day.
When it comes to acid reflux, there are certain foods that are almost universally problematic. The best strategy is to avoid them, but they often make up over half of many people’s diets.
The following foods aggravate acid reflux, and should be avoided:
Packed with citric and malic acid, tomatoes and tomato products — including sauce, soup, juice, etc. — can make the stomach produce too much gastric acid (the chemical responsible for breaking down food). And when volumes get too high, the acid can be forced to flow up the esophagus, says biomedical expert Jeremy Tian, Ph.D., M.D., senior research scientist at USANA Health Sciences. Unfortunately, there’s not much you can do — even cooking tomatoes won’t reduce the acidity significantly enough to prevent acid reflux, says Christine Frissora, M.D. If you’re making a pizza or pasta sauce, though, don’t use it as an excuse to make a heavy cream sauce because high-fat foods can also trigger symptoms (more on that later), adds Frissora. Instead, try whipping up some fresh pesto.
Bad news for chocolate lovers: Chocolate seems to cause more reflux than any other food. It’s a triple whammy:
- Chocolate contains caffeine and other stimulants such as theobromine, which cause reflux.
- Chocolate is high in fat, and fat causes reflux.
- Chocolate is also high in cocoa, and cocoa causes reflux.
Theoretically, dark chocolate isn’t as bad as high-fat milk chocolate, but let’s face it—all chocolate is bad for reflux.
Tangy Citrus Fruits
Oranges, grapefruits and orange juice are classic heartburn foods. “These are very acidic,” says Robynne Chutkan, MD. Chutkan is the founder of the Digestive Center for Women in Chevy Chase, Md. and a gastroenterologist at Georgetown Hospital in Washington, D.C. “As a result of being so acidic,” she says, “they are likely to cause heartburn, especially when consumed on an otherwise empty stomach.”
Soda and other carbonated beverages are some of the main causes of acid reflux. The bubbles of carbonation expand inside the stomach, and the increased pressure contributes to reflux. Sodas with caffeine and those that are acidic (almost all) are even worse.
Of the beverages that were tested, Coke, Tab, and Diet Pepsi were the most acidic. All carbonated beverages can be a problem, so the authors recommend abstaining completely to avoid acid reflux.
Garlic and Onion
Bonnie Taub-Dix, MA, RD, says, “Some people with heartburn do not do well with either garlic or onion.” Taub-Dix, a spokeswoman for the American Dietetic Association, is a nutritionist in private practice in New York City and Woodmere, N.Y. “It’s all very individual,” she says. For avoiding heartburn, she offers the following suggestion: “Keep a food log to help you track the foods that are your heartburn offenders, and try to develop a list of safe foods.” Foods like broiled chicken, baked sweet potatoes, toast, or cottage cheese, she says, are on the safe side of the heartburn food list.
How many carbonated beverages you drink is a huge predictor of your heartburn risk, according to Jeremy Tian, Ph.D., M.D. Why? “The gas released from carbonated beverages increases gastric pressure,” explains Tian. Basically, all of those bubbles start pushing on your stomach, stretching it, and forcing the esophageal sphincter open. And while any bubbles can prove bad for your belly, sodas may present even more problems. Many contain caffeine (which, in some people, can trigger acid reflux symptoms) and are also highly acidic, adds Tian. And diet sodas tend to be even worse, typically having a pH between 2.5 and 3.7.
Chutkan says that while many people think peppermint is soothing for the tummy, it is actually a heartburn trigger food. Her advice? Skip the after-dinner mints — especially after a rich meal. “They may be good for your breath on a date,” she says, “but they are not so good if you are prone to heartburn.”
Peppermint may increase your chances of heartburn because it relaxes the sphincter muscle that lay between the stomach and esophagus. This allows stomach acids to flow back into the esophagus.
Fried food is the single most recognized cause of reflux. It is also the food most often associated with heartburn, which is chest pain from esophageal reflux.
Deep-fried (or even not-so-deep-fried) foods are on the “bad list” because of their high fat content.
They’re one of the most common foods patients with acid reflux complain as triggering reflux symptoms, but research shows that spicy foods do not affect the pressure with which the esophageal sphincter snaps shut. The problem, rather, may be that spicy foods irritate the esophagus, according to Christine Frissora, M.D. What’s more, if the dish contains onions (and many spicy ones do), they could contribute to any reflux symptoms, says Jeremy Tian, Ph.D., M.D.
High-fat dairy products
All high-fat foods cause reflux. There is no reason to believe that one high-fat butter or cheese is better than another in this regard. If you have reflux and a serious cheese habit, something has to give.
Use a small amount of these foods as flavoring, but not as main ingredients. Low fat is better than no fat.
Acid reflux is caused by high-fat cuts of meat—beef, pork, lamb—which stay longer in the stomach and increase the chance of acid reflux.
Try cutting back to a lean cut of meat and eat it only once a week.
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