What is gastroesophageal reflux disease (GERD), and how can good nutrition help?

Gastroesophageal reflux disease, or GERD, occurs when the lower esophageal sphincter (LES) does not close properly and stomach contents leak back into the esophagus. The LES is a ring-like muscle at the bottom of the esophagus that acts like a valve between the esophagus and stomach. Heartburn occurs when refluxed stomach acid touches the lining of the esophagus, causing a burning sensation in the chest. Heartburn that occurs more than two times a week may be considered GERD, and it can eventually lead to more serious health problems.

The purpose of this diet is to reduce the reflux of stomach fluid into the esophagus and to avoid foods that irritate the esophageal mucosa. It may be necessary to lose weight, since excess weight increases stomach pressure.

Avoid the following foods:

  • Caffeine (regular coffee, regular tea, chocolate)
  • Citrus fruits/juices
  • Carbonated beverages
  • Alcohol
  • Mints (peppermint, spearmint)
  • Tomato products
  • Fried, greasy foods
  • Spicy foods
  • Garlic and onions

Special instructions:

  1. Eat small, frequent meals. Large meals may increase stomach pressure, and therefore reflux.
  2. Fat takes the longest time to leave the stomach; therefore, reduce the total amount of fat that you eat at a meal by decreasing the amount of margarine, butter, oils, salad dressings, gravy, fatty meats, and full-fat dairy/milk products such as sour cream, cheese, and whole milk.
  3. Maintain an upright posture while eating and for 45-60 minutes afterward.
  4. Avoid eating 2-3 hours before bedtime.
  5. Avoid clothing that is tight in the abdominal area.
  6. Achieve and maintain a healthy weight.
  7. When sleeping, raise the head of the bed 6-8 inches, using wooden blocks under the bedposts. Extra pillows will not work.
  8. Stop smoking.

Dietary Guidelines for GERD Diet

The following table can help you choose foods that will reduce stomach reflux. Your individual tolerances may differ.

Milk and milk products

  • Tolerated: Fat-free, low-fat, and reduced-fat milk, low-fat buttermilk, low-fat or fat-free yogurt, soy milk
  • Not tolerated: Whole milk, chocolate milk, chocolate shakes or drinks, milkshakes, whole milk fat yogurt.

Breads and cereals

  • Tolerated: Plain (with or without whole grain flour) bread, cereals, rolls, and crackers, pancakes, waffles, muffins made with low-fat ingredients, bagels, corn tortillas.
  • Not tolerated: Breads and cereals prepared with high-fat ingredients such as croissants, biscuits, doughnuts, sweet rolls, muffins, granola, pizza, French toast

Desserts

  • Tolerated: Angel food cake, sponge cake, low-fat cookies, gelatin, fruit-based desserts, sherbet, fruit ice, reduced-fat ice cream, pudding or custard made with 1% or 2% low-fat milk, fat-free pudding
  • Not tolerated: All other pies, cookies, and cakes, ice cream, any desserts containing chocolate frosting, whole milk pudding, pastries

Fats

  • Tolerated: Nonfat or low-fat dressings and mayonnaise, non- fat liquid or powdered cream substitutes, fat-free or reduced-fat sour cream and cream cheese, low-fat butter and margarine substitutes, vegetable oils <8>
  • Not tolerated: Gravies, heavy cream, bacon, meat drip- pings, butter, margarine, vegetable oils, regular sour cream, cream cheeses, nuts, olives, avocados/guacamole, nut butters, vegetable oils >8 tsp

Fruits

  • Tolerated: Fresh, frozen, and canned fruits as tolerated, juices (any except those in the right column)
  • Not tolerated: Orange, lemon, lime, tangerine, pineapple, grapefruit

Meats and meat substitutes

  • Tolerated: Well-cooked lean meat, poultry (without skin), fish (fresh or water-packed), lean pork, shellfish, non- fat/low-fat yogurt, low-fat luncheon meats and cheeses, low-fat hot dogs, tofu, dried beans and peas (includes fat-free refried beans), eggs
  • Not tolerated: Fried meat, poultry, fish, or eggs, regular luncheon meats, hot dogs, sausages, refried beans

Potatoes and potato substitutes

  • Tolerated: Baked, boiled, and mashed potatoes without added fat, plain pasta, pasta with low-fat cream sauce, rice
  • Not tolerated: French-fried potatoes, risotto, potato chips, pastas served with cream sauces and tomato-based sauces

Soups

  • Tolerated: Fat-free broths, homemade soups made with lean meat and vegetables (except tomatoes) and fat-free or low-fat milk
  • Not tolerated: Regular cream and tomato-based soups

Sweets

  • Tolerated: Sugar, honey, jam, jelly, molasses, maple syrup, hard candy, marshmallows
  • Not tolerated: Coconut, cream-filled candies, nuts, chocolate, spearmint, peppermint

Vegetables

  • Tolerated: Plain fresh, frozen, and canned vegetables prepared without added fat
  • Not tolerated: Fried or creamed vegetables, tomatoes and tomato products, onions, vegetable juices

Miscellaneous

  • Tolerated: Salt, oregano, sage, pepper, other spices and herbs (as tolerated), decaffeinated coffee, decaffeinated tea, non-mint tea
  • Not tolerated: Spices and herbs in tomato-based sauces, chili and jalapeno peppers, vinegar, carbonated beverages, caffeinated or mint-flavored coffee and/or teas, alcoholic beverages

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 11/11/2011...#15530

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