6 Things I'd Cut If I Had Acid Reflux

Summary

Dr. Will Bulsiewicz explains that reflux is not simply a problem of producing too much stomach acid. It involves both the lower esophageal sphincter—the valve between the stomach and esophagus—allowing reflux, and damage to the esophagus’s protective lining.

He compares the lining’s tight-junction proteins to grout between tiles. When the barrier is weakened, refluxed contents can reach sensitive nerves and cause symptoms.

Foods and drinks to limit

Dr. Bulsiewicz recommends reducing these six categories:

• Coffee and caffeine: May lower pressure in the valve.
• Chocolate: May also reduce valve pressure.
• High-fat meals: Can lower valve pressure and increase episodes of inappropriate valve relaxation. Even healthy fats may be an issue in large amounts at once.
• Carbonated drinks: Bubbles can increase burping and valve relaxations.
• Alcohol, including wine: May lower valve tone and irritate the esophageal lining.
• Added sugar: Reducing it may reduce acid exposure, according to the studies he discusses.

He says evidence for routinely avoiding tomatoes and spicy foods is limited. If they trigger symptoms for you, avoid them; otherwise, he says there is no need to cut them automatically.

Habits and foods to build into a reflux routine

• Increase fiber: Aim for at least 25 g daily for women and 38 g for men, using foods such as berries, oats, beans, and vegetables.
• Include protein at meals: Prefer lower-fat sources where possible.
• Check labels for added sugar: It can be present in bread, sauces, and dressings.
• Chew gum after meals: Chewing for about an hour may promote swallowing and saliva production, helping clear or neutralize acid in the esophagus.
• Add ginger: It may help the stomach empty more quickly. Use it in tea or meals if desired.
• Eat a plant-predominant diet: Dr. Bulsiewicz describes a study in which a plant-heavy Mediterranean-style diet with alkaline water performed at least as well as standard reflux medication for people with reflux reaching the throat or voice box. He notes that the study was retrospective, not a randomized controlled trial.
• Choose smaller meals: A stretched, full stomach can make reflux more likely.
• Leave about four hours between meals when practical: This allows the gut’s between-meal “housekeeping” cycle to occur.
• Stop eating at least three hours before lying down: Staying upright lets gravity help clear the esophagus.

If changing everything feels overwhelming, Dr. Bulsiewicz suggests starting with more fiber at the next meal and avoiding lying down within three hours of eating. Improvement may take consistent effort over several weeks.

Presenters and sources

• Presenter: Dr. Will Bulsiewicz, gastroenterologist.
• Named researcher referenced: Dr. Roy Orlando, whose 1980s research on esophageal tissue and tight junctions is discussed.
• Other source referenced: An unnamed retrospective study comparing standard reflux medication with a plant-heavy Mediterranean-style diet plus alkaline water.