What's causing your heartburn? Acid reflux diet sheet

What is acid reflux?

Acid reflux, also known as gastro-oesophageal reflux disease (GORD) is caused by acid from the stomach leaking up into your gullet (oesophagus). When we say we have heartburn, we're describing the feeling of acid reflux - that burning pain in your chest. Acid reflux can also cause this sensation in your throat.

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Digestive health

Acid reflux and oesophagitis

When acid from the stomach leaks up into the oesophagus (tube carrying the food from the mouth to the stomach) the condition is known as acid reflux. This may cause heartburn and other symptoms. A medicine which reduces the amount of acid made in the stomach is a common treatment and usually works well. Some people take short courses of medication when symptoms flare up. Some people need long-term daily medication to keep symptoms away.

by Dr Pippa Vincent, MRCGP

What causes acid reflux?

The symptoms can be caused by several different factors in the body.

• The stomach may be producing too much acid. One of the triggers for this can be stress.

• The muscle ring (sphincter) at the bottom of the gullet (oesophagus) may be too relaxed and open, allowing food and acid to reflux upwards. Alcohol and smoking both relax the sphincter.

• In people with a hiatus hernia, stomach contents can reflux easily into the oesophagus.

• The stomach may be slow to empty after eating. This is more likely if you eat a fatty meal.

• Something may be increasing the pressure in the tummy (abdomen), forcing stomach contents upwards. Factors which increase the pressure include tight clothing, obesity, pregnancy and coughing.

Diagram of upper gut and nearby organs

Diagram of normal stomach

What can trigger acid reflux?

It is helpful to try to identify whether there are any particular foods which trigger your acid reflux. It might be a good idea to keep a food diary for at least a week, recording what you eat and drink and what symptoms you have.

There is quite a big list of foods which are said to cause acid reflux. However, they may not all apply to you. For some people, acid reflux may not be triggered by particular foods at all but by other factors. Sometimes the trigger may be a combination of foods and other factors.

There are lots of factors around eating which can make these symptoms worse:

• Eating late at night. If possible, don't eat a large meal within three hours of going to bed.

• Eating just before you exercise.

• Eating large meals.

• Eating quickly.

• Obesity. Even a moderate weight loss may help to reduce symptoms.

• Having a lot of fluid to drink with a meal.

Foods to avoid with acid reflux

There are some foods which individual people find make acid reflux worse. An acid reflux diet doesn't have to mean missing out on all these foods - your food triggers may be different. But these foods have all been suggested as reflux triggers, so it's worth noting if you get symptoms after eating any of the following:

• Chocolate.

• Mint.

• Tomatoes.

• Onions.

• Garlic.

• Citrus fruits such as oranges and lemons.

• Caffeinated and fizzy drinks.

• Coffee

• Peppers.

• Cucumber.

• Spicy foods.

• Processed meats - for example, salami, bacon.

How to get rid of acid reflux

An acid reflux diet involves cutting all of the suggested foods out of your diet for one or two weeks to see if your symptoms disappear. If they do disappear then you could add these foods back into your diet one at a time to see if they are what is causing your reflux.

If your symptoms come back, perhaps because of other factors as listed above, you may need to cut out potential triggers again until the symptoms have settled down.

Foods to eat with acid reflux

There aren't any specific foods to eat to treat that feeling of heartburn, but in general, a healthy diet is associated with a lower risk of acid reflux symptoms. In particular:

• A high-fibre diet is likely to reduce symptoms of reflux.

• Fresh fruits and vegetables, especially raw fruits and leafy green vegetables.

• Non-acidic fruit like melons and bananas may be better than more acidic fruits such as oranges.

• Good bacteria (probiotics), such as those found in yoghurt.