What are the foods to avoid with GERD acid reflux?
Two of the most common questions I get asked about acid reflux treatment are: “What are the foods to avoid with GERD?” and “What foods cause acid reflux?”
Most people have heard the conventional wisdom that acidic foods like tomatoes and citrus fruits can trigger heartburn. But there is a more comprehensive list of foods to avoid with acid reflux. And each trigger has a specific reason. I help my patients identify these specific triggers.
Low Acid Diet for GERD & LPR
Beyond the common triggers of acid reflux, many sufferers – especially those with LPR (Laryngopharyngeal Reflux – or “Silent Reflux”) will require a more comprehensive approach.
Those with LPR often do very well on a low acid diet. This is a diet that restricts foods tested at lower than a pH of 4. This is because the enzyme pepsin is present in the material that gets refluxed from the stomach. Pepsin is triggered by stomach acid, AND acid in food.
Stomach Acid (HCl)
The stomach is an acidic environment – this is very important to its health and proper functioning. The enzyme pepsin is released into the stomach to break down pepsin – but stomach acid (HCl – hydrochloric acid) is required to activate it – pepsin only works in an acidic environment.
Stomach acid serves a whole bunch of other important functions – it acts as a sterilizer to get rid of many unwanted bugs in our food that can make us sick, it begins to break protein down, it activates pepsin to further break protein down, and it also is needed to soak certain vitamins and minerals so that they can be absorbed by the body.
When you have reflux, material from the stomach comes back up into the esophagus (your swallowing tube), larynx (voice box) and/or pharynx (area behind mouth & nose). This material may contain some partially digested food, and also has stomach acid and pepsin mixed in with it.
The pepsin can cling to the lining of these structures. When you eat acidic food, it may activate the pepsin attached to these areas. The pepsin can then actually try to “digest” the lining of your esophagus, pharynx or larynx!! This may explain many of the symptoms that are associated with LPR.
Comprehensive Dietary Approach
When I work with patients who suffer from GERD or LPR we always work on avoiding the key food triggers of acid reflux, but we also typically use a strict low acid diet initially, to support healing and repair.
Some people are later able to add back in some acidic foods in moderation. Diet is just ONE aspect of a treatment plan for GERD acid reflux or LPR – but it is a KEY one!