Introduction
At some point or other, many of us may have experienced burning sensations in our stomachs or the feeling of nausea crawling up our throats. These could be symptoms of acid reflux. Acid reflux, or gastro-oesophagal reflux Disease (GORD), when acid reflux happens recurrently, is associated with the acidic contents of the stomach flowing backwards into the throat. While acid reflux is something that could occur from time to time, with 20% of the population developing symptoms of acid reflux occasionally, it requires medical attention in the case of constant occurrence.
Medications like antacids, which neutralise stomach acids, help with symptom management. However, many health professionals would recommend making changes to lifestyle to manage acid reflux before taking medications to see if they may alleviate the symptoms. This article will focus on diet management as a lifestyle change and what the best foods are to help with acid reflux. Let’s get started.
Understanding acid reflux
Explanation of acid reflux and its symptoms
Acid reflux is the regurgitation of stomach contents into the oesophagus, a muscular tube connecting the throat to the stomach. This reverse flow irritates the lining of the oesophagus, leading to a burning sensation in the chest commonly referred to as heartburn.
The stomach maintains a highly acidic environment essential for efficient food digestion. Specialised cells lining the stomach contribute to this acidity by releasing gastric juice and enzymes while simultaneously protecting the organ through the production of mucus. This acts as a shield against the corrosive nature of its acidic contents.
Unlike the stomach, the oesophagus lacks protective mechanisms against stomach acid, thus leading to irritation and inflammation when the acidic contents pass through the tube. Chronic acid reflux, resulting from continued exposure of the oesophagus to stomach acid, is termed GORD.
Some of the symptoms are:
- Heartburn
- Chest pains associated with heartburn
- Unpleasant sour taste due to the stomach acid in the mouth
- Recurring cough or hiccups
- Bad breath
- Hoarse voice
- New/progressive asthma
- Bloating
- Nausea
- Sleep troubles
Symptoms usually worsen after eating, when lying down or even when bending over.
Factors contributing to acid reflux
Several elements can impact the occurrence and intensity of acid reflux. These factors encompass:
- Dietary Choices: Certain food items and beverages, like those with high spiciness levels, citrus fruits, chocolate, caffeine, alcoholic drinks, and meals rich in fat, can serve as triggers or aggravate acid reflux symptoms.
- Overconsumption: The intake of substantial meals or rapid eating can exert additional pressure on the lower oesophageal sphincter (LOS), the muscular barrier that separates the stomach from the oesophagus, thereby promoting reflux.
- Reclining After Eating: Assuming a reclined or horizontal position shortly after eating can facilitate the backward flow of stomach acid into the oesophagus.
- Excess Weight: Being overweight can elevate abdominal pressure, causing the movement of stomach contents into the oesophagus.
- Smoking or constant exposure to second-hand smoke: Nicotine can weaken the LOS and may heighten the risk of experiencing acid reflux.
- Pregnancy: Hormonal changes and increased abdominal pressure during pregnancy can lead to acid reflux as the digestion process is slowed down.
- Hiatal Hernia: A hiatal hernia arises when a portion of the stomach protrudes through the diaphragm into the chest area, making it easier for acid to flow into the oesophagus.
- Medications: Certain medications, such as ibuprofen and aspirin, can relax the LOS, augmenting the likelihood of acid reflux.
- Stress: Heightened stress levels can lead to changes in eating habits, an increase in stomach acid production, and a decrease in the production of protective stomach lining hormones. These factors have the potential to worsen acid reflux symptoms.
- Constrictive Attire: Wearing tight clothing around the waist, including belts and garments, can heighten abdominal pressure, contributing to acid reflux.
- Age: The risk of developing acid reflux often increases with advancing age, as the LOS may gradually lose its strength.
- Underlying Medical Conditions: Certain health conditions like gastroparesis (a condition where stomach emptying is delayed) can affect the proper functioning of the LOS and add to the likelihood of experiencing acid reflux.
It's important to note that the experience of acid reflux can vary among individuals, and susceptibility can arise from a combination of these factors. Recommendations for managing and alleviating acid reflux symptoms often involve lifestyle adjustments and dietary modifications. Seeking guidance from a healthcare professional is advisable for tailored advice and treatment options.
Best foods for acid reflux
Below, we discuss certain foods that research suggests can alleviate acid reflux symptoms. However, it's important to note that different foods may have varying effects on individuals, and what works for one person may not be suitable for another.
- Non-citrus fruits: Citrus fruits like tomatoes, lemons, and oranges are a trigger for acid reflux as they lower the acidic conditions inside the stomach. Therefore, non-citrus fruits are the better option, with examples of such fruits being bananas, papaya and berries. In fact, bananas are also rich in pectin, a soluble fibre that aids smooth digestion by preventing food from lingering too long in the stomach. This helps reduce acid production and lowers the risk of acid reflux.1
- Vegetables: Leafy vegetables like broccoli, kale, and spinach contain low fat and sugar, which helps decrease stomach acid production since they are rich in fibre. The fibre helps in bowel movements and prevents constipation, which would otherwise result in acid reflux symptoms.1
- Lean proteins: Lean or low-fat proteins like fish, skinless poultry and tofu minimise acid reflux symptoms, too, unlike high-fat proteins, which relax the LOS and set off acid reflux.1
- Healthy complex carbohydrates: Complex carbohydrates like steel-cut oats, whole grains and brown rice are high-fibre foods, and as mentioned earlier, fibre helps reduce acid reflux symptoms.
- Healthy fats: Oils like sunflower oil, sesame oil and olive oil can be helpful in neutralising stomach acid. Other healthy fats include avocado, almonds, flaxseed and walnuts.
- Roots: Ginger has inflammatory properties that inhibit stomach acid production, while licorice root has compounds that inhibit acid secretion through the inhibition of the H+/K+ ATPase enzyme.1
- Yoghurt: This is also helpful as it contains probiotics (micro-organisms like bacteria and yeast that promote gut health), which are useful in bowel movements. Yoghurt is also soothing for stomach discomfort. As compared to non-fat yoghurt, low-fat is a better option as it is notably better at preserving the integrity of the intestinal barrier than non-fat yoghurt when it encounters pro-inflammatory cytokines (small signalling proteins that promote inflammation in the body).1
- Other probiotics: Besides yoghurt, other probiotic-rich fermented foods like kefir, sauerkraut and kimchi are also known to enhance digestion and help individuals with GORD.1
- Aloe vera: Aloe vera has soothing properties on the digestive system, and it contains enzymes that aid in the breaking down of sugars and fats, promoting healthy digestive system operations. Drinking small amounts of pure aloe vera juice before meals can be beneficial in reducing acid reflux symptoms.1
Portion control and eating habits
- Importance of smaller meals: Opting for smaller but more frequent meals reduces pressure on the LOS as acid exposure in the oesophageal tube may be more extreme when eating a high-calorie diet as compared to eating a low-calorie meal of similar fat content.1
- Avoiding late-night snacking: Refraining from eating close to bedtime is crucial as it allows your stomach more time to digest food before lying down.1 This reduces the likelihood of acid reflux during the night, as gravity aids in keeping stomach contents in place when you're upright.
- Eating slowly and mindfully: Consuming meals at a slower pace and paying attention to what you eat can aid digestion. Rushing through meals or eating while distracted may lead to overeating and increased pressure on the LOS, potentially aggravating acid reflux symptoms.1
FAQs
When should I seek medical attention for acid reflux?
If you experience frequent or severe acid reflux symptoms, it's advisable to consult a healthcare professional. Chronic acid reflux, known as GORD, may require medical evaluation and treatment.
What are some common trigger foods for acid reflux?
Common trigger foods include citrus fruits, spicy foods, chocolate, caffeine, alcohol, high-fat meals, and carbonated beverages. These can alleviate acid reflux symptoms in many individuals.
How can I manage acid reflux at night?
To manage acid reflux at night, avoid eating close to bedtime, sleep with your upper body elevated, and consider dietary choices that are less likely to trigger symptoms. If your reflux persists, consult a healthcare provider.
Summary
Acid reflux is a common condition characterised by the regurgitation of stomach contents into the oesophagus, leading to symptoms like heartburn, nausea or chest pains. Gastro-Oesophageal Reflux Disease (GORD) is the chronic form of acid reflux. To manage acid reflux, lifestyle changes are often recommended before resorting to medications. One key aspect is diet management, where certain foods can help alleviate symptoms. These include non-citrus fruits, lean proteins, vegetables, healthy carbohydrates and fats, roots like ginger, and probiotic-rich foods like yoghurt. However, individual responses to these changes may vary, and it is important to consult healthcare professionals for personalised guidance and treatment options tailored to an individual’s specific needs.
Reference:
- Herdiana Y. Functional food in relation to gastroesophageal reflux disease(Gerd). Nutrients [Internet]. 2023 Aug 15 [cited 2023 Sep 15];15(16):3583. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10458865/