Acid reflux: foods to avoid and how to treat it

Heartburn is the main symptom of acid reflux
Heartburn is the main symptom of acid reflux Credit: People Images

Nothing beats the smug contentment of sitting down on the sofa after you’ve had a hearty meal. But, for some of us, this happy bubble is burst when we have a sudden attack of heartburn.

Heartburn affects 1 in 10 adults in the UK every week, according to the London Gastroenterology Centre. This is typically a symptom of acid reflux - otherwise known as gastro-oesophageal reflux disease (GORD).

To understand acid reflux, you first need to understand food digestion. When we eat, our stomach creates acid to destroy bacteria and break down the food we have consumed. Acid reflux occurs when this acid travels upwards into the oesophogus.

“Contrary to popular thought, acid reflux is not due to excess production of acid in the stomach,” explains Professor Lovat, director at the London Gastroenterology Centre. “It is instead due to a poorly functioning valve at the top of the stomach – the lower oesophageal sphincter – which opens when people swallow to allow food down into the stomach but prevents acid from coming back up.”

Certain foods can make acid reflux more likely. The condition also “tends to develop in middle age”, according to Prof. Lovat, although he says it can also affect young people.

Symptoms

No two cases of acid reflux are the same. However, the most common symptoms of this condition are:

  • Heartburn
  • Sour taste in your mouth

While those are the two main symptoms, you may also have acid reflux if you suffer from the following:

  • Unpleasant breath

  • A persistent cough

  • Sore throat or hoarse voice

  • Nausea and bloating

If you have persistent symptoms, you should go and see your GP, according to Professor Prasad, consultant general physician and gastroenterologist at The Lister Hospital.

He adds that you should certainly see a GP if you have “alarm symptoms”, which may include losing weight, breathing difficulties, nausea, vomiting and difficulty in swallowing.

Causes

The causes of acid reflux can vary between cases. Sometimes there is a clear cause, or “a trigger that on some level is slightly predictable,” according to Prof. Prasad. Such triggers may include certain foods, including spicy dishes, chocolate and fatty foods. Alcohol, caffeine and coffee may also be triggers.

Eating late at night “and not leaving enough time before lying down” can also cause acid reflux, according to Prof. Lovat. As a result, he recommends leaving at least 2-3 hours between your meal and lying down or going to bed.

Being overweight can contribute to acid reflux. This is because the fat in the abdomen puts pressure on the stomach, so the acid is pushed upwards towards the valve at the top of the stomach and into the throat. For this same reason, tight clothing and pregnancy can also cause acid reflux.

The reflux can be in response to medicines, which damage the oesophagus. “Some prescribed drugs make things worse as well, in particular calcium channel blockers for blood pressure,” says Prof. Lovat. Drugs such as ibruprofen can also damage the oesophagus. 

While these are the most common reasons for acid reflux, however, sometimes there is no clear cause. “There will be a group of patients who can’t identify a trigger and will have reflux symptoms,” Prof. Prasad surmises.

How to manage acid reflux

If you suffer from acid reflux, the experts have tips for how you can manage the condition. “Generally we would recommend lifestyle and dietary modification,” says Prof. Prasad. This includes maintaining a healthy weight and avoiding large meals.

Be sure not to eat just before you go to sleep. Acid reflux typically occurs within two hours of eating, according to the London Gastroenterology Centre. “Make sure there’s a nice gap between meals and bedtime – typically three hours is a good rule of thumb,” says Prof. Prasad. Eating smaller meals, more frequently throughout the day, can also help with digestion.

Another handy tip is to prop yourself up in bed, keeping your head elevated, as you go to sleep. This encourages the acid to flow downwards instead of upwards into your throat, and is particularly effective if you have a cough or issues with clearing your throat, according to Prof. Prasad.

Foods to avoid if you have acid reflux

As well as altering your lifestyle, it can be beneficial to modify your diet. “Certain people will find certain things in their diet trigger reflux symptoms. So, where appropriate, you can selectively try to eliminate some of those triggers,” advises Prof. Prasad.

 If you have had chronic symptoms or symptoms that have persisted for a couple of days, it’s worth trying to change your diet, as “certain foods trigger or worsen symptoms,” according to Prof. Lovat.

 According to the experts, the following can contribute to acid reflux:

  •  Acidic fruit
  • Caffeine
  • Coffee

  • Fizzy drinks

  • Alcohol

  • Chocolate

  • Fatty foods

  • Spicy food

Caffeine, alcohol and chocolate might be responsible for relaxing the lower oesophageal sphincter - which can cause the valve to allow the upward movement of acid from the stomach.

Meanwhile, acidic fruit and spicy food can cause damage to the oesophagus, which could exacerbate your symptoms.

Treatments

If altering your lifestyle and diet does not improve the situation, you should go to the pharmacist. They may prescribe you with antacids to neutralise the acid in your stomach. This is an effective treatment for those with mild forms of acid reflux.

If antacids do not work, you may be prescribed with histamine 2 receptor antagonists (also known as H2 receptor blockers), which reduce the amount of acid your stomach can produce.  “They tend to be more effective in decreasing both the frequency and severity of heartburn symptoms, compared to antacids,” according to Prof. Prasad.

If you have more frequent or severe symptoms of acid reflux, you may be prescribed Proton Pump Inhibitors (PPIs), which are responsible for the long-term reduction of acid in your stomach.  

Alternatively, it is possible to have a surgical procedure to try to fix the valve at the top of your stomach or improve the muscles at the bottom of your oesophagus. This solution is not for everyone, however. “Surgery is for the small number of people who don’t get adequate symptomatic relief from drugs or who get side effects from drugs,” Prof. Lovat explains.

License this content