How can I prevent gastro-esophageal reflux disease (GERD)?

No one is exactly sure why gastroesophageal reflux disease (GERD) and heartburn affect some people and not others, but you can take steps to prevent GERD and heartburn by addressing the risk factors that are under your control. These include obesity and smoking. You can start a weight-loss program if you are overweight or try to quit smoking if you are a smoker. Before taking new medications, it is a good idea to check with your doctor to see if they increase your risk of GERD and heartburn.

Changing what you eat and drink can help if you have gastroesophageal reflux disease (GERD) and heartburn. Foods that can trigger heartburn and other GERD symptoms include:

  • Spicy foods
  • Fried or fatty foods
  • Acidic foods
  • Tomato sauce or paste
  • Chocolate
  • Peppermint
  • Garlic
  • Onions
  • Citrus fruit

Drinks that can trigger heartburn and other GERD symptoms include:

  • Alcohol
  • Coffee and other caffeinated drinks
  • Carbonated drinks
  • Citrus juice

In addition to avoiding these items, eating smaller portions may help control your GERD and heartburn symptoms. It is also a good idea to wait at least three hours after you eat before you lie down.

Gastroesophageal reflux disease (GERD) symptoms sometimes disappear if dietary or lifestyle excesses that cause the symptoms are reduced or eliminated. Avoiding these items may reduce your discomfort:

  • Coffee
  • Citrus drinks
  • Tomato-based products
  • Carbonated beverages
  • Chocolate
  • Peppermint
  • Fatty or spicy foods
  • Eating within three hours of bedtime
  • Smoking
  • Excess alcohol consumption
  • Excess weight gain
Ms. Ashley Koff, RD
Nutrition & Dietetics Specialist

I've received several requests (following my media stories and blogs) asking about the natural (non-medication) options for preventing gastroesophageal reflux disease (GERD). Note: Please, as always, contact me and/or your healthcare practitioner to discuss what's right for you rather than just taking any/all of these:

  1. Keep the digestive tract underwhelmed—small, frequent (about every 3 hours) eating occasions and chew food well.
  2. Plant enzymes with eating occasions (especially with animal proteins) to help breakdown the food.
  3. L-glutamine: this amino acid may aid tissue recovery.
  4. Probiotic: (strain specificity and quantity are key).
  5. Omega 3s may help reduce any inappropriate inflammation of the digestive tract.
  6. Chew deglycyrrhizinated licorice (DGL) between meals—this amino acid may aid tissue recovery.
  7. Mastic gum has antibacterial properties.
  8. Magnesium citrate or glycinate before bed to improve motility.

The classic symptoms of GERD (including heartburn, regurgitation, and even difficulty swallowing) may resolve with simple changes in diet and lifestyle. Most importantly, ‘trigger foods’, or foods that you find to be an irritant, should be avoided. Each person reacts differently to various foods; however, the most common trigger foods which aggravate GERD include spicy foods, tomatoes and tomato sauces, chocolate, caffeine, peppermint, alcohol and fatty foods.

Besides avoiding trigger foods, there are other simple lifestyle changes that can reduce symptomatic flare-ups. People struggling with GERD should avoid lying down immediately after eating a meal; ideally, three hours should separate eating and sleeping. Try lifting the head of your bed by 6-8 inches (or sleeping under multiple pillows). This can relieve symptoms by allowing gravity to keep acid from seeping back into the esophagus. Other tips to help combat GERD symptoms include eating multiple smaller meals throughout the day (as opposed to 2-3 larger meals), losing weight and avoiding tobacco products.

When symptoms persist despite all of these lifestyle changes, many patients will need the assistance of an acid blocking medication to relieve the discomfort from GERD.

Dr. Lisa Ganjhu, DO

If you’re suffering from the gurglings of GERD, it’s tough to know what might trigger an attack. In this video, gastroenterologist Dr. Lisa Ganjhu shares which foods to eat—and which to skip—to keep gastroesophageal reflux disease at bay.

Changing your diet is often a great way to decrease symptoms of having GERD or heartburn. For example, avoiding spicy foods, alcohol, coffee, greasy foods, chocolate, tomatoes or even peppermint could help you experience less heartburn. You don't have to change your diet, but you stand to gain a lot if it is making your GERD worse.

Another way to prevent gastroesophageal reflux disease is to lose weight. In addition to weight loss, it is recommended that you elevate the head of your bed, avoid foods that trigger reflux and do not eat within two hours of bedtime.

Dr. Lawrence S. Friedman, MD

Here are some prevention tips for people troubled by symptoms of gastroesophageal reflux disease (GERD):

  • Eat smaller meals. A large meal remains in the stomach for several hours, increasing the chances for gastroesophageal reflux. Therefore, anyone who suffers from this problem should distribute his or her daily food intake over three, four or five smaller meals.
  • Relax when you eat. Stress increases the production of stomach acid, so make meals a pleasant, relaxing experience. Sit down. Eat slowly. Chew completely. Play soothing music.
  • Relax between meals. Relaxation therapies such as deep breathing, meditation, massage, tai chi or yoga may help prevent and relieve heartburn.
  • Remain upright after eating. Try to maintain postures that reduce the risk for reflux for at least two hours after eating. For example, don't bend over or strain to lift heavy objects.
  • Avoid eating within three hours of going to bed. Do not eat bedtime snacks.
  • Lose weight. Excess pounds increase pressure on the stomach and can push acid into the esophagus.
  • Loosen up. Avoid tight belts, waistbands, and other clothing that puts pressure on your stomach.
  • Avoid foods that burn. Abstain from food or drink that increases gastric acid secretion, decreases lower esophageal sphincter (LES) pressure or slows the emptying of the stomach. Known offenders include high-fat foods, spicy dishes, tomatoes and tomato products, citrus fruits, garlic, onions, milk, carbonated drinks, coffee (including decaf), tea, chocolate, mints and alcohol.
  • Stop smoking. Nicotine stimulates stomach acid and impairs LES function.
  • Chew gum. It can increase saliva production, soothing the esophagus and washing acid back down to the stomach.
  • Consult your doctor about your medications. Drugs that can predispose you to reflux include aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs), oral contraceptives, hormone replacement therapy, narcotics, certain antidepressants and some asthma medications.
  • Raise your bed's head at night. If you're bothered by nighttime heartburn, elevate the head of your bed by placing a wedge (available in medical supply stores) under your upper body. But don't elevate your head with extra pillows. That makes reflux worse by bending you at the waist and compressing your stomach.
  • Exercise wisely. Wait at least two hours after a meal before engaging in vigorous physical activity, giving your stomach time to empty.
Sanjay Krishnan
Sanjay Krishnan on behalf of MDLIVE
Healthcare Specialist

Gatro-esophageal reflux disease is caused by stomach acid traveling upward into our food pipe otherwise known as our esophagus. The presence of this stomach acid burning our esophagus causes that burning sensation. We all have a valve between our esophagus and stomach that allows our food to flow from our esophagus into our stomach but prevents backwards flow. However, there are certain things that make this valve leaky, and allows the flow of stomach acid upwards and hence reflux. Symptoms are generally worse at night because you are lying down, and do not have the aid of gravity to help pull food in a downwards fashion.

To help prevent GERD or reflux, try to avoid lying down for at least 2 hours after a meal. Eating dinner earlier in the evening will help. There have been certain substances that make the valve between our esophagus and stomach leaky as I said earlier so avoiding these substances will help prevent reflux. Some of the most common are alcohol, nicotine, marijuana, chocolate, peppermint, tomatoes or tomato sauce, and spicy foods. I also suggest to people with this problem, placing cinder blocks under the head of their bed in order to raise it six inches so you are sleeping at a slight incline will help use the force of gravity to pull things downwards while you sleep might help. Do not use extra pillows as you are just inclining your head and not your actual esophagus and will be ineffective!

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.