Nutrition and gastroesophageal reflux

Nutrition and gastroesophageal reflux


Gastroesophageal reflux and diet are closely linked to each other, in terms of causes, therapy and prevention.
Surely, for the gastroesophageal reflux patient, the aspect of greatest interest is diet as therapy; this diet includes: the exclusion of certain foods (foods that are too fatty, coffee , chocolate, spices , fizzy drinks, etc.), the preference for certain types of foods ( lean protein foods , fruit without citric acid ,non-fat whole grains , vegetables , etc.), the use of healthy cooking and food preparation methods, and the slow and serene consumption of meals.

Brief review of gastroesophageal reflux

In medicine, the phenomenon whereby gastric juices go back from the stomach to the esophagus , even reaching the throat in the most serious cases, is called gastroesophageal reflux or gastric reflux .
Gastroesophageal reflux affects many people sporadically and can, in some circumstances, become a chronic disorder; when it assumes a chronic nature, it represents a real disease, whose specific name is gastroesophageal reflux disease but which, in common jargon, is simply called (and once again) gastroesophageal reflux.
In industrialized countries, gastroesophageal reflux disease is considered a fairly common condition, since, according to some statistics, it affects between 20 and 40% of people aged between 45 and 64 years.
When it is chronic, gastroesophageal reflux is due to a malfunction of the cardia , ie the valve which, placed between the esophagus and the stomach, prevents the ascent of food from the latter.
Among the factors that can affect the functioning of the cardia, there are conditions such as obesity , cigarette smoking , hiatal hernia , asthma , the constant intake of certain medicines, pregnancy, stress and an unhealthy diet .
To cope with chronic gastroesophageal reflux, you need:

  • Pharmacological therapy based on medicines such as antacids , alginates , H2 blockers and proton pump inhibitors , which buffer gastric acidity and/or reduce the stomach’s production of acidic digestive juices ,


  • Appropriate dietary therapy , which increases the tone of the cardia rather than relaxing it excessively, which maintains intra-abdominal pressure at low levels rather than increasing it and which involves a contained acid secretion from the stomach.

Diet and Lifestyle

Gastroesophageal reflux and diet are, respectively, a condition and a behavior of daily life which present – ​​as can also be deduced from the introduction – an inseparable link, not only at a causal level but also and above all at a therapeutic level.
The following sections of this article will deal with the very important role that a correct diet plays, within the treatment of chronic gastroesophageal reflux; the aim is to provide readers with a guide that collects information on how to eat, which foods to eat, which foods to avoid, how to cook food, etc., in the presence of gastroesophageal reflux.

Small and frequent meals

The big binges to curb the pangs of hunger , due to a prolonged fasting , represent, for people with gastroesophageal reflux, one of the main reasons for the appearance of the symptoms.
This consequentiality between large binges and the phenomenon of gastric reflux explains why doctors warmly recommend the consumption of small and frequent meals : in fact, eating small quantities of food and with a certain daily frequency avoids overloading the stomach excessively, falling into a situation of fasting and consume more calories than the body actually needs.

Never skip a meal to avoid overloading the stomach excessively during the digestive process .

Eat away from the time of night’s rest

For those suffering from gastroesophageal reflux, a very common mistake that can trigger symptoms is going to bed shortly after a meal, therefore with the so-called “full belly”. The horizontal position, assumed in bed, in fact, favors the ascent of the acidic contents of the stomach towards the esophagus.
Regarding this topic, the wise advice of doctors and experts is to wait at least two hours before going to bed, and to lie down with the head raised from the bed by 15-20 centimetres.
The at least two hours of waiting are used by the stomach to digest the ingested food and empty part of the gastric juices, while the position with the head raised ensures that the remaining gastric juices do not go back up into the esophagus.

Maintain upright posture during and immediately after meals

If the horizontal position after meals favors the ascent of gastric juices into the esophagus, the upright position (therefore vertical) is instead an obstacle to the aforementioned ascent, for physical reasons.
All of this is why doctors recommend eating in an upright position and staying in that position for at least 45-60 minutes, even after eating.

Control of body weight and intra-abdominal pressure

Excessive abdominal fat leads to higher than normal intra-abdominal pressure . Having higher than normal intra-abdominal pressure tends to affect the structure and functioning of the stomach, especially the cardia; the latter, in fact, weakens from the muscular point of view , becoming less effective in containing the gastric juices in the stomach, which, at this point, are able to go back up into the esophagus more easily.
In the light of this, it is easy to understand the importance that a change in diet can have, in a context of gastroesophageal reflux and obesity, which must first aim at achieving and then maintaining thehealthy weight (therefore weight loss and consolidation of the new body weight).


The increase in intra-abdominal pressure may depend not only on excess abdominal fat , but also on other factors, such as:

  • Pregnancy , where the enlarged uterus pushes on the stomach;
  • The use of belts or clothes that are too tight at the waist ;
  • The unusual performance of a few sets of sit-ups after a big meal.

Foods to avoid

The sworn enemies of those suffering from gastroesophageal reflux include sauces and above all foods rich in fat (eg: fried foods , fatty red meats , fatty cheeses , too much oil , etc.); these, in fact, remain in the stomach for a long time (because they take a long time for digestion), induce a huge production of gastric juices (again for reasons related to digestion) and, finally, reduce the muscle tone of the cardia. Sauces and fatty foods aside, the list of foods to avoid in the presence of gastroesophageal reflux disease includes: caffeine
-based drinks (therefore coffee and tea), chocolate , mint , raw tomatoes , spirits , carbonated drinks and spices such as pepper , chilli , curry , nutmeg etc.


Leaving from the dietetic-food sphere, another important factor capable of triggering the phenomenon of gastroesophageal reflux is cigarette smoke . Scientific studies, in fact, have shown that smoking weakens the cardia and compromises its proper functioning.

What to eat

Once the foods to be avoided in case of gastroesophageal reflux have been listed, it remains to be clarified what the subject with the aforementioned problem can eat without worries.
Among the recommended-allowed foods in the presence of gastroesophageal reflux disease, we highlight:

  • Lean foods rich in proteins ( such as white meat , eggs , most fish , seafood , etc.), because, unlike fatty foods, they are easier to digest, involve less production of gastric juices and increase cardiac muscle tone.
  • Fresh vegetables , due to their low fat and sugar content , whose digestion requires a considerable production of gastric juices.
  • Low – fat whole grains . The large amount of fiber in whole grains absorbs the gastric juices of the stomach, making the phenomenon of gastroesophageal reflux less likely.
  • Fruit low in citric acid , such as melons , pears , apples , bananas and berries , because they keep the acidity level of the stomach within acceptable values.

It should be noted that the aforementioned foods are good foods for those suffering from gastroesophageal reflux, only on condition that their cooking and/or preparation respects certain rules (see the next section).

Sober cooking at low temperature

If cooked or prepared inadequately, even the foods indicated for those suffering from gastroesophageal reflux can be harmful and cause the acidic contents of the stomach to rise up into the esophagus.
For example, it is counterproductive to eat:

  • Fried eggs or vegetables;
  • White meat excessively seasoned with oil, sauces and/or spices;
  • grilled white meat cooked at very high temperatures;
  • Sugary fruit;
  • Overly toasted wholemeal bread ;
  • Etc.

Therefore, in the presence of gastroesophageal reflux, not only the types of foods consumed are important, but also the cooking and preparation methods , which must be healthy .
For example, they represent a winning choice:

  • Foil cooking for fish or lean meats ;
  • Steam cooking for vegetables;
  • Grilled white meat, cooked at low temperatures (it will then be the concern of the consumer to avoid eating any burnt parts);
  • Consumption raw and with a little oil of seasonal vegetables ;
  • The consumption of natural fruit, without added sugar;
  • The dressing of pasta with steamed vegetable sauces and a drizzle of oil, rather than with gravy rich in fats and flavours;
  • Etc.


When those suffering from gastroesophageal reflux eat food that is not suitable or cooked in an inadequate way, their organism, starting from the stomach, demonstrates a certain disappointment through symptoms which include, in addition to the classic heartburn in the retrosternal area and acid regurgitation , such as difficulty swallowing , chest pain , sore throat , hoarseness , bad breath etc.

Chew well and slowly

To complete a picture that already includes balanced nutrition , the choice of the right foods and the use of healthy cooking methods, there is also the serenity with which to consume meals .

In fact, eating well (“well” in the sense of healthy) is not enough, it is also necessary to chew slowly and swallow with caution . Certainly, an aid to adopting such an approach to food comes from frequenting serene and relaxing environments
at mealtimes .


The gastritis diet is based, in large part, on the same simple rules as the gastroesophageal reflux diet, presented in this article.


A diet like the one described above, undertaken at the first signs of gastroesophageal reflux (acidity, acid regurgitation, gastric distress, etc.), can prevent the latter from appearing with a certain constancy and taking on the contours of a chronic disorder.

Avoiding the chronicity of gastroesophageal reflux is important, because important complications can arise from it, such as esophageal ulcer, esophageal stenosis and Barrett’s esophagus .
Therefore, in the light of this and of what has been said in the previous sections of this article, in a context of gastroesophageal reflux, diet is a cornerstone of both therapy and prevention.

Table. What kinds of foods are indicated and which are not, in the presence of gastroesophageal reflux?

Type of food What’s good What is not good
Milk and derived products Skimmed milk , with up to 2% fat.
Low-fat yogurt .
Whole milk and milk with a fat content of ≥ 4%.
Milk Chocolate .
Vegetables Most vegetables Raw tomatoes.
All vegetables fried or seasoned with dips.
Fruit Fruits with a low citric acid content (e.g. apples, melons, pears, berries, bananas, peaches , etc.). Citrus fruits (e.g. oranges , grapefruit , lemon , etc.).
Pineapple .
Bread and cereals All low-fat preparations. Preparations combined with milk and milk derivatives.
Preparations with too much fat.
The toasted bread.
Meat and meat substitutes Lean meats, eggs, fish (lean is better) and seafood. Cold cuts of meat.
Fatty meats (e.g. sausage , bacon , chicken skin , etc.).
Fats and oils Small doses, preferably of vegetable origin. Large doses, regardless of whether it is of animal or vegetable origin.
Sweets and desserts All sweets without or low in fat (less than 3 grams). Chocolate.
Desserts prepared with oil and/or fat (e.g. butter ).
Drinks Water , decaffeinated drinks and non-acidic fruit juices . Caffeinated drinks, mint, alcohol , peppermint tea, and sodas .
Soups All preparations free or low in fat. Soups with the addition of fatty meats, milk, oil, etc.


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