It's GERD Awareness week: Let's talk acid reflux

From changing sleeping and eating patterns to understanding 'trigger' foods, there are ways to improve symptoms of gastroesophageal reflux disease.

Andy De Santis, RD 4 minute read November 22, 2021
Stomach heartburn. Stomach pain, gastritis, indigestion, vomiting, heartburn problems. Heartburn and Gastritis isolated. The concept with indigestion and stomach pain problems. Vector flat

For combatting acid reflux think about changing how you eat, rather than what you eat. GETTY

The term acid reflux is often used interchangeably with the condition it refers to: Gastroesophageal Reflux Disease, or GERD.

According to the Canadian Digestive Health Foundation (CDHF), GERD affects approximately 15 per cent of adults in North America and the medication used to treat it is among the most prescribed in Canada. On top of that, the age demographic of GERD patients is trending downwards, with an increasing number of diagnoses happening in those as young as 30-years-old.

What is GERD?
When the contents of your stomach persistently enter your esophagus to the point that it causes regular discomfort, such heart burn or regurgitation into the mouth, you more or less have landed on GERD — although only a doctor can diagnose it.

In the short to medium term, the discomfort caused by these symptoms is painful to say the least, but if untreated, in the long-term, they can lead to significant damage to your esophagus and increase your risk of more complex health concerns. But you are not powerless in managing this condition.

How fight GERD
While pharmaceutical intervention is a common and effective treatment for GERD, there are some lifestyle changes that can also make a huge difference.

Eating and sleeping patterns
If you’re looking for an anti-reflux superfood, you won’t find it here. Instead of focusing on what you eat, think about changing how you eat. For example, slow the speed of your eating because fast eating may increase GERD risk; avoid eating beyond fullness by spreading your caloric intake more evenly throughout the day rather than concentrating it over one or two large meals; don’t consume very hot foods like soups at their peak temperature — allow them to cool; don’t lie down (whether on the couch or in bed) within three hours of eating or, at minimum, increase the amount of time between your last bite and heading to bed as much as possible; and when you do lie down to go to sleep, consider elevating the head of your bed by six to eight inches.

Don’t get too trapped by “trigger” foods
It is common to eliminate “trigger” foods when it comes to GERD. Anecdotally, there are a number of foods which have been reported to worsen acid reflux symptoms in some people, but high quality scientific evidence does not exist to strongly support the universal elimination of these foods, which tend to include caffeinated and carbonated beverages, spicy foods, fast/fried foods, alcohol and chocolate. You can certainly try, and while it is possible that consuming these foods in large quantities could be particularly problematic for some people, this is not clearly fleshed out by the current science.

Quitting smoking, which is also considered a trigger, could also help, (with GERD and other health concerns, of course).

Consider low risk alternative approaches
As a dietitian, I understand the desire of GERD sufferers to seek out alternative or complimentary approaches to managing their condition. However, there is limited evidence for the majority of these interventions, and although they are generally low risk, it’s a good idea to check with your healthcare provider if you are considering trying them out..

One such alternative is psyllium fibre, a unique form of plant fibre that is often used in various digestive health contexts, including GERD. There is limited evidence that suggests utilizing 10 grams of psyllium fibre daily (five grams twice a day) may reduce heart burn and acid reflux episodes in GERD sufferers. Acupuncture has also been explored as a way to reduce GERD symptoms using trigger points CV12, ST36, SP6 and PC6. Limited evidence also shows that the strong antioxidant properties of melatonin  may offer some additional protection to your esophagus when used in conjunction with standard GERD medication. Other potential solutions include chewing gum for 30 minutes after a meal may reduce episodes of reflux, while meditation and other mindfulness based stress reduction (MBSR) strategies also have a role to play in symptom reduction, particularly by addressing the link between mental health and GERD symptoms, given their effect on quality of life.

While none of this advice is intended to replace that of your physician, it does provide a comprehensive look at the options available to GERD sufferers — even if the evidence supporting these interventions — low risk as they may be — isn’t yet that robust.

Andy is a registered dietitian and author who has operated a private practice in Toronto since 2015.  He spends his free time eating, writing and talking about kale @AndyTheRD. He can be reached at