Managing GERD (Gastroesophageal Reflux)

Judy Seybold, MS, RDN, LD, CLC
Chief Nutrition Officer


Gastroesophageal Reflux Disease or GERD is a form of acid reflux, or what happens when stomach acid flows into the esophagus (the tube in your digestive tract connecting your mouth and stomach). Food normally travels down the esophagus after being eaten and swallowed, and a band of muscle called the lower esophageal sphincter controls how the food enters the stomach. With GERD, that band of muscle becomes relaxed at the wrong times, and stomach acid flows back into the esophagus, causing inflammation and pain in the chest and throat, called heartburn.

Acid reflux can happen to anyone, but GERD is caused by frequent acid reflux and can affect people of any age. The way you eat and the types of foods in your diet can cause acid reflux. There are also many conditions that can contribute to development of GERD, including:

  • Asthma
  • Certain medications
  • Connective tissue disorders
  • Drinking alcohol
  • Hiatal hernia
  • Overweight or obese
  • Pregnancy
  • Smoking

The most obvious sign of GERD is heartburn, a burning sensation in your chest and throat that has nothing to do with your heart. This pain is typically felt after eating and may be worse in the evenings. Other symptoms of GERD include:

  • Bad breath
  • Difficulty or pain with swallowing
  • Pain in chest or upper abdomen
  • Problems or painful swallowing
  • Regurgitating of food or sour liquid
  • Vomiting

If you experience symptoms of GERD, consult with your doctor about how to effectively treat and manage the condition. Often following some basic lifestyle and diet changes, and utilizing medication when necessary, helps keep GERD under control.


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Managing GERD

  • Stop smoking.
  • Achieve and maintain a healthy weight.
  • Eat small, frequent meals.
  • Sit upright while eating and for 60 minutes afterward.
  • Eat at least 2 hours before bedtime.
  • Avoid tight clothing.
  • Sleep with the head of the bed raised 6-8 inches.

Healthy Eating Tips

Understanding how diet and eating habits affect GERD can be very helpful in minimizing symptoms. Maintaining a healthy weight is helpful in preventing GERD. Because larger meals are more likely to cause reflux, eating smaller, more frequent meals often helps many people trying to get relief from GERD. Keeping your body in an upright position after eating can help prevent reflux, and it is best to not eat right before bed. Allow about 2-3 hours before bedtime to digest your food.

Dietary changes can have a big impact on GERD. Finding the foods that you are most sensitive to takes a bit of trial and error, but many people have success following these general guidelines when trying to determine how to keep their GERD symptoms minimized. By keeping a food diary and noting when you have symptoms, you may be able to more quickly determine which foods are likely to trigger your GERD.

Foods to limit or avoid:

  • Alcohol
  • Caffeine (including coffee, tea)
  • Carbonated beverages
  • Chocolate
  • Citrus fruits and juices
  • Fried or high-fat foods
  • Garlic and onions
  • Mint (peppermint, spearmint)
  • Spicy foods and black pepper
  • Tomato products

Foods to include:

  • Beans and lentils
  • Lean meats and fish
  • Low-fat or fat-free dairy products
  • Variety of non-citrus fruits
  • Variety of vegetables without added fat from sauces or gravies
  • Whole-grain and high-fiber foods

A diet to provide relief from GERD should be personalized to fit an individual’s dietary needs. Determine what is best for you and work with your doctor to determine how to best manage your GERD. A registered dietitian can help create a GERD-friendly diet that is both nutritious and delicious.

Additional Resources

Academy of Nutrition and Dietetics
Cleveland Clinic