How to Prevent Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease (GERD) occurs when stomach contents such as acid, bile, or food repeatedly flow back up into the esophagus, the tube that connects the stomach to the mouth. It’s one of the most common digestive conditions in the United States, affecting around 20 percent of Americans.

GERD can cause a number of unpleasant acid reflux symptoms, including heartburn, regurgitation of stomach contents into the mouth or throat, nausea, and difficulty swallowing, among others. Without proper treatment and prevention, GERD can cause damage to the esophagus.

Although over-the-counter and prescription medications can help treat GERD, lifestyle changes can go a long way to manage and prevent symptoms.

In a study of more than 100,000 people, researchers found that five lifestyle factors predicted which study participants were less likely to develop GERD. These included a healthy diet, a healthy body weight, never smoking, regular moderate to vigorous exercise, and no more than two cups of coffee, tea, or soda per day.

These strategies can also minimize and prevent symptoms among people who already have GERD.

Here’s a closer look at these and other strategies that can help manage and prevent GERD.

Diet for GERD and Acid Reflux

GERD can be caused by a number of factors, including obesity, pregnancy, hiatal hernia, smoking, and certain medications, among others.

Different factors can trigger symptoms, and triggers often vary from person to person. While diet alone probably isn’t enough to cause GERD, certain foods can definitely improve or trigger reflux symptoms. That’s why it’s often important to watch what you eat if you have GERD.

Eat a Reflux-Friendly Diet

A healthy diet is important for weight management and overall health, which in turn can reduce the risk of GERD. But an emphasis on certain foods can do more to prevent acid reflux. For instance, adequate high-fiber foods each day can help you feel full and less likely to overeat (a known culprit for heartburn). Some examples of high-fiber foods are:

Oatmeal
Brown rice
Sweet potatoes
Broccoli
Carrots
Green beans

Foods lower in acid are also less likely to lead to reflux. They include:

Bananas
Melons
Cauliflower
Fennel
Nuts

“Foods that are higher in water content can also help to dilute the acidic contents of the stomach,” says Ali Khan, MD, a gastroenterologist with Gastro Health in Fairfax, Virginia. Some examples include:

Watermelon
Cucumbers
Celery
Lettuce
Broth-based soups

Avoid Foods and Drinks That Can Cause Acid Reflux

“Decreasing acidic foods is the mainstay for dietary modifications when it comes to GERD management,” Dr. Khan says. This is especially true if diet triggers your GERD symptoms, though this may differ from person to person. Common foods that can trigger acid reflux include:

Spicy foods
Fried or fatty foods
Citrus fruits
Tomato-based sauces
Chocolate
Peppermint
Caffeine
Carbonated drinks

Other Lifestyle Changes That Can Prevent GERD

In addition to diet, several other lifestyle factors play a role in preventing GERD.

Maintain a Healthy Body Weight

If you’re overweight or have obesity, weight loss can prevent GERD symptoms. That’s because extra weight puts more pressure on your stomach, which can cause more stomach acid to regurgitate into the esophagus.

“By maintaining a healthy body and less weight around our abdomen, we allow our food to be digested more easily,” Khan says. “Food contents travel downwards, instead of refluxing up into our esophagus where they do not belong.”

If you want to lose weight, it helps to make small but lasting lifestyle changes, including calculating how many calories you need each day to lose weight, making healthier food choices, and exercising regularly. It can also help to work with your doctor to set achievable goals for yourself.

Eat Smaller Meals Throughout the Day

When it comes to preventing GERD, it’s not just what you eat that matters; it’s also when and how much you eat, says Joan Chen, MD, a gastroenterologist with University of Michigan Health in Ann Arbor.

“Large meal volumes cause greater gastric distension and may take longer to empty from the stomach,” she says. “This can lead to more frequent air venting through a process called transient lower esophageal sphincter relaxation (TLESR). During TLESR, patients will often have reflux of gastric content along with air, leading to heartburn and regurgitation.”

Eating right before you go to sleep can also be problematic, especially if it’s a large meal. “This is why we recommend patients with GERD to eat smaller, potentially more frequent meals, and avoid eating close to bedtime,” Dr. Chen says.

Exercise Regularly

There’s no clear evidence that exercise alone helps prevent GERD, says Sunil Amin, MD, a gastroenterologist with the University of Miami Health System. “However, so as long as it causes one to lose weight it can certainly improve GERD indirectly,” he says.

Although exercise can help, it’s important to choose the right kind of exercise. That’s because certain types of physical activity may actually lead to exercise-induced reflux symptoms in some people.

“Workouts that increase intra-abdominal pressure, such as weight lifting, can induce retrograde flow of gastric content,” Chen says. “Even in endurance sports such as running, reflux has been shown to worsen during exercise through an increase in frequency of TLESR and lower esophageal sphincter pressure.”

If you find that high-impact exercises like running make your reflux worse, try toning down the intensity or opt for low-impact exercises like walking or an elliptical machine instead. It can also help to keep your body upright during exercise, which allows gravity to work in your favor and keep food and digestive acids in your stomach.

If you continue to experience reflux symptoms during or after exercise, let your doctor know. They can help you find a solution that works for you.

Avoid Smoking

Smoking exacerbates GERD by weakening the sphincter, a ring-shaped muscle that separates the esophagus from the stomach. This can allow stomach contents to flow back up into the esophagus. “Quitting smoking is one of the best things people can do not only for GERD, but their overall health,” Khan says.

One study of 141 people who successfully quit smoking found that nearly half reported fewer GERD symptoms one year later.

Quitting smoking has many other health benefits as well. For instance, smoking is also a major risk factor for esophageal cancer, and quitting smoking can help you reduce your risk.

Wear Loose-Fitting Clothing

Tight clothes, especially around the waistband, can increase abdominal pressure, which can cause stomach acid to flow back up into the esophagus.

“In people prone to reflux symptoms, it is therefore recommended that they avoid form-fitting clothes or use of a tight belt,” Chen says. Instead, opt for looser clothing that’s more comfortable around the waist.

Tweak Your Bedtime Routine

If you get reflux at night, certain changes to your evening routine can help. “Specifically, one should wait at least three hours before their last meal before going to bed,” Dr. Amin says. “This may mean you have to move dinnertime up.”

“Other interventions that may help are elevating the head of the bed using a wedge or blocks and sleeping on your left side,” Amin adds.

Medications That Can Make GERD Worse

Some medications and dietary supplements can irritate the esophagus or trigger reflux symptoms, such as:

Some antibiotics
Bisphosphonates, which treat osteoporosis or other bone conditions
Pain relievers, such as ibuprofen and aspirin
Opioids or narcotics
Potassium supplements

Don’t stop taking any medication you’ve been prescribed without first talking to your doctor. If you have any questions or concerns about the effects of medications or supplements on GERD symptoms, your doctor can help you find a solution that works for you.

The Takeaway

GERD causes unpleasant symptoms, but certain lifestyle changes can help keep those symptoms at bay. If you have frequent reflux symptoms, it’s important to maintain a healthy weight, eat a nutritious diet, avoid trigger foods, opt for smaller meals throughout the day, avoid smoking, exercise, wear loose-fitting clothes, and practice good sleep habits. Certain medications can also trigger GERD, which may be worth discussing with your doctor. If your symptoms persist even after you’ve taken steps to reduce them, it’s important to see a gastroenterologist and discuss next steps.

Diet for GERD and Acid Reflux

Eat a Reflux-Friendly Diet

Avoid Foods and Drinks That Can Cause Acid Reflux

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