You probably know that quiet burning that creeps up after a meal. Sometimes it passes.
For many people, it comes back night after night, and no one explains which everyday choices are keeping it going.
About 1 in 5 adults in the United States live with gastroesophageal reflux disease, or GERD, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
GERD is the lasting form of acid reflux. The ring of muscle at the top of the stomach, called the lower esophageal sphincter, does not close properly, and acid washes back up into the food pipe.
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Several of the triggers are so ordinary that most sufferers never connect them to their symptoms.
The NIH's patient guide on MedlinePlus names a short list of foods and drinks that make GERD worse. Here are the seven that come up most often.
The everyday foods on the NIH trigger list
1. Coffee and other caffeinated drinks. Caffeine can relax the valve that keeps stomach acid down. The NIH list includes soda, coffee and tea. Even decaffeinated coffee is a problem, because it still raises stomach acid.
2. Chocolate. Compounds in chocolate relax that same valve and let acid slip back up. The NIH groups chocolate on its avoid list alongside the caffeinated drinks.
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3. Fried and fatty foods. A high-fat meal empties from the stomach slowly and loosens the valve at the top, so acid has more time and more room to push back up into the esophagus.
4. Alcohol. Alcohol relaxes the valve and irritates the lining of the food pipe directly. The NIH's advice to GERD patients is blunt. Do not drink alcohol.
5. Citrus fruits. Oranges, grapefruit, lemons and pineapple are naturally acidic and can irritate an already sore esophagus. NIH lists them under the high-acid fruits and vegetables to avoid.
6. Tomatoes and tomato products. NIH names tomatoes and tomato-based dishes like pizza, chili and spaghetti. They are acidic, and researchers suspect they also loosen the valve at the top of the stomach.
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7. Spicy foods. Capsaicin, the compound that gives chili peppers their heat, stimulates nerve receptors in the esophagus. In tissue already irritated by acid, that can turn one meal into a long evening of burning.
NIH also singles out spearmint and peppermint, for the same reason as chocolate. Both can relax the valve that holds stomach acid down.
What to eat instead
The alternatives are not strange. Non-citrus fruit like apples, pears, bananas and melons tends to be gentle.
Water-rich vegetables such as cucumber, celery and lettuce rarely bother the esophagus.
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Lean protein, whole grains and low-fat dairy are generally safe swaps for a fried or fatty main course.
If you drink coffee in the morning, smaller cups or non-caffeinated options on some days may help. Remember that regular decaf still raises stomach acid.
For sauces, basil and pesto are gentler than a tomato base. For heat, herbs like oregano, rosemary and thyme add flavor without lighting up the esophagus.
A simple timing change the NIH recommends for nighttime reflux
What you eat matters. So does when. The NIDDK's diet guidance tells patients that eating meals at least 3 hours before lying down or going to bed may improve symptoms.
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The stomach digests more easily when you are upright. Lying down with a full stomach makes it mechanically easier for acid to push back into the food pipe.
Persistent heartburn more than twice a week, trouble swallowing, or a feeling that food is stuck is not something to self-treat for long. Those are signs to talk with a doctor.
If reflux has been going on for years, there are specific warning signs that your esophagus may already have changed. It is worth checking them against your own symptoms before adjusting any medication on your own.
This article is made and published by Mie Hermansen, who may have used AI in the preparation.