GERD Triggers: What's Turning the Heat Up on Your Heartburn?

By Olufemi Kassim, MD, Digestive Health Program

Gastroesophageal reflux disease, or GERD, is a common digestive condition in adults and children. One in three people in the United States report having GERD symptoms in the past week.

GERD occurs when stomach acid rises into the esophagus. The stomach contents are usually kept in place by a valve, or sphincter, between the esophagus and stomach.

In GERD, the sphincter leaks and acid escapes back into your esophagus. This action is called acid reflux.

The esophagus does not have a thick, protective mucosal layer like the stomach. Persistent backwash of stomach acid can cause irritation, inflammation and more serious long-term conditions.

What are the symptoms of GERD?

Symptoms of GERD vary from person to person. The most common symptom is heartburn that some people describe as a burning feeling in their chest and throat. Other symptoms include:

• Regurgitation of food or sour stomach acid into the mouth
• Chest pain
• Frequent burping
• Nausea
• Persistent cough, sore throat or hoarseness
• Trouble swallowing or pain when swallowing
• Vomiting

Almost everyone experiences these symptoms once in a while. With GERD, symptoms occur two or more days per week and may be severe enough to impact your quality of life.

GERD triggers

People experience GERD in different ways. What triggers one person’s symptoms may not affect someone else. By understanding your triggers, you can control your condition and feel better.

Triggers of gastroesophageal reflux disease (GERD) include:

GERD trigger #1: What you eat

Many types of foods can cause GERD, but they don’t all act in the same way. Some foods increase the acidity of the stomach, which could make GERD symptoms worse.

Others relax the esophageal sphincter, making acid reflux more likely. Still other foods take a long time to digest and cause your stomach to increase acid production.

Spicy foods, onions and garlic are common GERD triggers. Other triggers include:

• Alcohol: Not only does alcohol relax the esophageal sphincter, but it can also damage the lining of the stomach and esophagus.
• Carbonated beverages: Some carbonated drinks are highly acidic or caffeinated, both of which can cause GERD symptoms.
• Chocolate: Chocolate is a favorite food for many, but it can exacerbate GERD by relaxing the esophageal sphincter.
• Citrus fruits and tomatoes: Because they are acidic, citrus fruits and tomatoes increase the acidity of your stomach.
• Coffee and other caffeinated beverages: Caffeine relaxes the esophageal sphincter, which can increase acid reflux.
• Fried and fatty foods: High-fat foods take longer to digest and can increase acid production.
• Peppermint: Though commonly used to calm an upset stomach, peppermint relaxes the esophageal sphincter and can make GERD worse.

For patients with GERD, doctors recommend cutting out all trigger foods to start. Though this may include many of your favorite foods, it’s only temporary.

Slowly, you can add foods back into your diet to see if they make your symptoms worse. The good news is that many people improve their GERD symptoms by identifying and managing their trigger foods.

GERD trigger #2: How much you eat

Big meals, especially in the evening, can trigger GERD. Try to eat more frequent, smaller meals.

This allows time for your stomach to digest and prevent food from sitting in your stomach for too long.

GERD trigger #3: When you eat

The timing of your meals is also important. Eating before bed is a common GERD trigger. When you’re upright, gravity helps keep stomach acid down.

When you lay down, food is more likely to seep into your esophagus. Plan your last meal of the day for two to three hours before your bedtime.

Exercising on a full stomach can also trigger GERD. Jumping (cardio) or bending (yoga) can put pressure on the esophageal sphincter and cause reflux. If you’re planning vigorous exercise, give yourself a two-to-three-hour window to digest your food.

GERD care at Loyola Medicine

On its own, GERD is not a serious medical problem. Over time, it can lead to more severe health conditions. Patients with persistent GERD can develop esophageal stricture (narrowing of the esophagus), Barrett's esophagus or esophageal cancer.

If your symptoms are persistent and severe, the digestive health program at Loyola offers comprehensive GERD care. Loyola gastroenterologists help you manage GERD by controlling your triggers or with medication. Registered dietitians are also available to help you make dietary changes that work best for you.

Loyola gastroenterologists also work with you to make lifestyle changes, such as losing weight and quitting smoking. These changes can reduce GERD and improve your overall health.

To make an appointment, call 888-584-7888 or self-schedule an appointment online.

Olufemi Kassim, MD, is a gastroenterologist at Loyola Medicine. Her clinical focus is functional gastrointestinal disorders, including irritable bowel syndrome (IBS) and functional dyspepsia. Her research interests include fecal microbiota transplantation in the setting of IBS, and health disparities in colorectal cancer screening.

Dr. Kassim earned her medical degree at Vanderbilt University School of Medicine. She completed her residency and fellowship at the University of Chicago Medical Center and is board certified in gastroenterology and internal medicine.

Book an appointment today to see Dr. Kassim or another Loyola specialist by self-scheduling an in-person or virtual appointment using myLoyola.