What to eat when you have chronic heartburn

Avoid spicy foods, and keep some dazzle in your diet with low-fat sauces and fresh herbs.

chronic heartburn foods
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The fiery feeling of heartburn is the last way you want to remember a great meal. But when your doctor says you have chronic heartburn caused by gastroesophageal reflux disease (see "What is GERD?"), you may worry that a bland and disappointing menu is in your future. "That may not be true," says Dr. Kyle Staller, a gastroenterologist at Harvard-affiliated Massachusetts General Hospital. "The foods that trigger heartburn are different for everyone." He suggests keeping a journal to determine which foods cause symptoms.

Common culprits

Some foods and ingredients may intensify heartburn, such as spicy foods, citrus, tomato sauces, and vinegar.

Fatty and fried foods linger longer in the stomach. That may increase stomach pressure and force open the muscles that keep stomach acid out of the esophagus.

Other common heartburn triggers include chocolate, caffeine, onions, peppermint, carbonated drinks, and alcohol.

What's for dinner?

You can still enjoy lean meats, fish, poultry, vegetables, legumes, fruits, and whole grains. The trick is making them flavorful.

If spices bother you, try using only small amounts, and be mindful of blends that contain cayenne or chili powder. Or use fresh herbs instead. "Fresh herbs are less concentrated and may be less irritating," says Emily Gelsomin, a registered dietitian with Harvard-affiliated Massachusetts General Hospital. She recommends using fresh parsley, oregano, and basil.

Another tip: roast your food. "This makes vegetables sweeter. The natural sugars come out and caramelize," says Gelsomin. Carrots, sweet potatoes, cauliflower, broccoli, squash, and Brussels sprouts work well. Broiling, sautéing, or grilling food also brings out intense flavor.

Eat vegetables raw. "Tomato sauce may bother you, but a fresh tomato may not," says Gelsomin.

Use sauces, but cut the fat. Blend low-fat yogurt with cucumber and basil, or sauté mushrooms in a little olive oil. "Or make a pesto. Blend basil, pine nuts, Parmesan cheese, and a dash of olive oil or water. Use a tablespoon of it on food," suggests Gelsomin.

Breakfast and lunch

Avoid fatty meats like ham or bacon. "Oatmeal is a great option. Throw in bananas, raisins, and maybe a hint of cinnamon," suggests Gelsomin. Other possibilities: low-fat yogurt with fruit or nuts, any kind of eggs, whole-grain toast, or a side of chilled whole grains like quinoa mixed with fruit or topped with a dollop of yogurt.

For lunch, think salads with protein such as chicken or beans. "But maybe use a yogurt-based dressing, to avoid vinegar and citrus," says Gelsomin.

What is GERD?

One of the most common causes of heartburn is called gastroesophageal reflux disease (GERD). It occurs when stomach acid backs up into the esophagus, the tube connecting the mouth and stomach, usually because the ringlike muscles that prevent backflow stop working properly. In addition to heartburn, GERD may cause nausea, a sour taste in the mouth, difficulty swallowing, a sore throat, coughing, and tightness in the chest.

Medications to treat GERD reduce stomach acid. Antacid pills and liquids have been around the longest. More recently, proton-pump inhibitors (PPIs), such as omeprazole (Prilosec) or lansoprazole (Prevacid), and H2 blockers, such as cimetidine (Tagamet) or ranitidine (Zantac), have become available, many over the counter. Long-term use of PPIs is linked to a risk of bone fractures, low vitamin B12, and pneumonia. Some recent studies have suggested that long-term PPI use may increase the risk of dementia, heart attack, and chronic kidney disease, although this has not been proved.

Don't fool yourself into thinking medication allows you to frequently eat foods that once caused heartburn. "If medication controls your symptoms, then it's probably okay to have a 'trigger' food occasionally. But if you do that too often, the heartburn will return," says Dr. Kyle Staller, a gastroenterologist at Harvard-affiliated Massachusetts General Hospital. You may not have to take a medication to control GERD symptoms. Eating smaller meals and avoiding food triggers can help (see accompanying article). "Weight loss and quitting smoking will help most," says Dr. Staller.