Acid Reflux

ACID REFLUX
What is acid reflux?
Acid reflux occurs when acidic stomach juices back up from the stomach into the esophagus. This acid sometimes
spills into the larynx. There are two different kinds of acid reflux: gastroesophageal reflux (GERD) and
laryngopharyngeal reflux (LPR). A person can have one or both kinds of reflux.
GERD occurs when stomach acid flows up from the stomach into the esophagus. It usually occurs at night when
people are laying down. Symptoms may include: heartburn, belching, regurgitation of stomach contents and
swallowing difficulties.
LPR occurs when stomach acid travels up through the esophagus and spills into the larynx or pharynx (voice box).
It can occur during the day or night. The acid irritates the vocal folds and surrounding tissues. As the acid moves
quickly up through the esophagus into the larynx, patients with LPR often do not experience heartburn.
Symptoms may include: hoarseness, excessive mucus (throat clearing), post-nasal drip, coughing, throat soreness or
burning, choking episodes (can wake person up out of a sound sleep), difficulty swallowing or feeling of a lump in
the throat.
How is acid reflux treated?
Reflux can be treated through dietary and lifestyle modifications, medications—usually proton pump inhibitors
(PPIs), and in some cases surgery. Certain foods are more likely to cause acid reflux. By removing or limiting these
foods from your diet, you can reduce incidences of acid reflux.
Lifestyle modifications: Do not lie down or exercise directly after eating or wear clothing that is tight around the
waist. Eat 3-4 small meals a day instead of 2-3 large ones. If you are overweight, try to lose weight. Tobacco can
cause reflux, so reducing or stopping smoking can be helpful. Do not eat anything 2-3 hours before going to bed.
If reflux is occurring at night, elevate the head of your bed 4-6 inches by putting phone books under the front legs
or by buying a wedge pillow. Using 2 or more regular pillows can make reflux worse as it causes the body to curl.
How to take reflux medication: If you are taking one PPI a day, take it in the morning on an empty stomach 30
minutes to an hour before eating breakfast. If you take two PPIs a day, take one in the morning and the other one
on an empty stomach 30 minutes to an hour before dinner.
How long before I see an improvement?
It can take 4-6 weeks for acid burns in the esophagus and larynx to heal, so do not stop medication or
dietary/lifestyle modifications without consulting your doctor. It can take 3-4 months for full resolution.
What problems can acid reflux cause? Long-term reflux in can cause laryngeal ulcers or granulomas, vocal fold
scarring, pneumonia, Barrett’s esophagus, and in some cases esophageal or throat cancer.

Food Group Foods Allowed Foods to Avoid

Dairy Products Skim mild, low-fat buttermilk, low-fat cottage cheese Whole milk, 2% milk, chocolate milk, cream, half and half,
(1% milk fat), and cheeses made with part skim milk. whole milk cheeses, and hot cocoa.
Meats and Baked, boiled, broiled, stewed or roasted: beef, lamb, Fried or fatty meats: pork, bacon, sausage, meat or fish
Protein veal, fish, poultry; dried beans, peas or lentils (if packed in oil, luncheon meats, peanut butter, and
Alternatives tolerated). frankfurters.
Eggs Prepared any way without added fat. Egg whites as Fried eggs.
desired. Limit to one whole egg a day.
Vegetables All prepared without added fat. Avoid vegetables which Avoid tomato sauce
may cause gastrointestinal discomfort.
Fruit Avoid fruits which may cause gastrointestinal Avoid citrus.

discomfort.
Breads Commercial whole grain or enriched bread, French Commercial sweet rolls, donuts, croissants, pastries.
bread, hamburger buns, hard or plain rolls, saltines,
Breads graham crackers, melba toast, English muffins and

(continued) bagels. Homemade biscuits, muffins, waffles and
pancakes.
Cereals All cereals, hot or cold. None.
Potatoes and Potatoes, rice, noodles, spaghetti and macaroni. Fried potatoes or rice. Anything prepared with cheese or
Substitutes white sauces.
Fats Butter, margarine, vegetable oils, mayonnaise, brown Lard, bacon drippings, salt pork, meat drippings, regular
gravy and reduced calorie/mildly seasoned salad gravies and salad dressing.
dressing.
Beverages Water, flavored water, decaffeinated coffee or tea and Caffeinated coffee or tea, citrus juice (orange, grapefruit,
herbal tea. lemonade, cranberry), caffeinated beverages, milkshakes,
carbonated beverages and alcohol.
Soups Consommé, fat-free broth, bouillon, Commercial cream soups, those made with whole milk,
packaged/dehydrated soup and soups made with skim cream or added fat.
milk.
Desserts/ Fruit, gelatin, fruit whips prepared with skim milk, Ice cream, commercial pies, cakes, cookies and puddings
sherbet, fruit ices, meringues, angel food cake, jelly, jam, made with whole milk. Any dessert containing chocolate,
Sweets
preserves, sugar, syrup, and honey. nuts, cream, coconut or whole milk.
Seasonings and Mild seasonings. Hard glycerine based candies. Hot or spicy seasonings. Cough drops that contain
cough drops menthol or are mint/peppermint flavor.

Food Group Foods Allowed Foods to Avoid
Dairy Skim mild, low-fat buttermilk, low-fat Whole milk, 2% milk, chocolate milk,
Products cottage cheese (1% milk fat), and cheeses cream, half and half, whole milk cheeses,
made with part skim milk. and hot cocoa.
Meats and Baked, boiled, broiled, stewed or roasted: Fried or fatty meats: pork, bacon, sausage,
Protein beef, lamb, veal, fish, poultry; dried beans, meat or fish packed in oil, luncheon meats,
Alternatives peas or lentils (if tolerated). peanut butter, and frankfurters.
Eggs Prepared any way without added fat. Egg Fried eggs.
whites as desired. Limit to one whole egg
a day.
Vegetables All prepared without added fat. Avoid Avoid tomato sauce
vegetables which may cause
gastrointestinal discomfort.
Fruit Avoid fruits which may cause Avoid citrus.
gastrointestinal discomfort.
Breads Commercial whole grain or enriched Commercial sweet rolls, donuts, croissants,
bread, French bread, hamburger buns, pastries.
hard or plain rolls, saltines, graham
crackers, melba toast, English muffins and
bagels. Homemade biscuits, muffins,
waffles and pancakes.
Cereals All cereals, hot or cold. None.

Potatoes and Potatoes, rice, noodles, spaghetti and Fried potatoes or rice. Anything prepared
Substitutes macaroni. with cheese or white sauces.
Fats Butter, margarine, vegetable oils, Lard, bacon drippings, salt pork, meat
mayonnaise, brown gravy and reduced drippings, regular gravies and salad dressing.
calorie/mildly seasoned salad dressing.
Beverages Water, flavored water, decaffeinated Caffeinated coffee or tea, citrus juice
coffee or tea and herbal tea. (orange, grapefruit, lemonade, cranberry),
caffeinated beverages, milkshakes,
carbonated beverages and alcohol.
Soups Consommé, fat-free broth, bouillon, Commercial cream soups, those made with
packaged/dehydrated soup and soups whole milk, cream or added fat.
made with skim milk.
Desserts/ Fruit, gelatin, fruit whips prepared with Ice cream, commercial pies, cakes, cookies
Sweets skim milk, sherbet, fruit ices, meringues, and puddings made with whole milk. Any
angel food cake, jelly, jam, preserves, dessert containing chocolate, nuts, cream,
sugar, syrup, and honey. coconut or whole milk.
Seasonings Mild seasonings. Hot or spicy seasonings.
and cough Hard candies. Cough drops that contain menthol or are
drops mint/peppermint flavor.

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Food Group Foods Allowed Foods to Avoid

Fruit Avoid fruits which may cause gastrointestinal Avoid citrus.

Breads graham crackers, melba toast, English muffins and

Cereals All cereals, hot or cold. None.

Cereals All cereals, hot or cold. None.

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