Managing gastroesophageal reflux disease or GORD

Gastroesophageal reflux disease (GORD) is a condition that affects your food pipe (oesophagus). If you have GORD, you may get acid reflux (when stomach acid flows up into the throat and mouth) and heartburn after meals.

This section suggests different ways to manage GORD.

Keeping to a healthy weight

Being overweight can cause GORD or make your symptoms worse. For this reason, it is important to make sure that your weight is within a healthy range.

The body mass index (BMI) is used to check whether you are a healthy weight for your height. You can calculate your BMI yourself or your dietitian can help you to do this.

Calculating your BMI

To calculate your BMI, you need to:

• divide your weight in kilograms (kg) by your height in metres (m)
• then divide the answer by your height again to get your BMI

For example:

• If you weigh 70kg and you are 1.75m tall, divide 70 by 1.75. The answer is 40. 
• Next, divide 40 by 1.75. The answer is 22.9.
• Your BMI is 22.9.

If your BMI is between 18.5 and 24.9, your weight is thought to be within a healthy range. However, if you have a BMI higher than 25, it is best to lose weight. You need to aim to lose 5 to 10% of your body weight.

Making changes to your lifestyle

Simple lifestyle changes can help to improve your symptoms and make you feel much better.

Stopping smoking

If you want to stop smoking, you can:

• speak to your nurse for guidance and support
• call our stop smoking service on 020 7188 0995
• call the free NHS smoking helpline (the Smokefree National Helpline) on 0300 123 1044

Making changes to your diet

If you have GORD, there are no specific diets to follow or foods to avoid. It is important to have a varied and balanced diet. However, some people with GORD find that certain foods and drinks trigger their symptoms.

The following section lists foods and drinks that are common triggers for GORD symptoms. If a particular food or drink causes a problem for you, it is best to avoid this.

If you stop having any drinks, remember to replace them with others to make sure that you do not get dehydrated. Aim to have about 2 litres of fluids every day, such as water, herbal or fruit teas, diluted fruit juices or sugar-free squash.

Highly spiced foods

Highly spiced foods, such as onion, garlic and chilli, may trigger GORD symptoms. If these foods affect you, try to:

• leave them out of your diet
• only use small amounts of herbs and dried spices to flavour your meals

Chocolate

Chocolate is sometimes associated with GORD symptoms.

If chocolate triggers symptoms for you, it is worth reducing how much you eat or avoiding it. You could try boiled sweets, gums or mints instead.

Citrus fruits

GORD symptoms can sometimes be triggered by citrus fruits, such as:

• lemons
• oranges
• satsumas
• clementines 
• grapefruits

If you are affected, avoid citrus fruits and have other fruits instead like apples, pears, bananas, melons, plums, apricots or nectarines.

You need to aim to have 5 portions of fruit and vegetables a day as part of your diet.

Tea and coffee

Tea and coffee have been found to trigger GORD symptoms in some people. If you drink a lot of tea and coffee, try to reduce the amount gradually over a few weeks.

If you suddenly stop drinking tea and coffee, you may get symptoms of caffeine withdrawal. These can include:

• headaches
• feeling sick (nausea)
• tiredness

Any withdrawal symptoms should resolve with time. You can take your usual painkillers if you get bad headaches.

Peppermint tea

Sometimes, peppermint tea can make GORD symptoms worse. It often has a relaxing effect on the lower oesophageal sphincter muscle. This can increase the flow of stomach acid up into the throat and mouth.

If you drink peppermint tea, try to reduce the amount and see whether your GORD symptoms improve.

Alcohol

Alcohol is often associated with GORD. It is best to reduce how much alcohol you drink if this contributes to your symptoms.

Fizzy drinks

Fizzy (carbonated) drinks contain gas, which sometimes causes belching or burping. As a result, acid from the stomach can travel into the food pipe and trigger GORD symptoms.

Amount of food

Large amounts of food or drink can trigger GORD symptoms. Try to eat small meals with regular snacks instead of larger meals. This might mean having 3 small meals and 3 snacks a day to meet your nutritional requirements.

Fibre

Increasing fibre in the diet has been shown to reduce GORD symptoms. Aim for 30g of fibre every day. It is best to choose foods rich in fibre from a variety of sources, including:

• wholegrains
• fruit and vegetables
• nuts and seeds
• beans
• pulses

Avoiding constipation

It is important that you try to avoid being constipated. Constipation can increase the pressure in your tummy (abdomen), which can in turn cause acid reflux symptoms.

To avoid constipation, you need to:

• include plenty of fibre-rich foods in your diet
• aim to drink about 2 litres of fluids a day

If you regularly have constipation, please ask your dietitian for advice.