What fruits make reflux worse?

Gastroesophageal reflux disease (GERD) is a common condition where stomach acid frequently flows back up into the esophagus. This is also called acid reflux. The reflux of stomach acid can cause discomfort, inflammation, and damage to the lining of the esophagus over time. While GERD affects people differently, certain foods and drinks are more likely to trigger symptoms like heartburn, regurgitation, and nausea. Understanding which foods tend to aggravate reflux can help prevent flare-ups.

Acidic Fruits

Fruits that are highly acidic are more likely to cause reflux symptoms in people with GERD. Acidic foods lower the sphincter pressure at the bottom of the esophagus, making it easier for stomach contents to flow upwards. They also contain acids that can irritate the esophageal lining. Here are some examples of acidic fruits to watch out for:

• Citrus fruits like oranges, grapefruit, lemons, limes
• Pineapples
• Tomatoes
• Strawberries

While healthy in moderation, it’s best to avoid citrus fruits if you have frequent reflux. Their high acid content can aggravate inflammation. Pineapples are also quite acidic and contain bromelain, an enzyme that may further promote reflux. Tomatoes are commonly thought to worsen reflux despite their many health benefits. If you find raw tomatoes bother your stomach, try cooking them first which can make them easier to digest.

Dried Fruits

Dried fruits like raisins, apricots, dates, and prunes are concentrated sources of natural sugar. Their high sugar and low water content means they take longer to digest, and may ferment in the stomach leading to gas, bloating, and increased acid production. This creates an environment perfect for reflux. Dried fruits are best avoided if you frequently experience reflux or signs of dyspepsia after eating them.

Fruits High in FODMAPs

FODMAPs (Fermentable Oligo-, Di-, Mono-saccharides and Polyols) refer to a group of carbs that may not be properly absorbed in the small intestine of some people. When FODMAPs reach the large intestine, the bacteria that live there ferment them, releasing gas that can aggravate reflux. Fruits high in FODMAPs include:

• Apples
• Pears
• Watermelon
• Mangoes
• Cherries
• Nectarines

If you have GERD, limit high-FODMAP fruits and see if that helps improve your symptoms. You may be able to tolerate small servings of these fruits if you don’t have an underlying digestive issue.

Bananas

Bananas are often recommended as a food to help control reflux symptoms. But some people report bananas make their reflux worse. This may be due to:

• Ripeness – overripe bananas contain more sugars and fewer starch-digesting enzymes, increasing fermentation.
• FODMAPs – bananas contain small amounts of FODMAPs.
• Histamine intolerance – ripe bananas contain histamine, which some people are sensitive to.

If bananas trigger your reflux, try limiting them or choosing greener, less ripe bananas which may be better tolerated.

What About Reflux-Friendly Fruits?

While fruits often feature on lists of foods to avoid with GERD, not all fruits have to be off-limits if you have reflux. Some fruits are better tolerated and less likely to trigger symptoms. Good fruits to try include:

• Melons – honeydew, cantaloupe
• Berries – blueberries, raspberries, blackberries, strawberries
• Kiwis
• Bananas – green, unripe
• Avocados
• Coconuts
• Olives

Melons like honeydew and cantaloupe have a high water content which can help dilute stomach acid. Berries are rich in antioxidants and tend to be relatively low acid. Just take strawberries in moderation. Kiwis and olives are low acid options as well. Unripe green bananas and avocados are starchier, making them easier on the stomach. Coconut products may also be well tolerated.

Tips for Managing Reflux with Fruit

If you enjoy fruit but need to manage reflux, here are some tips that may help:

• Stick to low acid fruits like melons, bananas, berries
• Limit portion sizes of dried, acidic, or high-FODMAP fruits
• Eat fruits separately from other foods
• Avoid lying down or bending over after eating fruit
• Stay upright for 2-3 hours after eating to avoid reflux

Pay attention to your own tolerance. Reflux triggers can vary by individual. Keeping a food diary can help identify your personal trigger fruits to avoid. With care in choosing fruits and managing portions, many people with GERD can still enjoy fruit without issue.

The Bottom Line

Fruits most likely to aggravate reflux include citrus fruits, tomatoes, pineapple, dried fruits, and fruits high in FODMAPs. Bananas may also trigger symptoms in some cases. The safest fruits for GERD are melons, berries, kiwis, avocados, green bananas, and coconut products. Enjoy reflux-friendly fruits in moderation alongside other dietary and lifestyle changes to manage your symptoms.