The typical advice about acidic foods to avoid with GERD goes something like this: “Stay away from lemons, tomatoes, and oranges because they make your stomach more acidic.”
But that can’t be the real issue—your stomach is designed to handle acid levels far stronger than anything you eat. Even when you’re taking acid-blocking medication, the added acidity from food is negligible compared to the baseline strength of your stomach acid.
The real problem begins when that acid escapes. During a reflux episode, stomach acid and digestive enzymes like pepsin travel up into your throat, where they don’t belong. Once that tissue is irritated—or the muscle that keeps acid in your stomach becomes inflamed—even mildly acidic foods can keep the cycle going for days.
The effect of acidic foods depends not just on their pH, but on the condition of your throat when they hit it. Two foods with the same acidity can feel completely different—especially if one also contains other triggers that you may be sensitive to. It’s often the combination of factors that turns an otherwise harmless food into a major reflux trigger.
In this article, we’ll break down the most common types of acidic triggers—starting with the usual suspects and ending with some surprising troublemakers.
Table of Contents
1 Highly Acidic Foods
Here are the usual suspects—foods with a low pH (under 5) that are known to irritate the throat, especially if it’s already inflamed from a recent flare up:
- Citrus fruits (oranges, grapefruits, lemons)
- Tomato products (sauce, paste, ketchup)
- Vinegar and vinegar-based dressings
- Soda and carbonated beverages
- Sour candies and acidic fruit juices
- etc..
These foods don’t increase your stomach acid levels, but once acid has made contact with your throat, they can really intensify symptoms if it’s already inflamed. That’s partly because reflux doesn’t just bring up acid—it also carries digestive enzymes like pepsin, which linger in the throat and can be reactivated by even mildly acidic foods. If you’re dealing with a flare up, these are best avoided entirely until your throat has time to recover.
2 Acidic Fermentable Carbs
Some acidic foods are also high in fermentable carbohydrates (FODMAPs), which for some people, can lead to gas, bloating, and put upward pressure on the LES. That pressure, when added to an LES that already has low closing pressure, increases the chance of acid escaping into your esophagus.
Here are a few examples—remember, a difference of 1 pH represents a 10x change in acidity:
| Food | Acidity (Lower = More Acidic) | FODMAP Content |
|---|---|---|
| 🍎 Pomegranates | 2.9 – 3.2 | Low–Moderate |
| 🍒 Cherries | 3.2 – 4.0 | High |
| 🍎 Apples | 3.3 – 4.0 | High |
| 🍐 Pears | 3.5 – 4.6 | High |
| 🍌 Bananas (ripe) | 4.5 – 5.2 | High |
Even though these are often seen as healthy, their fermentability can make them problematic if that is a trigger for you. If you suspect a FODMAP sensitivity, try tracking them for a couple weeks to see if you notice any patterns.
3 Acidic High Histamine Foods
Histamines are naturally present in many aged, fermented, or processed foods. If your body doesn’t break them down well, they can cause inflammation, slow digestion, and worsen reflux. But histamine isn’t just about how much is in the food—it’s also about how your body reacts to it.
Some foods are high in histamine themselves, while others act as histamine liberators, meaning they trigger your body to release histamine internally—even if the food contains very little on its own. That’s why foods labeled low histamine can still cause problems for sensitive individuals if they’re also liberators.
Here are some examples:
| Food | Acidity (Lower = More Acidic) | Histamine Activity (Level / Liberator) |
|---|---|---|
| 🍋 Lemons | 2.0 – 2.6 | Low / Yes |
| 🍓 Strawberries | 3.0 – 3.9 | Low / Yes |
| 🍊 Oranges | 3.0 – 4.0 | Low / Yes |
| 🍊 Tangerines | 3.5 – 4.2 | Low / Yes |
| 🫒 Green Olives | 3.6 – 4.6 | High / No |
| 🍅 Tomatoes | 4.1 – 4.6 | High / No |
| 🌶️ Chili Peppers | 4.6 – 5.2 | Low / Yes |
To make things worse, many of these are also highly acidic—creating a double hit for your throat and your digestion.
4 The Triple Threats
Some of the most frustrating reflux triggers are the ones that seem healthy on the surface—like fresh fruit. But certain fruits can be deceptively problematic if you’re dealing with acid reflux, histamine sensitivity, or FODMAP intolerance.
Here are example foods that are acidic and high in fermentable carbohydrates and some can even trigger histamine release. If you’re in a flare, these fruits might not feel as good as they look:
| Food | Acidity (Lower = More Acidic) | Histamine Activity | FODMAP Content |
|---|---|---|---|
| 🍑 Plum | 2.8 – 3.5 | Liberator | High |
| 🍊 Grapefruit | 2.9 – 3.8 | Liberator (High) | Moderate |
| 🍑 Prune | 2.9 – 3.9 | Liberator | High |
| 🍑 Apricot | 3.3 – 4.8 | Liberator | High |
During recovery, swapping them for gentler fruits like melons can make a big difference. And it’s not just fruits. Some of the most commonly recommended fermented foods for reflux—like kefir, sauerkraut, or kombucha—can also be triple threats. Some are acidic, high in histamine, and high in FODMAPs, which can make them especially difficult depending on your sensitivities.
For instance, over my 15 years with reflux I became increasingly intolerant to milk based products. But a few weeks into my recovery I tested yogurt and it went down just fine, which was great for me given its probiotic content. So if you’re struggling with these now, it might not be no but not yet. Let’s take a look at how those stack up:
| Food | Acidity (Lower = More Acidic) | Histamine (Level / Liberator) | FODMAP Content |
|---|---|---|---|
| 🧉 Kombucha | 2.5 – 3.5 | High / Yes | High |
| 🥬 Sauerkraut | 3.5 – 4.0 | High / No | High |
| 🥒 Fermented Veg | 4.0 – 4.5 | Low–Moderate / No | Varies by vegetable |
| 🥛 Yogurt (plain) | 4.0 – 4.6 | Low–Moderate / No | Moderate |
| 🥥 Coconut Yogurt | 4.2 – 4.6 | Low / No | Low (if unsweetened) |
| 🥛 Kefir | 4.2 – 4.6 | High / Yes | High |
If you find that you’re struggling with any of these categories it may be worth pausing until you can get back to a healthy state—not because they’re inherently bad, but because their combined effects can prevent you from making steady improvements.
Wrapping It Up
If you’ve been struggling to figure out which acidic foods make your reflux worse, I hope this breakdown gave you some clarity. It’s not just about acidity on paper—it’s about how that food interacts with your current digestive health, your throat, and the deeper root issues that drive reflux in the first place.
Some foods may be clear triggers for you. Others might only cause issues when you’re already inflamed. Remember, you don’t have to cut these foods forever. The goal is to give your body some time to reduce inflammation while you work on a broader plan to address the underlying causes of your reflux.
Don’t worry. You’re not stuck, and you’re definitely not alone. Healing is possible, and I’m here to help you get there. If you need further help on triggers, check out my ten worst foods for reflux article.
This content is for informational purposes only and is not medical advice. Consult your physician for personalized care.
This free site uses affiliate links. If it's helpful, consider purchasing using the product links —I earn a small commission at no extra cost to you.
