Ever wonder why some “reflux trigger” foods affect you while others don’t? I used to think I just had a bad reflux trigger list, but after checking multiple medical sources, I noticed something odd—the lists for what foods to avoid with acid reflux don’t match!
Sure, there were the usual suspects like onions, tomatoes, and chocolate, but beyond that, the recommendations varied. So, being a bit of a nerd, I decided to compile multiple lists to find the common triggers. Big mistake. Instead of clarity, I ended up with a chaotic list of hundreds of foods, where the repeats felt more like a coincidence than a pattern. So what’s really going on?
Turns out, most reflux trigger lists aren’t based on large-scale diagnostic studies that link food reactions to specific underlying conditions. Instead, they come from a mix of clinical observations, small studies, and a lot of anecdotal evidence. Some foods make the list because they’re known to relax the lower esophageal sphincter (LES) or increase stomach acid, while others show up simply because enough people reported issues with them.
But here’s the real problem: reflux isn’t one-size-fits-all. What triggers symptoms for one person might be totally fine for someone else. And without a reliable way to determine why certain foods affect some people but not others, these lists end up reflecting the experiences of the specific people included in the studies—rather than a universal truth.
I know we just met but I care about you too much to just throw another list at you. I want to help you understand what’s actually happening in your body when it comes to certain foods—so you can pinpoint your own unique triggers:
- First, we’ll break things down into trigger categories and how each affects your reflux over time.
- Then, we’ll dig deeper into the foods themselves to identify the specific attributes that make reflux worse.
This way, when you recognize a trigger, you’ll have a better sense of whether other foods with similar properties might also be a problem for you.
Table of Contents
Why Reflux Triggers Are Unique
I’ve spent countless hours digging through studies published by the National Institutes of Health—riveting reads with titles like “Elimination of Dietary Triggers Is Successful in Treating Symptoms of Gastroesophageal Reflux Disease.” But I love it because it has opened my eyes to things I never understood during my 15 years with reflux.
Sorting through it all isn’t always straightforward, as the studies cover a wide range of perspectives from mainstream medical to naturalistic, but it’s given me a deeper understanding of reflux triggers—and a much clearer picture of what actually works. Having this clarity was instrumental in my own reflux journey. For me, understanding what’s going on is the difference between reducing symptoms to being done with them and I hope the same for you.
Three Little Known Categories of Reflux Triggers
Over time, I’ve come to see reflux triggers in three main categories— they’re kind of like those pimples from your childhood that pop up if you were prone to breakouts. The first is what I call global triggers—these are the universal causes just like the habits that would make anyone break out (for example, always touching your face with dirty hands). In reflux terms, these are the small handful of items you’ll see on just about every trigger list.
The second are deep triggers—like never washing your face or consistently eating junk food, which sets the stage for pimples to keep forming. In reflux terms, these are foods that increasingly knock your digestion off balance and lead to bigger flare-ups down the road.
Finally, there are shallow triggers—akin to that one random pimple you notice after indulging in something you know you shouldn’t have (and then feeling frustrated when your friend does the same thing and gets no pimple at all). In reflux terms, some of these will show up on the standard trigger lists and can cause an immediate reaction, even though it’s not always clear why they affect you and not someone else.
With that said, let’s take these one by one and then we’ll look at how some of the foods in the shallow trigger list trigger your reflux so you can narrow down what’s causing your symptoms. I think this approach will help you spot—and hopefully avoid—the foods most likely to cause trouble.
This is particularly important as the below study highlights the extreme variability of trigger foods:
“Several specific foods are known to precipitate gastroesophageal reflux disease (GERD) symptoms and GERD patients are usually advised to avoid such foods. Several studies have reported that high-fat foods, spicy foods, chocolate, mint, and citrus fruits are closely related to GERD symptoms, [but] the daily consumed foods are quite variable according to race, geographic specificity, diet habit, and culture.” – Choe & Collaborators
Global Reflux Triggers
So in our earlier example, the global triggers are the things that could cause anyone to break out—they’re not unique to any one person. No matter how clear your complexion is, if you’re constantly wiping dirty hands across it, you’ll eventually end up with a pimple.
The same goes for certain foods and drinks. They do tend to be on most trigger lists, but you may now know how they differ from other items in the list. To be clear, global reflux triggers don’t necessarily deepen the root causes of reflux; most of the time, they cause a short-term spike in symptoms that can last anywhere from a few hours to a few days.
Each of these triggers affects the Lower Esophageal Sphincter (LES)—the muscle between your stomach and your throat that controls the flow of food. Sometimes they cause the LES to relax, lowering its closing pressure. Other times, they create excess gas in your stomach, which puts upward pressure on the LES. In either case this allows stomach acid or gases to more easily travel upward.
Global triggers include caffeine (like coffee, tea, energy drinks), alcohol (wine, beer, liquors), chocolate, carbonated beverages (sodas, sparkling water), and mints. I didn’t realize that when my reflux was at its worst, one of my go-tos at the office—a mint or green tea—was actually making things worse.
“Diet plays a significant role in gastrointestinal health, with certain foods worsening GERD symptoms. High-fat meals, alcohol, chocolate, and carbonated beverages can reduce esophageal sphincter pressure and increase acid exposure.” –Herdiana & Collaborators
Sure, it helped “bury the acid” for a bit and freshened my breath, but I kept going back for more because my symptoms kept getting worse. I often thought, “this is a particularly bad episode,” not realizing I was making it worse.
Turns out mint and caffeine both relax the LES, and on top of that, I was chugging large amounts of water with each cup of tea. Normally water is fantastic, but having too much immediately after eating can dilute stomach acid and deepen indigestion—a double whammy.
A fourth addition to our list—besides the water, caffeine, and mint—is heavy or high-fat meals. Because reflux is basically a digestive issue, large or fatty meals push your digestion to its limits and pile extra stress on the LES, your last line of defense against acid backing up.
If your reflux keeps flaring, think about cutting back or temporarily avoiding these major offenders—like caffeine, alcohol, mints, carbonated drinks, and those heavy meals. Treat it like pressing the pause button on stuff that’s making you miserable so you can finally get a stable baseline. Then, once you’re no longer battling constant flare-ups, you’ll have an easier time tackling the deeper issues that cause reflux in the first place.
Oh, and as your caring friend I should tell you to continue drinking lots of water. Staying hydrated is super important. Just give yourself a couple hours to digest before you start chugging to avoid diluting your digestive process!
Deep Reflux Triggers
Remember our pimple analogy? Deep triggers are like never washing your face or consistently eating junk food—they set the stage for repeat breakouts. In reflux terms, these are the foods and habits that quietly undermine your digestive environment over time, making reflux more frequent and more intense. They’re the kinds of things that can gradually take you from occasional flare-ups in the early stages of reflux to the point where you’re actively seeking help. They might not spark an immediate flare-up, but they work behind the scenes to deepen the underlying causes of reflux. Then, when you do eat something even slightly triggering, your reflux is primed to flare up worse than ever.
One of the biggest factors behind these deeper triggers is something called dysbiosis—a fancy word for when the beneficial bacteria (probiotics) in your digestive tract get overshadowed by the harmful ones. This sets off a chain reaction: poor digestion, nutrient deficiencies, and low-level inflammation that all make reflux more likely.
Below is a list of deep triggers—things that, over time, quietly tip the scales against healthy digestion. You won’t find many of these on any trigger list!
- Refined Sugars and Sweets (table sugar, candy, sugary cereals, pastries, desserts)
- Artificial Sweeteners (aspartame, sucralose, saccharin, etc.)
- Processed or High-Fructose Corn Syrup Foods (commercial sauces, bottled dressings, many store-bought baked goods)
- Fried and Fast Foods (fried chicken, french fries, onion rings)
- Heavily Processed Snacks (chips, most packaged foods)
- Vegetable Oils (corn oil, soybean oil, sunflower oil)
- Trans Fats and Hydrogenated Oils (margarine, shortening, certain baked goods)
- Industrial Seed Oils (cottonseed, canola, grapeseed oil)
- Highly Preserved Meats (deli meats, sausages packed with additives)
- Sugary Drinks (sodas, sweetened teas, energy drinks)
- Excess Alcohol or Overly Sweet Alcoholic Beverages
- Refined White Flours and Starches (white breads, traditional pasta, crackers)
- Emulsifiers in Condiments (like polysorbate 80, carrageenan, monoglycerides, and diglycerides found in many dressings and sauces)
The thing is, excess sugar and processed (fake) foods feed harmful bacteria and promote chronic inflammation, setting the stage for a weakened, overtaxed digestive system. Over time, this imbalance not only erodes gut health but also makes you more prone to more severe flare-ups with trigger and non-trigger foods alike.
When your gut is healthy, it is far more capable of handling these franken foods than when it is in a compromised state. As with the global triggers, it’s best to avoid these entirely and stick with “real foods” especially while working towards healing. Try replacing them with high quantity of plant based foods, high in fiber, that feed the beneficial probiotic bacteria that promote healthy digestion.
Shallow Reflux Triggers
Think of shallow triggers as that one random pimple that pops up right in the middle of your forehead because you binged on that chocolate a couple days ago. It’s annoying because your friend did the exact same thing and got away with a clear face. Unlike global or deep triggers, shallow triggers can spark a near-immediate (0–2 hours) flare-up, often because your system is already primed for irritation. Here are the three main factors at play:
Acidity
Highly acidic foods (pH < 5) can easily inflame an already sensitive or irritated lower esophageal sphincter. Think citrus fruits (oranges, lemons, grapefruits), tomato sauces, coffee, alcohol, soda, vinegar-based condiments, and sour candies. If you notice these set you off, try aiming for foods in the more neutral pH range (around 5–7) instead.
Sometimes, even foods that aren’t inherently acidic can be problematic if they come in a can or a box. By law, canned foods must elevate their acidity to ward off harmful bacteria—the same defense your stomach uses. Kinda makes you wonder why they prescribe acid-blocking drugs… but I can tell you more about that in another article.
The same goes for many fermented foods, like kimchi, kombucha, or sauerkraut. While they’re fantastic for gut health due to their beneficial bacteria, the fermentation process makes them highly acidic. If you’re already dealing with a flare-up, it might be best to avoid them until your throat has time to settle down. In fact, you might check out my Best Alkaline Foods article.
Also, I should clarify that these foods aren’t making your stomach more acidic. Aside from carbonated beverages, they’re not strong enough to significantly alter your stomach’s pH. The issue is the throat irritation we’re trying to avoid. When you already have reflux inflaming your throat, piling on more acidity can make things worse.
Another point of clarification with all three shallow-trigger categories is that they’re by no means universal. Acidity is a common culprit for reflux sufferers because the throat gets extra exposure to acid from reflux events. Still, even for those with reflux, there can be stretches when the throat isn’t quite so sensitive. That’s why it’s crucial to test this out yourself and pay close attention to how you feel.
Personally, I’ve had times when a single reflux event irritated my throat, leaving me more prone to reflux in the days that followed—almost like a chain reaction until I could break the cycle. During those flare-ups, avoiding additional acidity made a noticeable difference in my recovery time.
Histamines
Before diving into this next category, let me briefly explain what histamines are: they’re chemicals your body releases as part of your immune response. They also play a role in digestion by helping to produce stomach acid. Normally, your body breaks down histamines, but if too much builds up—whether from food, enzyme issues, or gut imbalances—it can slow digestion and leave food undigested, making reflux worse.
Some foods naturally contain more histamines than others. Aged cheeses, cured meats, and fermented products (like sauerkraut, kombucha, or wine) to name a few. Other sources include vinegar-based dressings, tomatoes, spinach, shellfish, and even certain nuts. Leftovers can also be a challenge for some since histamine levels rise the longer food sits.
If your body doesn’t clear out histamines well, they can lead to extra inflammation and food sitting on the stomach for extended periods—none of which help with reflux. Try looking into the histamine levels of foods you suspect may have triggered you. Keeping a food journal can help you spot patterns.
But just like acidity, histamines may not be an issue for you. Before throwing the baby out with the bathwater, it’s important to test and pay close attention to your body’s signals to determine if histamines are a problem. This is especially important for maintaining dietary diversity, which we’ll explore more shortly.
Fermentable Carbs (FODMAPs)
One could dedicate an entire blog to Fermentable Carbohydrates (FODMAPs), so I won’t go too deep into the details here. The key thing to know is that if you’re sensitive to FODMAPs, the fermentation of certain foods in your gut can lead to increased bloating, gas, and internal pressure on the LES—all of which can worsen reflux. This framework helps explain why foods like garlic, onions, pears, and even certain grains can be problematic for some people but not for others.
If you’ve ever cut out something like onions for a week and noticed fewer flare-ups, that’s likely because you’re pinpointing a FODMAP sensitivity. But, like the other categories, FODMAP elimination isn’t meant to be a permanent strategy. A wide variety of foods is crucial for a healthy gut bacterial balance, so use a FODMAP reduction as a temporary tool to stabilize symptoms. Meanwhile, keep working on those deeper-rooted issues that leave you more vulnerable to reflux.
Wrapping It All Up
As I’ve hopefully impressed on you, reflux triggers come in all shapes and sizes—some are universal troublemakers (global triggers), some quietly break down your defenses from the inside out (deep triggers), and others pop up fast and furious when your system is extra primed for irritation (shallow triggers). Identifying them is rarely straightforward, but it’s a process worth investing in. Remember:
- Global triggers are the usual suspects—caffeine, alcohol, large fatty meals, chocolate, and so on—that create a short-term flare in most people dealing with reflux
- Deep triggers undermine your gut health over time, making your reflux worse in the long run if they aren’t addressed.
- Shallow triggers can cause immediate irritation or discomfort, often linked to factors like acidity, histamines, or fermentable carbs (FODMAPs).
The key is using this deeper insight to discover which foods are triggering you; you can make targeted choices to avoid the foods that are causing flare ups or deepening your condition. Just give yourself some grace with this. Rarely will you get it right on the next meal.
Studies show that 74% of people will continue eating the trigger foods, once identified. Not surprising, that percentage is even higher (82%) in people who have developed erosive esophagitis:
“In total, 74.0% (214/289) of patients still often consumed the triggering foods, even those foods that sometimes and often induced their reflux symptoms, and RE patients had higher percentage than NERD patients (82.1% vs. 66.4%, p = 0.002)”, while there were no significant differences in the percentage of patients who still often ate any type of triggering food between NERD and RE except the staple foods mentioned above.” – Herdiana & Collaborators
In contrast, my hope is that you will pay close attention to your body, keep learning, experimenting, and gently investigating your way toward a better baseline. By focusing on better digestion, a healthier microbiome, you’ll give yourself a stable baseline that you can use to begin working on the deeper underlying issues that cause reflux.
I’ve written a lot on this important subject; to learn more check out my other articles covering reflux vitamin deficiencies.
This content is for informational purposes only and is not medical advice. Consult your physician for personalized care.
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