The biggest things to avoid with acid reflux fall into two categories: foods and drinks that relax the muscular valve between your stomach and esophagus, and habits that increase pressure on your stomach. Addressing both can significantly reduce how often you experience heartburn and how severe it feels.
Foods That Trigger Reflux
Certain foods cause the valve at the top of your stomach (the lower esophageal sphincter) to relax when it shouldn’t, or they slow digestion so food sits in your stomach longer. Both make it easier for acid to wash back up into your esophagus. The most common culprits, per Johns Hopkins Medicine, are foods high in fat, salt, or spice:
- Fried food and fast food
- Pizza
- Fatty meats like bacon and sausage
- Cheese
- Potato chips and processed snacks
- Chili powder, cayenne, and black or white pepper
Beyond the high-fat and spicy category, several other foods relax that valve or directly irritate the esophageal lining: tomato-based sauces, citrus fruits, chocolate, peppermint, and carbonated beverages. These are worth paying attention to individually, because triggers vary from person to person. You may tolerate citrus just fine but find that chocolate sets you off every time.
It’s worth noting that the American College of Gastroenterology describes the evidence behind blanket food elimination as “limited and variable.” Their recommendation is to identify and avoid your personal trigger foods rather than cutting out every item on a generic list. A good approach is to remove the most common offenders for a couple of weeks, then reintroduce them one at a time to see which ones actually bother you.
Drinks That Make It Worse
Coffee, tea, and soda all increase reflux risk, and the relationship is dose-dependent. A large study from Massachusetts General Hospital found that people who drank six servings of coffee daily had a 36% greater risk of reflux symptoms compared to non-drinkers. Six daily servings of tea raised the risk by 26%, and six sodas by 29%.
The surprising finding: switching to decaf doesn’t necessarily help. The risk was similar for caffeinated and decaffeinated coffee and soda. Decaffeinated tea was actually associated with a higher risk than caffeinated tea. This suggests something beyond caffeine is driving the problem, possibly the acidity of these beverages or other compounds that relax the esophageal valve.
Alcohol is another well-established trigger. It both relaxes the valve and can directly irritate the esophageal lining. If you’re not ready to cut it out entirely, drinking less, choosing lower-alcohol options, and not drinking close to bedtime can all help reduce symptoms.
Eating Habits That Increase Pressure
What you eat matters, but so does how and when. Large meals fill the stomach and push its contents upward toward the esophagus. The American Gastroenterological Association recommends eating smaller, more frequent meals to reduce the digestive load and prevent overfilling.
Timing matters just as much. You should stop eating at least three hours before lying down. When you’re upright, gravity helps keep stomach acid where it belongs. Lie down with a full stomach and you remove that advantage entirely. Late-night snacking is one of the most common and most fixable causes of nighttime reflux.
Eating quickly is another overlooked habit. When you eat fast, you tend to swallow more air and overfill your stomach before your body registers fullness. Slowing down gives your digestive system time to keep pace.
Sleep Positions That Promote Reflux
Sleeping flat on your back or right side allows acid to pool in the esophagus longer. A study of 57 people with chronic heartburn found that while the number of reflux episodes was similar regardless of position, acid cleared from the esophagus much faster when participants slept on their left side compared to their back or right side. This likely comes down to anatomy: the stomach curves in a way that keeps acid pooled away from the valve when you’re on your left.
Elevating the head of your bed also helps. A wedge pillow that raises your upper body (not just your head) uses gravity to keep acid down. Stacking regular pillows doesn’t work as well because it bends you at the waist rather than creating a gradual incline.
Exercise That Worsens Symptoms
Physical activity is generally good for reflux because it helps with weight management, but certain types of exercise increase abdominal pressure and push stomach contents upward. The main ones to be cautious with are stomach crunches, abdominal presses, heavy weightlifting, running, sprinting, cycling, and gymnastics.
Any exercise that requires you to lie flat also makes reflux more likely. If you want to stay active without triggering symptoms, walking, light hiking, swimming, and low-impact activities tend to be better tolerated. Timing helps here too: exercising on a full stomach is a reliable way to provoke reflux, so wait at least an hour or two after eating before working out.
Medications That Can Cause or Worsen Reflux
Some medications irritate the esophageal lining directly, while others relax the valve or increase acid production. If you take any of these regularly and have reflux symptoms, it’s worth discussing alternatives with your prescriber.
Medications that can directly irritate the esophagus include common pain relievers like ibuprofen and aspirin, certain antibiotics, iron supplements, and potassium supplements. This type of irritation, sometimes called pill esophagitis, is more likely when pills are swallowed with too little water or taken right before lying down. Drinking a full glass of water and staying upright for at least 15 to 30 minutes after taking these can reduce the risk.
A separate group of medications worsens reflux by relaxing the esophageal valve. This includes certain blood pressure medications (calcium channel blockers, nitrates), some antidepressants, sedatives like benzodiazepines, opioid painkillers, and progesterone. These don’t irritate the esophagus themselves but make it easier for stomach acid to escape upward.
Other Habits Worth Changing
Carrying excess weight, particularly around the midsection, increases abdominal pressure and is one of the strongest risk factors for persistent reflux. Even modest weight loss can improve symptoms noticeably. Tobacco use also relaxes the esophageal valve and is consistently linked to worsening reflux.
Tight clothing around the waist, including belts, shapewear, and high-waisted pants that compress the abdomen, can physically squeeze stomach contents upward. If you notice symptoms are worse when wearing certain outfits, that’s not a coincidence. Looser clothing around meals and in the evening is a simple change that can make a real difference.