I Have Severe Acid Reflux—Should I Eat an Alkaline Diet?

If you suffer from severe acid reflux, finding the right foods to eat can feel overwhelming. Fortunately, adopting a lean, green, clean, and alkaline diet can help manage symptoms, reduce discomfort, and promote healing. In this post, we’ll break down what to eat, what to avoid, and how food choices affect this common health condition.

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Understanding the Severity of Acid Reflux

Acid reflux exists on a spectrum, ranging from mildly annoying to life-disrupting or even life-threatening. Here are a few examples:

• Life-threatening: Recurring pneumonia or severe esophageal damage
• Disabling: Laryngitis for voice professionals like singers or actors
• Disruptive: Persistent coughing, chest discomfort, or trouble swallowing
• Annoying: Occasional heartburn or frequent burping

If your acid reflux is severe or life-altering, you may need a more targeted approach, such as a reflux detox program to help the esophagus heal. For those dealing with mild to moderate symptoms, a few dietary shifts can make a significant difference.

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Acid vs. Alkaline: What’s the Difference?

Understanding the difference between acidic and alkaline foods is key to managing acid reflux. The pH scale measures how acidic or alkaline a substance is, ranging from 0 to 14:

• Acidic: Foods and drinks with a pH below 7 are acidic. Examples include citrus fruits, soda, coffee, and processed foods.
• Neutral: A pH of 7 is considered neutral—neither acidic nor alkaline.
• Alkaline: Foods with a pH above 7 are alkaline. Examples include avocados, olives, and coconut milk. 

While your stomach needs acid to digest food, consuming too many acidic foods can trigger reflux and inflammation. An alkaline diet focuses on foods that help reduce acid exposure, which is especially important for those with severe reflux. By choosing alkaline-rich vegetables, fruits, and whole grains, you also provide your body with the support it needs to heal.

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The Purpose of a Low-Acid Diet

The goal of a low-acid diet is to calm inflammation and protect sensitive tissues in your esophagus, throat, and airway. 

Pepsin, a primary digestive enzyme, plays a key role in acid reflux symptoms. While it normally functions to break down proteins in the stomach, this enzyme can migrate to the esophagus, where it becomes active in the presence of acidic foods or drinks, leading to tissue damage. A low-acid, alkaline-based diet helps deactivate its damaging activity, reduce inflammation, promote healing, and has been shown to help manage reflux. 

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The Best Diet for Acid Reflux: Lean, Green, Clean, and Alkaline

When it comes to managing this health condition, food matters. The goal is to eat foods that support digestion, soothe the esophagus, and prevent triggering reflux episodes.

Here’s what each category means:

• Lean: Focus on low-fat options since fatty foods can weaken the lower esophageal sphincter (LES), allowing stomach acid to escape.
• Clean: Avoid highly processed foods, harmful chemicals, and artificial additives. For example, steer clear of high fructose corn syrup or processed beverages with added ascorbic acid (Vitamin C), which is acidic.
• Green: Prioritize vegetables that are non-acidic and easy on digestion.
• Alkaline: Incorporate foods that help balance your body’s pH and neutralize stomach acid.

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Foods to Eat on an Alkaline Diet for Acid Reflux

Here’s a breakdown of the best foods to include in your reflux diet:

Lean Protein Sources

• Poultry (chicken, turkey)
• Fish (especially baked or grilled)
• Eggs (preferably boiled or poached)

Whole Grains and Carbs

• Oatmeal
• Bread (whole grain, sourdough)
• Bagels
• Rice
• Pasta
• Popcorn (plain, no butter)

Dairy 

• Milk

Vegetables

• Leafy greens (spinach, kale, chard)
• Broccoli & cauliflower
• Zucchini
• Carrots
• String beans
• Mushrooms
• Potatoes (sweet or white)
• Beets
• Fennel
• Ginger (natural anti-inflammatory)

Fruits:

• Avocados
• Melons (cantaloupe, honeydew)
• Bananas
• Red apples
• Pears
• Plums
• Figs & dates

Other Soothing Options

• Honey 

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Foods to Avoid with Severe Acid Reflux

Certain foods can worsen acid reflux by relaxing the LES, allowing gastric acids and digestive enzymes to flow back into the esophagus. These foods can also reactivate enzyme molecules already present, exacerbating tissue irritation.  Here’s what to avoid:

• Fried and fatty foods
• Carbonated beverages
• Alcohol
• Chocolate
• Citrus fruits (oranges, lemons)
• Tomatoes and tomato-based sauces
• Coffee and caffeinated drinks
• Processed foods with added acids (like ascorbic acid)

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Why an Alkaline Diet Matters

An alkaline diet emphasizes low-acidity, nutrient-rich foods that protect the esophagus by reducing inflammation and preventing acid damage. 

When combined with lean proteins and clean, whole foods, this approach not only helps manage acid reflux but also supports long-term esophageal health and healing.

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For more information about diagnosis and treatment of acid reflux, see two companion books on Amazon: Dr. Koufman’s Acid Reflux Diet and Dropping Acid: The Reflux Diet Cookbook & Cure. If you would like to receive personalized guidance and strategies for lasting relief, consider scheduling an online consultation.