Acid reflux, also known as gastroesophageal reflux disease (GERD), is a condition where stomach acid frequently flows back up into the esophagus. This can cause symptoms like heartburn, regurgitation, and chest pain. While acid reflux can be triggered by different foods, desserts tend to be some of the biggest culprits. However, there are still many delicious dessert options that are unlikely to cause reflux symptoms.
What causes acid reflux?
When we eat, food travels down the esophagus into the stomach. At the end of the esophagus is a ring of muscle known as the lower esophageal sphincter (LES). After swallowing, the LES relaxes to allow food into the stomach then tightens back up to prevent stomach contents from flowing back up. Acid reflux occurs when the LES becomes weak or relaxes inappropriately, allowing acidic stomach contents to rise up into the esophagus. This can cause irritation and inflammation, leading to common reflux symptoms.
There are several factors that can contribute to the LES becoming weakened or relaxing abnormally, including:
- Hiatal hernia – when part of the stomach pushes up through the diaphragm into the chest
- Pregnancy – hormone changes can weaken the LES
- Obesity
- Smoking
- Certain medications like asthma inhalers, calcium channel blockers, sedatives, etc.
- Eating large meals
- Eating late at night or close to bedtime
- Consuming alcohol, chocolate, caffeine, spicy foods, high-fat foods, citrus fruits, tomatoes
Why are desserts problematic for acid reflux?
Desserts tend to contain ingredients that can trigger or worsen acid reflux. Some of the main culprits include:
- Chocolate – contains methylxanthines like caffeine and theobromine, which can relax the LES
- High-fat ingredients – foods high in fat like cream, butter, oil, etc. delay stomach emptying
- Citrus fruits – citric acid can irritate the esophageal lining
- Spices – cinnamon, mint, pepper, etc. may relax the LES
- Carbonated beverages – the bubbles expand in the stomach, increasing pressure on the LES
- Caffeine – found in coffee, chocolate, soda; can relax the LES
- Alcohol – wine, beer, and liquor irritate the esophageal lining
- High-sugar foods – large amounts of added sugars create more acidity
Additionally, the rich, dense consistency of many desserts means they take longer to digest. Food sitting in the stomach for prolonged periods can cause increased pressure on the LES. The larger serving sizes typical of desserts also distend the stomach more than other foods.
Tips for choosing reflux-friendly desserts
While desserts with the ingredients above may need to be limited or avoided, you don’t have to swear off sweets entirely because of acid reflux. There are many delicious options to satisfy your sweet tooth that are unlikely to cause reflux symptoms. Here are some tips:
- Choose low-fat desserts like angel food cake, meringue cookies, or fresh fruit with whipped cream
- Opt for low-acid fruits like bananas, melons, apples, pears, peaches, plums
- Avoid or limit chocolate, citrus fruits, alcohol, carbonation, spices, caffeine
- Stick to small portion sizes and avoid eating dessert right before bedtime
- Allow time after eating dessert before lying down
- Consume desserts separately from other foods rather than at the end of a large meal
Best desserts for acid reflux
Keeping the above tips in mind, here are some of the top dessert choices that tend to be gentlest on those with acid reflux:
Fresh fruit
Fresh fruit is typically low in fat, not too acidic, and contains lots of vitamins, minerals, and fiber. Melons like honeydew, cantaloupe, and watermelon make refreshing desserts, as do most berries like strawberries, blueberries, and raspberries. Bananas, apples, pears, peaches, and plums are other great options.
Fruit crisps and crumbles
Fruit crisps and crumbles feature fresh fruit baked with an oat or flour topping. Choose low-acid fruits and avoid adding extra spices beyond cinnamon. Go easy on the butter in the topping to keep fat content low. Serve warm with a dollop of whipped cream or ice cream if desired.
Angel food cake
Sponge cakes like angel food cake contain lots of air bubbles, making them light and lower in fat. Angel food cake gets its lift only from whipped egg whites, with no added fat. Top with fresh fruit and whipped cream for an easy low-fat dessert.
Gelatin
Gelatin desserts like Jell-O provide a cool, smooth treat for acid reflux. Opt for low-sugar varieties sweetened with an alternative like stevia. Avoid acidic fruits like oranges, pineapple, or mango which can irritate the throat.
Rice pudding
Creamy rice pudding makes a soothing dessert choice. Select recipes without too much added sugar and go easy on raisins, cinnamon, or other mix-ins that may be aggravating.
Banana ice cream
Blend up frozen bananas for a healthy alternative to ice cream. Bananas are low in acid and fat, and banana ice cream has no added sugar. Customize with a sprinkle of nuts or a drizzle of chocolate if desired.
Sorbet
Fruit sorbets provide a lighter alternative to ice cream without dairy or added fat. Stick to varieties made with low-acid fruits like melon, berries, peach, or pear. Limit added sugars by choosing sorbet over sherbet.
Frozen yogurt
Tart frozen yogurt is lower in fat than ice cream. Stick to plain flavors or those with low-acid fruit. Avoid addons like chocolate chips, citrus syrups, or sour candy pieces which can aggravate reflux.
Worst desserts for acid reflux
On the other hand, these popular desserts tend to be the most problematic for acid reflux sufferers:
Cheesecake
Rich and creamy cheesecake sits heavily in the stomach, increasing pressure on the LES. Fattier versions made with sour cream or cream cheese are especially troublesome.
citrus treats
any dessert with citrus fruit or juice – like key lime pie, lemon bars, orange sorbet – will irritate the esophagus. Citric and ascorbic acids naturally found in citrus aggravate reflux.
Chocolate cake or brownies
The chocolate and cocoa powder in chocolate cake and brownies contain caffeine and other compounds that stimulate acid production and relax the LES. Fat content is also quite high.
Coffee-based desserts
The caffeine in tiramisu, mocha cake, and coffee-flavored ice creams relaxes the LES. These items also tend to contain chocolate.
Spicy desserts
Steer clear of intensely spicy or pepper-flavored items like molten lava cakes with chili pepper. Gingerbread and anything with strong cinnamon flavor may also irritate symptoms.
Alcoholic desserts
Boozy treats like rum cake, bourbon pecan pie, or spiked milkshakes can worsen reflux by irritating the esophageal lining and relaxing the LES.
Fried desserts
Fried desserts like donuts and fried ice cream introduce more fat that can delay gastric emptying and put pressure on the LES, triggering symptoms.
Ingredients to limit or avoid
In general, minimizing or avoiding the following ingredients whenever possible can help prevent acid reflux flare-ups:
- Chocolate
- Citrus fruits and juices
- Spices like mint, pepper, chili, ginger
- Carbonated beverages
- Alcohol
- High fat dairy like cream, butter, sour cream
- Added sugars and syrups
- Caffeine
- Fried foods
Healthy baking substitutions
When baking desserts at home, there are several ingredient swaps you can try to make recipes friendlier for acid reflux:
- Use unflavored yogurt, coconut cream, or pumpkin puree instead of sour cream
- Swap in heart-healthy oils like avocado or canola oil for butter
- Replace heavy cream with evaporated skim milk
- Use fruit purees or applesauce instead of oil or butter
- Try almond extract rather than lemon or vanilla
- Sub in cocoa powder for chocolate chips
- Limit added sugar by using stevia, honey, dates, or banana
Lifestyle changes to prevent reflux
While avoiding problematic foods can help minimize acid reflux episodes, lifestyle modifications are often needed to really help control symptoms. Some changes worth implementing include:
- Quitting smoking
- Reaching or maintaining a healthy body weight
- Not eating within 2-3 hours of bedtime
- Sleeping with head elevated 6-8 inches
- Avoiding tight clothing that puts pressure on the stomach
- Eating smaller, more frequent meals
- Reducing portion sizes, especially of trigger foods
- Practicing stress management techniques
When to see a doctor
While occasional acid reflux is common and usually manageable with diet and lifestyle changes, frequent or severe symptoms may require medical attention. It’s a good idea to see your doctor if you experience any of the following:
- Heartburn or regurgitation more than twice per week
- Difficulty or pain when swallowing
- Unintentional weight loss
- Frequent cough or hoarseness
- Disruptive nighttime reflux symptoms
- Blood in vomit or stools
A doctor can evaluate your symptoms and risk factors and provide guidance on any needed testing or treatment. They may recommend prescription medications, surgery, or other interventions to properly manage gastroesophageal reflux disease.
The bottom line
Having acid reflux doesn’t mean dessert is off the menu. There are plenty of delicious, satisfying low-fat desserts that are unlikely to aggravate reflux. Fruit-based options like baked apples, pears, or berry crumbles are great choices. Light and airy angel food cake or lower-fat puddings and custards also tend to be gentle options if avoided in large portions. While traditional culprits like chocolate cake and ice cream may need to be reserved for special occasions, there are still plenty of ways for those with acid reflux to indulge their sweet tooth.
