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Acid reflux salmon: 7 Low-Acid Foods to Add to Your Reflux Diet – GERD Center


Diet & Reflux | Palmyra Surgical Bariatric Surgery

Jun 21 in
Diet & Reflux by

How to make healthy choices when buying fish for your reflux-reduction diet.

There are plenty of fish in the sea, but this also applies to the supermarket, causing a great deal of confusion for many consumers. As if deciding whether or not to buy organic produce isn’t complex enough, fish choices present shoppers with all kinds of questions they may not have the answers to. Should you buy farmed fish or wild caught? What exactly is mercury contamination?
For those who suffer from the symptoms of acid reflux in Macon, fish may be one of the best sources of protein, providing a low-fat alternative for people who have reflux symptoms triggered by fatty foods. The fats they do contain are the good kind—omega-3 fatty acids can provide you with a wide range of health benefits from protection against heart disease to the relief of inflammation. However, if you find yourself constantly walking away from the fish counter empty-handed, it may help to address the questions above and make fish as beneficial a part of your diet as possible.

Farm-Raised or Wild Caught?

Though salmon is frequently touted for its nutritional value, many environmental groups warn of the negative impacts that farmed salmon can have on natural ecosystems. They also warn that farm-raised salmon can contain high levels of PCBs, a group of manmade organic chemicals used in numerous products and materials until banned for their toxicity in 1979. PCBs do not break down easily, meaning that they still remain in many parts of the environment and may travel long distances, cycling between soil, air and water. They often accumulate in the bodies of small organisms like fish and may cause cancer or other issues in the immune, nervous, endocrine and reproductive systems.
Though fish farming, or aquaculture, can help to create a more sustainable source of fish and reduce the impact of fishing in the ocean, the actual impact and healthiness of farmed fish varies widely based on methods, location and species. Monterey Bay Aquarium, a respected and popular aquarium in Monterey California, has compiled a guide for which fish are safest and most environmentally-friendly in each region of the United States. For residents in Macon and the rest of the Southeast, here are some fish that are generally considered safe to buy farm-raised:

  • Catfish
  • Baramundi
  • Tilapia
  • Rainbow trout
  • Arctic char

What is Mercury Contamination, Anyway?

Due to pollution, mercury is commonly found as a contaminate in many waters. Though recent safeguards for clean air may reduce mercury pollution from power plants, measures for reducing industrial mercury pollution from some other sources have become deadlocked, meaning that mercury contamination will continue to be an issue for years to come.
Exposure to mercury is considered most dangerous for children and pregnant women, but can pose a serious threat to any human. Mercury acts as a neurotoxin when it enters the body, attacking the brain and nervous system. For adults, this can mean adverse effects for blood pressure regulation, vision and memory, while mercury poisoning in children can wreak havoc on their developing minds, resulting in learning disabilities and a delayed ability to walk and talk.
After entering a waterway due to industrial pollution, mercury is broken down by natural bacteria and works its way up the food chain as large fish eat smaller ones. Mercury doesn’t break down throughout this process—instead, it slowly accumulates, meaning that larger fish like tuna, shark and swordfish can continue to increase their concentrations of mercury until they reach more than 10,000 times that of their surrounding habitats.
Monterey Bay Aquarium’s Seafood Watch Guide suggests avoiding the following fish due to their high potential for contamination by mercury or other pollutants:

  • Grouper
  • Blue Striped Marlin
  • Sharks
  • Swordfish
  • Bluefin, Bigeye and Yellowfin Tuna

Though fish can be an important part of your diet to reduce acid reflux symptoms, buying the wrong kind of fish could be harmful for your body and the environment. Use this article as a starting point in educating yourself in healthy fish purchases and head to Monterey Bay Aquarium’s Seafood Watch page for more information. Remember: one of the best ways to make sure your food is healthy is to know where it came from.

Diet Changes for GERD – About GERD

Proper treatment of gastroesophageal reflux disease (GERD) always begins with a visit to a healthcare professional to obtain an accurate diagnosis. It is important to recognize that chronic reflux does not get better on its own. Over-the-counter remedies may provide short-term symptom relief, but can mask an underlying disease if used long-term.

Symptoms of GERD

Just about everyone has had heartburn – that uncomfortable burning feeling in the chest after eating a heavy meal – at some point in their life. But, while occasional heartburn is nothing to worry about, heartburn that occurs more than once a week, becomes more severe, or occurs at night and wakes you from sleep may indicate gastroesophageal reflux disease (GERD). And, a visit to the doctor is advised.

Learn more about symptoms of GERD

Treatment for GERD may include medications advised by your doctor and certain diet and lifestyle changes. A combination of approaches, and some trial and error, may be necessary.

Diet and lifestyle changes often begin with what to avoid. These include things that can trigger or worsen symptoms.

Examples of things to reduce or steer clear of in your diet include:

  • High fat foods
  • Caffeine
  • Chocolate
  • Onions
  • Peppermint
  • Carbonated beverages
  • Alcohol
  • Citrus and tomato products

Coming up with the appropriate diet and lifestyle changes involves discovering what works best for you. Not all triggers and treatments will affect all people in the same way. Bear in mind that when you eat may be just as important as what you eat. A particular food that causes reflux when eaten 3–4 hours before bedtime may be harmless earlier in the day.

Eating right for GERD does not have to mean cutting out all of your favorite foods. Making just a few, simple modifications to your current diet is often enough…

While no proven “GERD diet” exists, the following foods may help you ease or avoid symptoms.

Fruits and Vegetables

Fruits. While most likely avoiding citrus fruits and juices, like oranges and lemons, choose from a variety of non-citrus fruits such as bananas, melons, apples, and pears among others.

Vegetables. Select from the wide variety of vegetables. Avoid or reduce sauces or toppings that are high in fat or other irritants like tomatoes or onions.

Lean Proteins

Eggs. These are high in protein. However, if eggs are a problem for you, stick to the whites and stay clear of the higher fat yolks, which are more likely to cause symptoms.

Lean meat. High fat meals and fried foods tend to decrease lower esophageal sphincter (LES) pressure and delay stomach emptying, increasing the risk of reflux. Choose lean meats that are grilled, poached, broiled, or baked.

Complex Carbohydrates

Oatmeal, whole grain bread, rice, and couscous. All of these are good sources of healthy complex carbs. Whole grains and brown rice add fiber to your diet.

Potatoes and other root vegetables. These are great sources of healthy carbs and digestible fiber, but make sure to avoid adding onion and garlic during preparation, as these are common irritants.

Healthier Fats

Fat is a type of nutrient – high in calories but a necessary part of your diet. Not all fats are created equal. Generally avoid or reduce saturated fats (usually from meat and dairy) and trans fat (in processed foods, margarines, and shortenings). Try replacing them, in moderation, with unsaturated fats from plants or fish. Here are some examples:

Monounsaturated fats. Examples include oils such as olive, sesame, canola, and sunflower; avocados; peanuts and peanut butter; and many nuts and seeds.

Polyunsaturated fats. Examples include oils such as safflower, soybean, corn, flaxseed, and walnut; soybeans and tofu; and fatty fish such as salmon and trout.

Other Helpful Tips

Chew gum. Chewing gum (not spearmint or peppermint, which can relax the LES) increases saliva production and reduces the amount of acid in the esophagus.

Avoid alcohol. Alcohol is a known irritant that can weaken the LES and trigger reflux symptoms. However, while some people may experience a spike in symptoms after just one drink, others can tolerate moderate amounts. Experiment to see what works for you.

Keep good posture during and after a meal. It’s a good idea to sit up while eating and avoid lying flat for a minimum of two hours after eating a meal. Standing up and walking around after a meal helps encourage gastric juices to flow in the right direction.

Avoid eating immediately before bed. Digestion increases the amount of gastric acid present in the stomach. When you lay down, the ability of the LES to prevent stomach contents from traveling up the esophagus decreases. Occurring together, lots of stomach acid and a reclined position are a recipe for reflux. Timing can vary from individual to individual, but generally, eating a full meal less than three or four hours before bed is not advisable for GERD sufferers.

Eating right for GERD does not have to mean cutting out all of your favorite foods. Making just a few, simple modifications to your current diet is often enough to help reduce the discomforts of GERD. The goal is to create a diet based on a healthy variety of foods that include fruits and vegetables, lean sources of protein, complex carbohydrates, and healthy fats.

If you suspect that foods may trigger or worsen your symptoms of GERD, try keeping a one week daily diary.

Published in Digestive Health Matters, Vol. 23, No. 3.

What Foods to Avoid if You Have Acid Reflux


Elena Shashkina/Shutterstock

It may be one of the most iconic breakfast foods, but bacon is unfortunately one of the worst foods for triggering acid reflux. Fatty and greasy foods cause the lower esophageal sphincter (LES) to relax, which allows more acid to travel back up to the esophagus. Bacon fat, ham fat and lard all have high fat content.

Red meat

Grandriver via Getty Images

Besides bacon, red meats, which include beef, lamb and pork, typically have a higher percentage of fat than other types of meats. To help protect against acid reflux, eat foods like burgers and steaks sparingly.

Coffee or tea


Caffeine is a common trigger of heartburn, and coffee and tea can have a lot of it. Keep your coffee cup count low and replace it with something else, like a soothing cup of decaf tea. There are many kinds of tea without caffeine that can actually help soothe an upset stomach.

Carbonated drinks


Many people turn to carbonated drinks like soda or sparkling water to sip on instead of coffee or tea, however, those are acid reflux triggers as well. The bubbles in these kinds of drinks expand in your stomach, which can create more pressure and pain.

Black pepper

Bozhena Melnyk/Shutterstock

Perhaps an even more ubiquitous ingredient than garlic or onions, black pepper is an everyday seasoning that most people have in their spice drawers that can also contribute to heartburn and acid reflux.

Soups and salad dressings

Brent Hofacker/Shutterstock

Fried foods

Brent Hofacker/Shutterstock

French fries, tots or onion rings are some of the most-loved fast food items. Unfortunately, fried foods are some of the biggest culprits behind acid reflux. According to the University of Pittsburgh Medical Center, people with frequent heartburn or acid reflux should avoid fried foods and limit their consumption of fats and oils to three servings per day.


Oxana Denezhkina/Shutterstock

While some herbs and spices can help soothe inflammation, there’s one that can actually make things worse. Mint, and even products with mint flavoring, is a common acid reflux trigger.

The surprising new food rules to banish acid reflux

Most people’s image of the typical acid reflux patient is an overweight, middle-aged man who’s overdone it on burgers or pizza and is complaining of heartburn.

But as an ear, nose and throat doctor, I see patients every day who break the stereotypical mould — for acid damage afflicts people of all ages, including the very young. 

In fact, more than 7 million Britons suffer from it.

And it doesn’t just manifest itself as heartburn or regurgitation. 

These aren’t even the most common symptoms — in my practice, most acid reflux patients are more likely to have throat-related complaints, such as a lump-like sensation that causes difficulty swallowing.

Most acid reflux patients are more likely to have throat-related complaints, such as a lump-like sensation that causes difficulty swallowing

Other common symptoms include a chronic cough (that persists longer than eight weeks), frequent throat-clearing, hoarseness and a sore throat.  

Often, someone with these symptoms won’t realise they have reflux because the oesophageal tissues have likely been exposed to acid for so long, they’ve been numbed to its effects.

These ‘silent’ symptoms mean the condition can be overlooked, which has its own risks: a growing number of people are now succumbing to oesophageal cancer — the most extreme manifestation of acid damage.

But why are so many of us plagued by acid reflux in the first place? The answer, I believe, lies in the food and drink we consume every day.

Doctors used to be concerned about only the acid that came up from the stomach into the oesophagus — now we know the problem is also the acid from certain foods on their way down.

These foods cause problems in two ways: they loosen the valve at the bottom of the oesophagus (the lower oesophageal sphincter), allowing the stomach contents and acid to rise up, or they directly irritate the oesophagus.

Eating late at night can cause inflammation or put pressure on the oesophageal valve, as well as lead to bloating and gassiness

Our lifestyles also play a part. Smoking, eating late at night, rushing our food and being overweight can cause inflammation or put pressure on the oesophageal valve (rushing our meals and eating late can lead to bloating and gassiness). 

Stress is also implicated, as it triggers the release of hormones that can increase production of gastric acid.

Based on my 27 years’ experience treating patients with acid reflux, I’ve devised a plan to tackle this growing problem, which I set out in my new book, The Acid Watcher Diet.

This plan has two stages: a 28-day ‘healing’ phase, where you avoid foods that trigger acid damage, such as citrus fruits, tomatoes, coffee, peppers, seed oils, chocolate and processed food generally, and choose instead those rich in compounds that help repair the damage, some of which are listed in the box below.


These are the foods and drinks you must eliminate in the first phase to create a digestive clean slate:

Fizzy drinks: Even sparkling water — though not acidic, its bubbles can rise from the stomach, carrying acid

Coffee and tea

Citrus fruit: Any with pH 4 or less, including lemon, lime and pineapple

Tomato: This activates and releases pepsin — the enzyme that can eat away and damage throat tissue — but can be neutralised in the second phase

Vinegar: All varieties activate pepsin

Wine: It is very acidic, measuring from pH 2. 9 to pH 3.9

Caffeine: Be aware it’s in some painkillers

Chocolate: This contains methylxanthine, which increases stomach acid production and is a carminative

Alcohol: Vodka and tequila are allowed in the next phase

Mint: A powerful carminative, whether as a herb, chewing gum or tea

Raw onion: This is a carminative and also a fructan, which means it causes the intestines to absorb water, causing bloating

Raw garlic: Also a carminative and a fructan. This is off-limits during both phases. Instead, use fennel


During the healing phase, the first 28 days, stick to foods with a pH of 5 or above, such as: 

Fish: Salmon, halibut, trout, plaice, sea bass, sole

Poultry: Chicken breast, minced turkey, eggs

Vegetables: Spinach, cos lettuce, rocket, curly kale, bok choy, broccoli, asparagus, celery, cucumbers, courgette, aubergine, potato, sweet potato, carrots (not baby ones), beetroot, chestnut mushrooms, basil, coriander, parsley, rosemary, dried thyme and sage

Raw fruit: Banana, papaya, cantaloupe, honeydew melon, watermelon, lychee and avocado

Dried fruit: Dates, raisins, desiccated coconut

Nuts and seeds: Cashews, pecans, pistachios, walnuts, pumpkin seeds, sesame seeds, almonds, pine nuts

Spreads: Fresh, organic peanut and almond butters

Cheese: Parmesan, mozzarella, other hard cheese

Bread and grains: Rolled oats, wholegrain pasta, wholegrain bread, wholegrain wheat flour

Condiments: Celtic salt, olive and coconut oil, soybean concentrate, vanilla extract, pea protein, white miso paste


This is followed by the maintenance phase, where you reintroduce some banned foods back into the diet.  

This second phase should last a minimum of two weeks, but you can follow it for life. 

More than 4,000 of my patients have tested my plan, and all reported relief from the pain and disruption of acid damage.

As well as losing weight, they had more energy and less inflammation in their throats. 

And many (with the exception of those who have Barrett’s oesophagus, where the cells lining the gullet become precancerous) have been able to stop taking medication such as proton pump inhibitors — which reduce the production of stomach acid to treat acid reflux.

Note: if you have symptoms several times a week, or over-the-counter medication isn’t working, see your GP to rule out other causes.


Before I set out the plan in more detail, let me explain why dietary acid is so damaging.

The key lies in pepsin, an enzyme that’s meant to help break down food in the stomach. 

Though this is a controversial new area, I am convinced pepsin presents a very real, lurking danger.

In the stomach, pepsin is inactive until woken up by acidic foods.

Illustration of a healthy stomach. In the stomach, pepsin, an enzyme that’s meant to help break down food, is inactive until woken up by acidic foods

But once mixed into gastric acid, it can surge up into the oesophagus, chest, vocal cords and throat, where pepsin molecules can attach to pepsin receptors. This is when the real trouble begins. 

Once pepsin is planted in your oesophagus, it is activated each time you eat or drink something acidic.

As you may recall from your school chemistry lessons, the pH scale runs from 1 to 14 — anything below pH 7 is considered acidic; everything above that is alkaline.

Pepsin becomes most active in an environment with a pH level between 1 and 4.

If there are no food proteins for it to break down (as there are in the stomach), the activated pepsin will eat away at the throat and oesophagus, causing problems from inflammation and heartburn to Barrett’s oesophagus — and possibly oesophageal cancer.

What’s especially worrying is that once pepsin gets into your gullet, it floats through the airways and can end up anywhere, including your lungs, where it can cause inflammation and conditions such as asthma and bronchitis.

Pepsin receptors have been found in the sinuses and middle ears in people with acid reflux. 

The concern is that, if activated repeatedly, pepsin can spark inflammation throughout the body.

A key feature of the Acid Watcher diet is that it keeps pepsin in your stomach, where it belongs, and prevents the activation of it outside the stomach.


The secret is not letting calories, carbohydrates or fat dictate whether a food is ‘good’ or ‘bad’: make choices based on a food’s acidity or pH value. 

A general rule is that the more processed a food, the more acidic it is, due to the chemicals used to preserve it.

Dietary acid is found in carbonated drinks (sweetened, fizzy drinks can have a pH of 2.5), commercially produced fruit juices and in products containing high-fructose corn syrup (a sweetener made using sulphuric acid), such as biscuits, cakes and ice cream.

A general rule is that the more processed a food, the more acidic it is, due to the chemicals used to preserve it

It’s even in canned soups and vegetables — especially if they’ve been pickled or fermented. If the label includes citric or ascorbic acid, this suggests the product is acidic.

And there are other foods you may be more surprised to learn are bad for an Acid Watcher — take the Mediterranean-style diet, for example. 


To work out if you have reflux, answer this question: within the last month, how did the following problems affect you? (Rate each from 0, no problem, to 5, severe):

  • Hoarseness or voice problem
  • Clearing your throat
  • Excess throat mucus or post-nasal drip
  • Difficulty swallowing
  • Coughing after you eat or are lying down
  • Difficulty breathing or choking episodes
  • Troublesome or annoying cough
  • Sensation of something sticking in throat or lump in throat
  • Heartburn, chest pain or indigestion

A total score of greater than 13 strongly suggests you could have acid reflux

It protects against inflammation, cardiovascular disease, obesity and insulin-resistance — a precursor to type 2 diabetes — but some of its staples are high-acid foods that must be avoided.

These include wine, tomatoes, vinegar, lemon, onion and garlic (the latter two play a role in bloating, indigestion and heart-burn by putting pressure on the oesophageal valve).

Of these, wine is the most detrimental — not only is it highly acidic, but all alcohol is a carminative, which means it loosens the oesophageal valve.

Other carminatives include chocolate, caffeine, fresh and dried mint and peppermint tea, so these should be avoided. 

However, some components of the Mediterranean diet are good for you, and the high-fibre content is important because it sweeps waste from your stomach, aiding healthy digestion and protecting your oesophagus.


So if acidic foods are bad, does that mean alkaline diets are good?

Some of these diets claim that, by curtailing acidic foods, you can help restore the pH balance of your blood, but this is impossible and complete rubbish: you cannot change or ‘balance’ your blood pH through dietary measures (it’s actually regulated by the kidneys).

Some of these diets claim that, by curtailing acidic foods, you can help restore the pH balance of your blood, but according to Dr Aviv this is impossible and complete rubbish

Another major misconception is that eliminating ‘acidic’ food groups — such as meat, it’s claimed — will reduce your acidic overload and make you healthier.

Again, rubbish. Cutting out food groups is the last thing you need, as some can aid healing from long-term acid exposure.

Similarly misguided is the ‘alkaline ash’ theory, which claims that some acidic food leaves an alkaline residue in the body.

Lemon is said to be one, and lemon water is touted as a home remedy for heartburn, but really, it activates pepsin in the throat. Such misinformation is downright dangerous.


You really must quit — here’s why: 100 per cent of smokers have acid reflux disease.

If you smoke, you are guaranteed to develop it throughout the length of your aerodigestive tract, from your throat to your oesophageal valve — that’s because cigarette smoke and nicotine delay stomach emptying, which puts pressure on the oesophageal valve.  

If you smoke, you are guaranteed to develop acid reflux disease throughout the length of your aerodigestive tract


The first phase of the diet — the 28-day healing phase — is based on eight principles that will help you eliminate or reduce inflammation and tissue damage. 

The first phase of the diet — the 28-day healing phase — is based on eight principles that will help you eliminate or reduce inflammation and tissue damage

These are:

1. Eliminate acid triggers.

2. Rein in your reflux-generating habits — quit smoking completely and cut out processed food. 

3. Avoid fried food — it loosens the oesophageal valve.

4. Eat three meals, and two mini-meals, at regular intervals between 7am and 7.30pm. This ensures you don’t overeat and allows the stomach three hours to digest before lying down, avoiding night-time reflux.

5. Practise the rule of five: you can eat foods with a pH value of 5 and higher, while pH 4 foods can be introduced in the maintenance phase. These foods will help heal the damage to your oesophagus by keeping pepsin in check.

6. Introduce more fibre into your diet — it keeps your digestion healthy, reducing reflux. 

Eat a daily minimum of 450g of vegetables above pH 5 (for example, five medium-sized carrots) — half of which should be raw — and a daily minimum of 225g raw fruit (a handful of cubed cantaloupe with a banana).

One meal a day should be vegetarian to maximise fibre intake.

7. Drink only water.

8. Avoid seed oils. These — rapeseed, sunflower, sesame oils — have a borderline pH, but are essentially acidic because their extraction process involves chemicals. Instead, use extra virgin olive oil.

Other borderline foods are peppers, berries and honey, as these stimulate pepsin production. 

(However, berries are permitted in both phases of the diet if you balance them with an acid neutraliser, such as almond milk, in a smoothie for example. Similarly, honey can be eaten if combined with a nut butter. )

Spices such as chilli are also not recommended during the healing phase, as they can loosen the oesophageal valve.


Regular exercise helps to accelerate weight loss, reducing pressure on the oesophageal valve.

But the type of exercise you do is important. 

Heavy weight-lifting, sit-ups and crunches, excessive jumping (such as in high-impact aerobics), competitive cycling and advanced yoga should all be avoided, as these can encourage gastric acid to flow upwards.

However, gentle yoga can be beneficial because its emphasis on deep-breathing can help reduce stress hormones that increase acid production (but be careful with the ‘downward dog’ pose, where the head is positioned below the waist, as this may trigger symptoms).

Reflux-safe exercises include cycling on a stationary bike (or one that doesn’t require you to crouch) and light weight training.

Heavy weight-lifting, sit-ups and crunches, excessive jumping, competitive cycling and advanced yoga should all be avoided, as these can encourage gastric acid to flow upwards


After 28 days, you should notice your reflux is much improved.

Next is the maintenance phase, where you can introduce foods with a pH of 4 or above — including red, yellow or green bell peppers, some varieties of apples and soft cheeses including feta and cottage cheese. 

This phase should last for two weeks, after which you can eat normally again.

If your symptoms return, or to protect yourself long-term, you can choose to stick to this stage for life.

Dr Jonathan Aviv is the clinical director of the Voice and Swallowing Centre at ENT and Allergy Associates in New York. 

He is also an ear, nose and throat professor at Icahn School of Medicine, New York. 

Adapted from The Acid Watcher Diet by Dr Jonathan Aviv, published by Hay House at £12.99. 

The 8 Best Dog Foods for Acid Reflux [ 2021 Reviews ]

If your dog is having problems with his food, you may wonder:

Do dogs suffer from acid reflux? How can I tell acid reflux from other problems my dog may have? Should I change my dog’s food?

Unlike us, dogs can’t just pop an antacid and eat that overstuffed burrito; other measures need to be taken, the first of which is often switching their dog food.

But choosing a dog food isn’t always straight forward.

So we’ve prepared this customized guide just for you. You can learn all about acid reflux in dogs and choose the best dog food for your best friend. So, if you’re ready, let’s dive in!

The Best Acid Reflux Dog Foods

Top Picks Rating Main Ingredients
1. Purina Pro Plan Focus Adult Sensitive Skin & Stomach Salmon & Rice Formula Dry Dog Food
(Editor’s Choice)
4.9 Salmon, Ground Rice, Canola Meal, Sunflower Oil, Chicory Root
2. Natural Balance L.I.D. Limited Ingredient Diets Sweet Potato & Fish Formula Grain-Free Dry Dog Food 4.8 Sweet Potatoes, Salmon, Canola Oil, Menhaden Fish Meal, Salmon Oil
3.  Purina Pro Plan Focus Adult Classic Sensitive Skin & Stomach Salmon & Rice Entree Canned Dog Food 4.8 Salmon, Rice, Fish, Potato Protein, Carrots
4. Wellness CORE Grain-Free Reduced Fat Turkey & Chicken Recipe Dry Dog Food 4.7 Deboned Turkey, Chicken Meal, Potatoes, Peas, Ground Flaxseed
5. Blue Buffalo Basics Limited Ingredient Grain-Free Formula Turkey & Potato Recipe Adult Dry Dog Food 4.7 Deboned Turkey, Potatoes, Canola Oil, Peas, Chicory Root
6. Merrick Limited Ingredient Diet Grain-Free Real Lamb Recipe Canned Dog Food 4.3 Deboned Lamb, Lamb Liver, Natural Flavor, Salt, Sunflower Oil
7. Taste of the Wild Pacific Stream Grain-Free Dry Dog Food 4. 7 Salmon, Ocean Fish Meal, Sweet Potatoes, Potatoes, Peas
8. American Journey LID Lamb & Sweet Potato Recipe Grain-Free Canned Dog Food 4.6 Lamb, Lamb Broth, Lamb Liver, Sweet Potatoes, Sunflower Oil

How to Switch Dog Food Without Getting Your Pup Sick

Acid Reflux Dog Food Reviews

1. Purina Pro Plan Focus Adult Sensitive Skin & Stomach Salmon & Rice Formula Dry Dog Food

Top 5 Ingredients: 1. Salmon, 2. Ground Rice, 3. Canola Meal, 4. Sunflower Oil, 5. Chicory Root

No matter what breed or size your dog is, the Purina Pro Plan Focus Dog Food is a good choice for dogs with digestive and acid reflux issues. This recipe is made with salmon as the main source of protein because of its easy digestibility. Additionally, it contains prebiotic fiber from chicory root to support the growth of healthy bacterial flora found in the intestine, which leads to better digestion. Also, it’s free of corn, wheat, and soy, which can cause stomach issues in dogs suffering from acid reflux and food sensitivity.

Purina Pro Plan Focus Dog Food also contains rice and oatmeal. Both of these are especially easy on a dog’s stomach, and help provide energy to they can stay active throughout the day. Omega 3 and 6 fatty acids help provide nourishment to your dog’s skin and make their coat shiny and soft. Finally, there’s glucosamine to keep your dog’s joints lubricated and functioning smoothly, which improves mobility.

2. Natural Balance L.I.D. Limited Ingredient Diets Sweet Potato & Fish Formula Grain-Free Dry Dog Food

Top 5 Ingredients: 1. Sweet Potatoes, 2. Salmon, 3. Canola Oil, 4. Menhaden Fish Meal, 5. Salmon Oil

For dogs suffering from acid reflux, a limited ingredient diet that’s lower in fats and proteins is important; and that’s what the Natural Balance LID dog food is all about. It contains very few selected ingredients like Salmon, which is easy to digest, non-allergenic, and provides plenty of essential amino acids and minerals. The second main ingredient is sweet potato, which is rich in fiber and contains carbohydrates to fuel your dog’s body.

Because dogs with acid reflux problems usually have sensitive stomachs, Natural Balance has eliminated wheat, soy, and corn to alleviate any digestive problems. This formula contains no artificial colors, flavors, or preservatives to make sure that your dog is receiving only the best nutrition. Apart from this, the dog food also contains omega-three acids, which play an important role in supporting the growth of a shiny and softer coat.

3. Purina Pro Plan Focus Adult Classic Sensitive Skin & Stomach Salmon & Rice Entree Canned Dog Food

Top 5 Ingredients: 1. Salmon, 2. Rice, 3. Fish, 4. Potato Protein, 5. Carrots

For dogs suffering from acid reflux, wet food tends to be quite the treat. And this Purina Pro Plan Focus wet dog food is one of the best, not only due to its pleasing texture and taste but its overall nutritional benefits. The main source of proteins in this formula is Salmon, which not only provides essential amino acids needed for muscle development but is also a source for Omega 6 fatty acids, which help nourish your dog’s skin and gives them a softer and shinier coat.

It also features easily digestible rice, which provides energy so your dog can stay active. The salmon in this dog food also contains DHA, which encourages cognitive development and greatly enhances the taste of the dog food, which is especially useful if you have a picky eater.

4. Wellness CORE Grain-Free Reduced Fat Turkey & Chicken Recipe Dry Dog Food

Top 5 Ingredients: 1. Deboned Turkey, 2. Chicken Meal, 3. Potatoes, 4. Peas, 5. Ground Flaxseed

Dogs that suffer from acid reflux are particularly reactive to excess fat; therefore, it’s crucial to keep it to a minimum. That is why Wellness Core Reduced-Fat Dog food is a great choice for those dogs that suffer from sensitive stomachs and acid reflux issues. The formula uses real, deboned turkey and chicken to aid in muscle nourishment while keeping things digestible. More importantly, the recipe is completely grain and gluten-free so that even the most sensitive dogs can digest their food properly.

Carbohydrates are sourced mainly from peas and potatoes, which provide plenty of energy and are highly digestible as well. Moreover, it contains many wholesome veggies and fruits like apples, blueberries, and kale that provide lots of vitamins, minerals, and antioxidants. What’s special with this dog food is that it contains almost 25% less fat than the original formula, plus its completely free of artificial colorings, flavorings, and preservatives. It’s also free of wheat, corn, soy, and meat by-products to ensure that your dog’s digestive health stays at its best.

5. Blue Buffalo Basics Limited Ingredient Grain-Free Formula Turkey & Potato Recipe Adult Dry Dog Food

Top 5 Ingredients: 1. Deboned Turkey, 2. Potatoes, 3. Canola Oil, 4. Peas, 5. Chicory Root

For dogs with sensitive stomachs and digestive issues like acid reflux, fewer ingredients are usually a better option. That is why Blue Buffalo has created its L.I.D. Turkey and Potato Dog Food to ensure that your dog gets proper nutrition in the fewest possible ingredients possible. The recipe includes only premium-quality ingredients like turkey, which provides nourishment and supports muscle growth. It also includes potatoes and peas, which supply carbohydrates to fuel your pooch so that they stay active and energetic.

Apart from this, this dog food also provides prebiotic support, which leads to better overall digestive health through the growth of beneficial intestinal bacteria. Also, the recipe contains multiple antioxidant-rich fruits and veggies which supply loads of vitamins and minerals. It also contains glucosamine, which supports joint and bone health. And lastly, the recipe is free from all kinds of harmful ingredients like wheat, corn, soy, meat by-products, and all sorts of artificial colors, flavors, and preservatives too.

6. Merrick Limited Ingredient Diet Grain-Free Real Lamb Recipe Canned Dog Food

Top 5 Ingredients: 1. Deboned Lamb, 2. Lamb Liver, 3. Dried Peas, 4. Sunflower Oil, 5. Flaxseed

Wet foods with easily digestible proteins and limited ingredients are a good choice for dogs experiencing acid reflux, and that’s what Merrick’s L.I.D. canned food is all about. It all starts with real, deboned lamb, which is not only very easy to digest but also contains plenty of essential amino acids to aid in muscle nourishment. Most of the carbs come from peas, along with sunflower oil and flaxseed which provide additional vitamins and minerals. Additionally, this recipe is completely free from grains, soy, wheat or corn which can upset the digestive system of some dogs. Along with this, the formula is also free of artificial colors, preservatives or flavors, which might cause allergies otherwise.

7. Taste of the Wild Pacific Stream Grain-Free Dry Dog Food

Top 5 Ingredients: 1. Sweet Potatoes, 2. Salmon, 3. Canola Oil, 4. Menhaden Fish Meal, 5. Salmon Oil

Taste of the Wild Pacific Stream Dog Food believes in the idea that the best diet for every dog is one that’s like that of their ancestors. Thus, they have created a formula that is not only nutritious but also contains ingredients that are easy on their stomachs, gradually helping overcome acid reflux. The main ingredient here is 100% real smoked salmon, which is easier to digest for dogs with sensitivities and allergies. Along with this, potatoes and peas provide your pooch with lots of carbs so they can always stay active.

Not only this, but the recipe is enriched with prebiotic fibers sourced from chicory root, which encourages the growth of beneficial bacteria in the digestive tract. Furthermore, fruits and vegetables like blueberries provide plenty of essential vitamins and antioxidants as well. Lastly, the recipe is made free of grains, wheat, soy or corn and contains no artificial colors, flavors, or preservatives to ensure the best digestive health.

8. American Journey Limited Ingredient Diet Lamb & Sweet Potato Recipe Grain-Free Canned Dog Food

Top 5 Ingredients: 1. Lamb, 2. Lamb Broth, 3. Sweet Potatoes, 4. Sunflower Oil, 5. Flaxseed

American Journey has come up with a very effective and delicious solution for dogs suffering from gastric issues, which also includes acid reflux. The reason why this dog food is so effective is that the main source of protein here is lamb. Real lamb in this dog food not only offers better digestibility compared to other proteins but also makes it much more appetizing. Sweet potatoes and lamb broth are the main carb sources that provide lots of energy, while sunflower oil and flaxseed both act as a source of Omega 3 and 6 fatty acids that keep your dog’s skin and coat healthy and soft. The whole process happens in the USA, using only the highest quality ingredients. Each dog food is made free of grains, wheat, soy or corn and doesn’t contain any sort of artificial flavors, colors, or preservatives.

9. Natural Balance L.I.D. Limited Ingredient Diets Chicken & Sweet Potato Formula Grain-Free Canned Dog Food

Top 5 Ingredients: 1. Chicken, 2. Chicken Broth, 3. Sweet Potatoes, 4. Chicken Liver, 5. Canola Oil

If your dog is one of the more sensitive digesters who can’t seem to enjoy anything they eat fully, Natural Balance’s L.I.D. canned dog food is the perfect choice for you. The whole formula is designed for the more sensitive dogs, starting with real chicken which not only provides plenty of proteins to encourage muscle growth but also adds texture and taste to the dog food. Carbs are derived mostly from sweet and regular potatoes, which act as a great alternative to grains, which can often upset a sensitive dog’s stomach. More than that, the dog food also contains many essential vitamins and minerals like vitamin A and B12 to strengthen the immune system. Aside from this, the dog food is also free from grains, wheat, soy, and corn, all of which are common allergens for dogs with sensitive stomachs.

10. Halo Holistic Chicken & Chicken Liver Adult Dry Dog Food

Top 5 Ingredients: 1. Chicken, 2. Chicken Liver, 3. Dried Egg Product, 4. Oatmeal, 5. Pearled Barley

Designed to provide each dog with complete and holistic nutrition, Halo Holistic incorporates a bunch of premium-ingredients and excludes all artificial ingredients to create a nutritionally fulfilling dog food.

The recipe is made from cage-free real chicken and lots of non-GMO and organically produced ingredients that provide complete macronutrient and micronutrient support to your dog. It also includes omega 3 and 6 fatty acids to nourish your dog’s skin and coat so they look healthier along with feeling healthier. And to satisfy and tempt your dog, the kibbles contain a meaty and irresistible flavor that attracts even the stubbornest canines.

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What is acid reflux in dogs?

Acid reflux is when the gastric acid in the stomach, which aid in digestion, travel up to the esophagus due to overproduction of acid or relaxation of the esophageal sphincter.

What causes acid reflux in dogs?

Any number of things can cause acid reflux. Primarily, it is caused by feeding your dog inappropriate or spicy foods, or food that is high in fat. In more serious cases, acid reflux can also result from obesity or even hiatal hernia.

How to know if your dog has acid reflux?

If your dog is suffering from acid reflux, you’ll notice that your dog is regurgitating their food quite often. Also, you might see your dog whining when eating because of pain, and they’ll start losing their appetite as well.

What is the best food for acid reflux in dogs?

If your dog is suffering from acid reflux, you’ll notice that your dog is regurgitating their food quite often. Also, you might see your dog whining when eating because of pain, and they’ll start losing their appetite as well.

Should you give your dog antacid?

Although dogs can take antacids, it’s generally not the most suitable or safest method of dealing with acid reflux. Human antacids are meant for humans and may cause problems for your dog. You should always consult your veterinarian before giving your dog any medicines made for humans.

What are the best proteins to feed a dog with acid reflux?

Some of the best proteins to feed dogs with acid reflux are fish like whitefish and salmon, or duck meat, as all of these proteins are very easy to digest and thus help in reducing acid overproduction.

Is acid reflux in dogs dangerous?

Acid reflux can cause the delicate lining of the esophagus to wear down which typically isn’t critical or life-threatening. However, in the long-term, it can cause loss of appetite which will lead to weight loss and weakness or fever as well.

Is acid reflux painful for dogs?

Yes, acid reflux can lead to heartburn in dogs just as it does humans. It may also become painful for them to swallow, which might cause them to lose their appetite. Also, keep an eye out for any signs of whining or pain while your dog is eating.

Can surgery cause acid reflux in dogs?

Yes, acid reflux can be a side effect caused by surgery. Typically, when anesthesia is administered, the gastroesophageal sphincter relaxes, which causes the content of the stomach, including the gastric acid to travel up to the esophagus.

Can you feed your dog with acid reflux homemade food?

Yes, homemade food is a great option for dogs suffering from acid reflux, as you have control over the ingredients and their proportions. Try to add proteins that are easy-to-digest like fish and reduce the fat content.

How to prevent acid reflux in dogs?

If you want to prevent acid reflux, don’t feed your dog table scraps or treats that contain lots of fats because these foods tend to cause overproduction of acid, some of which sneak up to the esophagus.

Buyer’s Guide

Although it is difficult to know if your dog is suffering from acid reflux, what’s even more difficult is finding a dog food to reverse it. Typically, dog food alone doesn’t have the power to completely eradicate acid reflux on its own if it’s serious. But it is a major factor which can help put an end to the problem, which is why it’s important to know which dog food to buy if your pup suffers from acid reflux.

But before heading into that direction, you need to completely understand what acid reflux is in dogs, what causes it, and how to recognize it.

Acid Reflux in Dogs

By definition, acid reflux is an uncontrollable reverse flow of the gastric or intestinal fluids into the esophagus. These fluids are very acidic, which helps dogs in digesting all the meat and food they eat.

The stomach has a lining that prevents acids from damaging it; the esophagus does not. So when the acid travels up to the esophagus, it wears down the mucous lining, which leads to inflammation and discomfort.

If left untreated, acid reflux can cause more serious problems in the future, which is why you must recognize the symptoms as soon as possible so that you can treat them more easily.

Recognizing acid reflux in dogs can be hard because dogs are typically very good at hiding it, and even if they do show them, the symptoms are usually so minor that they largely go unnoticed. Here are some of the most common symptoms of acid reflux in dogs:

Symptoms of acid reflux

  • Regurgitation of food:This is perhaps the most common symptom of all, and although it’s not that uncommon for dogs to regurgitate their food from time to time, it can signal an underlying issue. Note that regurgitation is different from vomiting and usually happens suddenly, unlike vomiting, which you can normally foresee.
  • Signs of pain while eating: If your dog is suffering from acid reflux, they’ll probably have an inflamed esophagus. So, when they’re eating, they’ll be in pain and might let out a whine or a howl when they’re swallowing food.
  • Gagging or burping:Dogs with acid reflux will usually try to clear the pathway by gagging, which might also lead to vomiting. Burping is also a sign of gastric issues, so keep an eye out for both.
  • Bad breath and tooth decay: When the gastric acid travels up to the esophagus, and some of it gets into the mouth, it’ll cause their breath a pungent smell. The acid will also wear down the enamel of your dog’s teeth, causing tooth decay.
  • Drooling or excessive salivation: Because acid travels up to the esophagus and causes your dog pain, you’ll notice that they are salivating or drooling excessively and might even start wheezing.
  • Loss of appetite: The pain of acid reflux can cause your dog to lose their appetite.
  • Weight loss: If your dog doesn’t eat, it’s obvious that they’ll start losing weight. Weight loss might be a slightly hard one to detect, so you need to keep a close eye if you want your dog to get better.

Ways to treat acid reflux in dogs

Although it sounds scary, acid reflux is treatable. When treating it, you need to make changes to their diet and everything that revolves around it because that’s what usually causes it in the first place.  There are many ways to treat acid reflux in dogs, but usually, diet is the factor that plays the biggest role. Keeping that in mind, the best way to deal with acid reflux would be to buy the right dog food. We’ll discuss what you need to look for in a dog food later.

Along with this, there are other ways to deal with acid reflux as well, including changing feeding frequency, trying out some common home remedies and using prescription medicine too if needed. Let’s go through each one of these:

1. Switching Dog Food

The first step you should probably take is to switch your dog food with one that’s going to help treat acid reflux. Your main goal here should be to look at the following properties in your dog food:

  • Low-Fat
  • Low-Protein
  • No artificial colors, flavors or preservatives
  • No wheat, soy or corn

You should look for a dog food that’s both low in proteins and fats because they increase the gastric acid in their stomachs. Also, look for a dog food that contains meat-based, easily digestible proteins like duck and lamb instead of plant proteins, which are harder to digest. Also, try to eliminate any dog food which contains allergens like wheat, soy, or corn, especially if you know your dog has existing sensitivity or allergy problems.

2. Homemade Dog Food

Another option is to switch to homecooked food instead of specialized dog food. Homemade dog food has its own advantages over packaged dog food. You have complete control over the ingredients, and you can choose what’s best for your dog and their needs. And although it requires a lot of effort to prepare and store the dog food, it’ll save you an extra few bucks.

If you do plan to cook your dog’s food by yourself, make sure that you use high-quality ingredients and proteins. Also, to ensure that your dog gets the best nutritional benefit, avoid using overly processed food or proteins like sausages and nuggets. Use grains like rice or vegetables like sweet potatoes that provide your dog with plenty of carbohydrates and energy.

3. Feed Small, Frequent Meals

Whether you choose to swap your dog food with another brand or cook it at home, feed them smaller meals more frequently throughout the day. Along with this, keep a bowl full of water beside or soak the dry food in water or bone broth. Feeding smaller meals more frequently causes less stress on their stomach and lowers the acidity level, which helps in reducing acid reflux. Also, if you feel like your dog eats too fast, purchase a slow-feeding bowl to help reduce both bloating and burping.

4. Treatment Through Medicine

If you feel like your dog is dealing with acid reflux of a more severe level, and it’s interfering with their health and daily life, then you can opt to treat it through prescription medicine. We highly suggest you consult a veterinarian for this, as they’ll suggest the medicine and dosage according to your dog’s need.

Pro-kinetic medication is sometimes prescribed to dogs suffering from acid reflux. It allows the food to pass through the digestive system more easily while strengthening the esophagus sphincter muscles to prevent the gastric acid from backing up into their esophagus. Pepcid is also sometimes prescribed by vets as it lowers gastric acid production, reducing acid reflux.

5. Home Remedies

Home remedies can be unreliable and even dangerous sometimes, but this particular remedy has been tested and is known to bring relief in acid reflux. It involves feeding your dog a piece of bread covered with natural honey. Natural honey is full of antioxidants and is known to have multiple beneficial health properties. It brings relief in heartburn and has a soothing effect on your dog’s stomach.

Preventing acid reflux in dogs

Like other health issues, preventing acid reflux is always easier than curing it. Much of the time, the cause of acid reflux in dogs is the feeding of inappropriate, high-fat, spicy foods by their owners. If you feed your pooch a treat or let them have your leftovers whenever they make puppy eyes, you are part of the problem.

Spicy food is one of the main culprits of acid reflux in dogs. Although you might think that a little leftover of your spicy food might not harm your dog, it will most probably cause acid overproduction, which will back up into their esophagus. Also, giving them too many fatty treats will cause overproduction of acid as well and, in the long-term, will cause obesity, which is a cause of acid reflux in itself.

Thus, it’s necessary to avoid these poor feeding habits, and it’s very important to control yourself, no matter how much it looks like your pup is dying to have just one bite of your food. Trust us; you’ll thank yourself later.


Foods to Avoid with GERD

Having gastroesophageal reflux disease (GERD) can make it difficult to enjoy having certain foods. Some foods and beverages can end up making symptoms worse.

What Foods Should Be Avoided with GERD?

When you have GERD, there are certain foods and drinks that might irritate your condition and cause symptoms to flare up. You should avoid eating foods that are high in fat, as well as foods and beverages that contain caffeine, such as coffee and chocolate. Other foods and drinks to avoid include onions, carbonated drinks, citrus fruits, and other products, tomato products, and peppermint.

What Foods Help Heal the Esophagus?

Some foods may provide relief from GERD symptoms. Your diet should include non-citrus fruits and vegetables, such as apples and carrots. Eating lean proteins, such as eggs and lean cuts of meat, can also help improve GERD symptoms for some people. Other foods to include in your diet are whole grains and other complex carbohydrates, as well as healthy fats, such as olive oil, peanut butter, flaxseed, and salmon.

Is Yogurt Good for GERD?

Yogurt that is low in fat is generally safe to eat for those who have GERD. You should avoid eating yogurt that contains whole fat rather than low amounts of fat. Whole fat yogurt can be harder for you to digest and might trigger GERD symptoms.

Is GERD Curable?

GERD is not considered curable, but there are ways to manage this condition through dietary and lifestyle changes. Maintaining proper posture while you eat and after eating instead of slouching can help lower your risk of GERD symptoms. Not eating right before bed can also help.

Can I Drink Milk if I Have GERD?

You can drink milk if you have GERD as long as it is low in fat. Avoid drinking whole milk, which can end up making GERD symptoms worse. Instead, choose skim milk, 1% or 2% milk, since these all contain lower amounts of fat and are easier to digest.

How Can I Heal My Esophagus?

Your doctor can recommend treatments that might help ease symptoms of GERD and prevent additional damage to your esophagus. There are surgical procedures that might help if you have severe GERD that does not respond to other forms of treatment, such as medication.

What Can I Eat During a GERD Flareup?

During a GERD flareup, you should avoid foods that make your symptoms worse. Eat foods that can help ease symptoms, such as fruits, vegetables, whole grains, lean meats, and healthy fats.

How Do You Make Acid Reflux Go Away Fast?

Some over-the-counter medications, such as antacids, can provide short-term relief from GERD symptoms. If you keep having these symptoms, you should see your doctor for treatment.

Is Coffee Bad for GERD?

Coffee contains caffeine, which can irritate your condition if you have GERD. If you use whole fat creamer in your coffee, this can cause your symptoms to become worse. Drink decaffeinated coffee and use low-fat creamer or milk to avoid GERD flareups.

If you have symptoms of GERD and are looking for treatment options, make an appointment today with Gramercy Park Digestive Disease Center. Our experienced gastroenterologists can provide treatment options and manage your symptoms in the most effective way possible.

10 Foods to ADD to Your Diet If You Have Acid Reflux

Acid reflux, also known as GERD, occurs when stomach acid flows back up from the stomach into the esophagus. Some are more susceptible to acid reflux than others, but it is typically caused by food or drink triggers. If you suffer from acid reflux, make sure to add these 10 foods to your diet.

  1. Salmon: Salmon is a great source of protein and fiber while also being low in cholesterol. Research has shown that foods high in fiber can help reduce the effects of acid reflux.
  2. Ginger: Ginger is naturally anti-inflammatory, and is a natural treatment for gastrointestinal problems, which is why many people drink ginger ale when they’re nauseous. You can add grated ginger to almost anything to ease acid reflux symptoms!
  3. Fruits: Non-citrus fruits like melons, apples, pears, and bananas are less likely to trigger acid reflux symptoms than citrus fruits like oranges, grapefruits, or lemons.
  4. Potatoes: Potatoes are low in acid, and are high in carbohydrates that are more likely to absorb acids.
  5. Broccoli: All green vegetables are good for acid reflux, but because broccoli is also high in vitamin-C, it is a superfood in terms of easing your acid reflux symptoms.
  6. Egg Whites: Eggs are a popular food item in terms of easing acid reflux, but some people find that the yolks have a high fat content which can trigger acid reflux. Egg whites are the low-fat, low-cholesterol option to help with acid reflux.
  7. Oatmeal: Oatmeal is a whole grain, high in fiber, and a great way to absorb some of the acid in your stomach that may be causing reflux.
  8. Lean Poultry: Low-fat meats like chicken and turkey are good to reduce acid reflux when grilled, broiled, or baked – NOT fried.
  9. Avocado: Despite being high in fat, avocados are rich in healthy fats, which can settle your stomach and prevent acid reflux symptoms.
  10. Whole Grain Rice: Whole grains are great to absorb the acids causing reflux, and rice is one of the most absorbent.

Managing your acid reflux symptoms is all about finding your triggers. Take the time to pay attention to what you are eating, what these foods are being cooked in, and how they are processed. If you’re feeling lost, or are considering making a dietary change, consult your doctor.





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90,000 Reflux gastritis: symptoms and treatment, diet

Diseases of the digestive system are widespread among the adult population. Casting a bolus is a normal option in some people. However, under unfavorable conditions, pathological reflux is formed, which provokes the occurrence of reflux gastritis. Its frequency of occurrence ranges from 20 to 50%. Gastroenterologists pay special attention to this nosological form, taking into account the etiological and pathogenetic mechanisms of the development of pathology.The condition requires a specific approach to diagnosis, diet and drug treatment.


What is reflux gastritis

Inflammatory changes are caused by disruption of the pylorus, which is located at the junction of the stomach into the duodenum. Insufficiency of the sphincter leads to the movement of the food bolus in the opposite direction: from the duodenum to the stomach.

Reflux gastritis is an inflammation of the gastric mucosa caused by the irritating effect of alkaline contents mixed with bile as a result of reflux from the duodenum.Dystrophic and necrobiotic changes in the epithelium of the stomach gradually occur. The secretion of hydrochloric acid increases, which, entering the intestines, causes duodenitis.

Biliary reflux gastritis: symptoms and treatment


The disease occurs due to the influence of a combination of factors. The development of reflux gastritis is largely due to lifestyle.

However, the formation of pathology is associated with the following reasons:

  • excessive consumption of alcoholic beverages;
  • 90,027 smoking;

  • the constant influence of stress, overwork, psychoemotional factors;
  • 90,027 overweight;

  • the state of pregnancy due to the displacement of internal organs;
  • concomitant chronic pathology of the gastrointestinal tract;
  • heavy physical activity associated with weight lifting;
  • gastric resection according to Billroth’s modifications for organ neoplasms;
  • plastic of the pylorus;
  • the use of medicines that reduce the tone of the sphincters.

Important! In the development of disorders, the main role belongs to the bacteria Helicobacter pylori, which causes an inflammatory process.

Classification of reflux gastritis

Pathology of the stomach, caused by the reflux of food contents, forms various variants of the inflammatory process. Reflux gastritis belongs to type C. Reactive changes appear due to chemical action on the gastric mucosa. Doctors use the classification presented in the table.

Table 1. Classification of gastritis

Chronic reflux gastritis

Inflammation of the stomach with insufficiency of the sphincters of the pylorus and cardia develops gradually. Chronic reflux gastritis is formed with typical symptoms. In this case, the defeat of the mucous membrane can be of a different nature: from catarrhal (superficial inflammation) to the formation of erosions or atrophy of the mucous membrane.

Superficial reflux gastritis

Against the background of duodeno-gastric reflux, the contents of the intestine enter the distal and antrum parts of the stomach.Constant irritation of the mucous membrane causes superficial catarrhal changes. There may be focal or diffuse superficial reflux gastritis (diffuse) with characteristic endoscopic signs on FGDS.

Erosive reflux gastritis

In some cases, superficial erosive foci without an atrophic process appear on the mucous membrane. These local signs are characteristic of erosive reflux gastritis. The pathological process has special symptoms and treatment, as in gastric ulcer.

Stomach erosion: symptoms and treatment, photo

Atrophic reflux gastritis

In severe cases, duodeno-gastric reflux leads to mucosal atrophy, hyperplastic and erosive process. In some patients, with prolonged aggressive exposure to gastric juice, subatrophic or diffuse atrophic reflux gastritis develops. Inflammatory changes are characterized by symptoms of an inflammatory condition with low acidity.

Atrophic gastritis: symptoms and treatment in women

Symptoms of reflux gastritis

For a long time, the signs of the disease are poorly expressed.It is only when reflux gastritis progresses that the symptoms begin to bother the patient. When they appear, you should contact a specialist for timely diagnosis and treatment. Inflammation of the stomach, which is accompanied by the reflux of food chyme from the duodenum, is characterized by the following manifestations:

  • aching pain and discomfort after eating;
  • a feeling of heaviness in the upper abdomen;
  • sour or bitter belching;
  • vomit mixed with partially digested food;
  • 90,027 weight loss;

    90,027 nausea;

  • Stool changes in the form of diarrhea or constipation.

If reflux gastritis is accompanied by dysfunction of the biliary tract, there is a reflux of bile into the stomach. The presence of bile acids causes a specific inflammatory process, in which there is a bitter taste in the mouth, vomiting with an admixture of bile.

Symptoms of reflux esophagitis attachment

In case of insufficiency of the sphincter of the cardiac part of the stomach, the reflux of gastric contents into the esophagus is observed.

This often happens during sleep, when a person is in a horizontal position, during pregnancy.Reflux gastritis with reflux esophagitis with the following clinical signs is gradually formed:

The aggressive effect of hydrochloric acid on the mucous membrane of the esophagus eventually leads to cicatricial changes and its narrowing.

Symptoms of duodenitis

An inflammatory reaction in the duodenum is rarely isolated. Basically, there is a chronic course of the disease, which occurs against the background of dysfunction of the sphincters of the gastrointestinal tract. The symptoms of reflux gastritis are accompanied by manifestations of duodenitis (inflammation of the duodenum) and bulbit (inflammation in the duodenal bulb):

  • discomfort in the upper abdomen after eating;
  • pain on palpation of the pyloroduodenal zone;
  • flatulence;
  • decreased appetite;
  • nonspecific signs in the form of irritability, increased fatigue.


To establish a correct diagnosis, a complete examination of the patient must be performed. The gastroenterologist clarifies complaints, anamnesis, assesses the objective status and prescribes additional research methods. The list of auxiliary diagnostic techniques includes:

  1. General and biochemical blood test.
  2. Fibroesophagogastroduodenoscopy (FEGDS) with histology of mucosal biopsy from different parts of the stomach.
  3. pH-metry to determine the acidity level in the upper digestive tract.
  4. Detection of Helicobacter pylori infection using urease test, enzyme-linked immunosorbent assay, PCR (determination of antibodies) and other methods.
  5. Ultrasound to determine the concomitant pathology of the biliary tract and pancreas.

Attention! In the presence of reflux with the development of esophagitis, symptoms appear that are characteristic of heart disease. In order to exclude cardiac pathology, ECG and Echo-KG are prescribed.

Reflux gastritis: treatment

The basic principle of disease care is an integrated approach to therapy.If there is chronic gastritis, reflux esophagitis, duodenitis treatment is prescribed by a gastroenterologist based on the results of the diagnosis. The first step on the road to recovery is a well-organized diet that includes special meals. The protocol provides for drug therapy and physiotherapy. The treatment regimen is aimed at eliminating the etiological causes and pathogenetic mechanisms of the development of the disease, preventing the exacerbation of the condition.

Drug treatment

The main direction of the protocol is the scheme of therapy, which is carried out medically – with pills and other forms of release for oral administration of the drug. Treatment of gastritis and reflux esophagitis includes groups of drugs that eliminate the symptoms of the disease and restore the functioning of the digestive tract.

Table 2. Drugs for the treatment of reflux gastritis

Groups of medicines Names of drugs Therapeutic effect
Antisecretory substances Pantoprazole,





Reduce the production of hydrochloric acid
Antacids Phosphalugel,



Create a protective layer on the surface of the mucous membrane, reduce the aggressive effect of secretions in a hyperacid state
Alginates Gaviscon,

Sodium alginate

Reacts with hydrochloric acid, forms a gel base on the surface of the epithelium with a neutral pH level
Prokinetics Motilium,


Normalizes intestinal motility, prevents the reflux of intestinal contents into the stomach and esophagus, reduces the manifestations of nausea, vomiting
Ursodeoxycholic acid Ursofalk,


Reduces the secretion of cholesterol, replaces the toxic form of bile acids with a non-toxic one
Bismuth preparations De-nol Shows antimicrobial and astringent effect
Gastroprotectors Sucralfate Forms a mucous membrane on the surface, prevents the reverse flow of bile, pepsin and hydrochloric acid


Antibiotics of the group of penicillins, macrolides, rifampicins Destroy Helicobacter pylori

Diet for reflux gastritis

Gastroenterologists pay special attention to the diet of patients with preodenal gastric reflux (DGR).Nutritional therapy for reflux gastritis is aimed at preventing food from being thrown into the upper digestive tract. Assign a menu according to table No. 5. It is recommended to adhere to a fractional regimen of meals in order to ensure complete digestion of food and reduce the stagnation of the food lump in the stomach. The list of permitted and prohibited products is presented in Table 3.

Table 3. Nutrition for reflux gastritis

What you can eat What not to eat
Soups with vegetable broths with any cereals Fish, beef, mushroom broth, borsch, cabbage soup
Cutlets, meatballs, meatballs, boiled or steamed Fried cutlets, meat, especially fatty varieties, smoked meat products, sausages
Low-fat types of fish – pike perch, carp, hake Fish with a high fat content – salmon, salmon, pelengas, belan
Baked potatoes, boiled Fried potatoes
Wheat bread, dried Rye bread, sweet yeast pastry
Egg soufflé or omelet Scrambled eggs
Non-acidic cottage cheese, yogurt, sour cream, low-fat milk Kefir, sour yogurt, fat cheese, fermented baked milk
Steamed vegetables Thermally unprocessed vegetables, including cabbage, radishes, onions, radishes, tomatoes
Fruit with a neutral flavor – apples, pears, peaches, plums Sour berries, fruits, citrus
Kissels and compotes Carbonated drinks, juices, fresh juices, coffee, strong tea, cocoa, honey, jam

Important! Before main meals, you should drink a glass of water at room temperature to reduce the concentration of hydrochloric acid in the stomach.

Treatment of reflux gastritis with folk remedies

In addition to traditional therapy, specialists recommend alternative medicine. Natural products have long been used to relieve symptoms of diseases and normalize the functioning of the gastrointestinal tract. When treating reflux gastritis with folk remedies, the most effective drugs and recipes are based on herbal ingredients. The recipes are presented in table 4.

Table 4. Traditional methods of reflux gastritis therapy

Medicinal substance Admission rules
Mixture of mint, anise, calamus, oregano herb Mix a tablespoon of each component, add 400 ml of water and infuse in a water bath for 20 minutes.Take 6 times a day, 100 ml
Sea buckthorn oil Drink 1 teaspoon before meals
Flax seed with chamomile and licorice root Combine 2 tablespoons of chamomile seeds and flowers with 1 tablespoon of licorice root. Pour 500 ml of boiling water, insist for an hour. Take half a glass 3 times a day
Rosehip decoction A tablespoon of berries is poured with a glass of boiling water and infused for 2 hours.The agent has a bactericidal effect and is useful in a hypoacid state
Dandelions The plants are covered with sugar. The resulting juice is taken 1 teaspoon 3 times a day, after dissolving it in water

Mineral water for reflux esophagitis and gastritis

Mineral water is an effective prophylactic and therapeutic agent for inflammatory processes of the digestive tract associated with the throwing of contents.A special composition of natural origin relieves unpleasant manifestations, improves digestion and motor function of organs. Suitable sulphate calcium-magnesium, sodium-calcium-chloride waters. The following types of sources help treat reflux gastritis:

  • Truskavetskaya – Sofia, Maria;
  • Morshinskaya;
  • Essentuki 4;
  • Borjomi;
  • Azov;
  • Kazachinskaya.


With a disease of the digestive system, which is associated with impaired motility and the throwing of contents into the upper sections, the doctor and the patient have two tasks.One of them is how to treat reflux gastritis. However, prevention of the condition remains an equally important issue. At the initial stage, it is necessary to minimize the influence of provoking factors, which include the normalization of the lifestyle, proper nutrition, and therapy of concomitant diseases. Secondary measures are aimed at the timely diagnosis and treatment of reflux gastritis and GERD. Compliance with the recommendations of the gastroenterologist helps to get rid of the problem forever and improve the prognosis of recovery.

Recommended materials:

Biliary reflux gastritis (biliary gastritis)

Reflux esophagitis: causes, symptoms and treatment in adults

Treatment of gastritis with high acidity with medicines

Antibodies to Helicobacter pylori: result of analysis and decoding

Folk remedies for gastritis – effective recipes and methods

Nutrition for erosive gastritis, an approximate menu for a week

Fluoroscopy of the stomach with barium

Symptoms of gastritis and stomach ulcer

FGS: some important recommendations for preparing for the study

Nutrition for epidermolysis bullosa | Dermatology in Russia

Nutrition for epidermolysis bullosa

Leslie Haynes, children’s nutritionist, London.(based on materials from DEBRA international)

All children need good nutrition to develop and enjoy the best quality of life. This is especially important for children with the most severe forms of EB (recessive dystrophic EB, Dowling-Meara simple EB, borderline EB) because it is necessary for growth and wound healing, and in fighting skin infections. Although it is impossible to cure EB with special diets (avoiding certain types of food in the diet or introducing megadoses of certain nutrients), with the help of a balanced diet, it is possible to create optimal conditions for wound healing and immunity.

Unfortunately, the nature of the borderline type of BE is such that dietary changes cannot lead to a long-term positive effect. However, certain dietary guidelines can have a positive effect on the quality of life of children with this condition. It is also necessary to find an individual approach and draw up a meal plan.

The following discussion focuses on a balanced diet for everyone, regardless of age or disease. Unfortunately, it is not possible to answer all the questions. And for children under 1 year old, there are special recommendations.

Why nutrition is important in BE

In children without BE, nutrition is mainly directed towards growth and development. In children with EB, the skin is fragile and easily damaged and may require an individualized diet that supports both growth and:

  • Compensates for nutrients lost through open wounds and lesions
  • adds nutrients needed for optimal healing
  • helps support an effective immune system to fight infection
  • promotes good gastrointestinal function and helps avoid constipation
  • last but not least, allows you to feel as good as possible and enjoy a good quality of life.

All children have “weekends”, for example, due to teething or a minor illness, when food intake is reduced, and children with EB are no different. Babies with EB often have to deal with blisters on the lining of the mouth and throat, which make feeding unpleasant and can significantly reduce food intake. Patients become very irritated at this time, they are reluctant to eat. On good days, when the kids are happy to eat, parents will feel like they can cope better with those days when food is inadequate.

What is diet food?

Diet food includes a balanced content of proteins, carbohydrates, fats, vitamins, minerals, fibers, water.
This is not as difficult as it sounds, because most foods contain a mixture of nutrients and dietary nutrition can be achieved with a variety of food combinations. The more varied the diet, the more likely it is to contain a good balance of nutrients. Most of the nutrients are used to meet the body’s needs for growth, recovery, and energy maintenance.Complex chemical processes in the body break down food into small particles and then absorb them into forms that allow us to live (this is called metabolism).
Nutritional requirements are relatively high during infancy, early childhood, and adolescence, when growth is rapid. In EB, blistering and fluid loss requires constant work by the body to restore substances and metabolic levels. The rate at which metabolism occurs may be higher than normal, especially if there is an infection.


Proteins are important for building strong, healthy body tissues, and promote wound healing. Milk (and other dairy products such as cheese and yogurt), meat, fish, and eggs are the main sources of animal protein. Vegetable proteins are found in legumes (peas, beans, lentils), nuts, and grains. The vegetarian diet must be carefully planned to ensure it meets the needs of any child. Nuts (other than nut butter) should not be given to children under 5; they may accidentally inhale or choke on them.


Fat is an important source of calories, and although some children with EB are physically inactive, they need sufficient calories to metabolize protein efficiently. If they do not consume enough calories from fats and carbohydrates, proteins are used as a source of calories instead of building body tissues. High-calorie foods that are high in fat and fatty foods are good for children with poor appetite. Butter, margarine, cream, butter, lard are obvious sources of fat.Less obvious sources of fat are high-fat milk, yogurt, most fatty cheeses, ice cream, meat (especially with a visible layer of fat), eggs, fish in oil (sardines, salmon), avocado, nut butter, and chocolate.


Carbohydrates are also an important source of calories and in some cases fiber, vitamins and minerals. Carbohydrates are useful mainly as a source of calories, biscuits, sugar, sweets, glucose, honey, jam and syrup are high in carbohydrates. Carbohydrates contain a wide range of nutrients, cereals, morning porridge, flour, pasta, bread, potatoes, fruits are especially useful.Puddings and cakes are valuable primarily for their energy content, but can also be a good source of protein when cooked with eggs and protein foods. All carbohydrates are important in the diet of children with EB. Sweets (biscuits, sugar) should be included in the diet not instead of, but with fewer less sweet foods (cereals, potatoes).


Fiber (difficult to digest part of food) is not absorbed and passes through the intestines. Fiber is very important for maintaining good health, normal gut function, and maintaining beneficial bacteria, which in turn helps your immune system function effectively.Fiber is found in unprocessed grains, flour, bread, pasta, muesli, oatmeal, brown rice, dry and fresh fruits and vegetables. Children with blisters on the lining of the mouth and throat may find it difficult to chew and swallow fibers. Citrus fruits (oranges, tangerines) and tomatoes can irritate the oral mucosa if they have blisters or sores. A diet rich in fiber is bulky, low in calories, and less food means fewer calories.


Vitamins are essential for growth and health.If a sufficiently varied diet is followed daily, the intake of vitamins is usually sufficient, however, if the intake is limited, it is recommended to take additional vitamins. There are several vitamins, and each has a specific function in the body.

For example, Vitamin A is mainly found in liver, milk, oily fish (mackerel), margarine and yogurt. Dark green, red, and yellow vegetables contain a substance called carotene, which the body converts to vitamin A.Vitamin A is essential for maintaining healthy skin, eyes, mucous membranes and strengthening the immune system.

Vitamins of group B are found in dairy products, meat, eggs, bread, cereals and potatoes. Various B vitamins have specific functions such as helping the body get energy for carbohydrate metabolism, maintaining healthy skin and blood, and promoting protein metabolism.

Vitamin C is found mainly in fruits, especially citrus fruits and some vegetables, such as green vegetables and potatoes.Vitamin C is essential for wound healing and iron absorption.

Vitamin D is found in butter, margarine, fatty fish, milk, eggs, liver. Fish liver fats are the best source of vitamin D. Sunlight on the skin produces vitamin D in the body. Together with calcium, vitamin D helps build strong bones and teeth.

Vitamin E has several important functions such as protecting cell walls and maintaining immunity. It is found in vegetable oils, nuts, green leafy vegetables, and wheat germ.


Minerals, like vitamins, are vital for health and growth and a well-balanced diet that usually provides normal needs. Iron, zinc, selenium, and calcium in particular are important in EB.

Iron . The main source of iron in the diet is meat (especially liver, kidney and corned beef), bread and fortified cereals. Iron is essential for healthy blood and the prevention of anemia. Iron loss can be significant if the skin is fragile and often affected.

Zinc is found in a wide variety of foods, including protein foods such as meat, shellfish and dairy products, as well as bread and cereals. It plays a vital role in many complex metabolic processes, including wound healing.

Selenium , together with vitamin E, play an essential role in protecting cells from damage, it also helps the immune system to produce antibodies. It is found in American (Brazilian) nuts, dairy products, and some seeds and grains.

Calcium with vitamin D are involved in building healthy bones and teeth. It is also essential for normal muscle and nerve function and blood clotting. Calcium is found in milk and dairy products (cheese and yogurt). Breast milk and infant formula are good sources of calcium, and babies with EB rarely need additional calcium.

Water , although often not considered a nutrient, is vital to maintaining good hydration levels.Adequate fluid intake is also important to prevent constipation.

Vitamin and mineral supplements

If food intake is limited by mouth ulcers, painful swallowing, or if needs increase, nutritional supplements should be prescribed. Excessive intake of food supplements can be harmful and should be consulted with a dietitian.


Breast milk is ideal for the growth and development of babies. It contains precious antibodies that protect your baby from infection, and prebiotics (substances that promote the growth of beneficial bacteria that are involved in many vital processes) can also reduce the risk of allergies.Thus, breast milk is very beneficial for babies with EB, even for a short period of time.

Tips for mums with EB:

  • Even if the baby has blisters on the oral mucosa, this does not necessarily preclude breastfeeding. Blisters usually rupture during breastfeeding, if not, nurse should be consulted
  • For minimal friction when your toddler touches the breast with the nose, apply soft white paraffin or petroleum jelly to the nipples and cheeks, lips and gums
  • Latch your baby to the breast often so that he suckles for as long as he wants
  • Take a lot of time for this so that none of you feel in a rush
  • If there is a lot of milk, pump a little milk so as not to scare the baby when the milk pours out
  • check that the baby has a flat grip on the nipple

If your baby feels painful to breastfeed or gets tired quickly, you can express milk and use a bottle with a teat or spoon to feed it.It is important not to squeeze the bottle tightly to prevent milk from entering the larynx, stimulating the cough reflex and reducing the ability to breathe milk into the lungs.

The opening in the nipple can be widened with a needle or scissors. Treat your nipples with antibacterial agents. Milk flowing in too quickly can cause coughing or fear.

Sometimes it is necessary to use supplements for breastfeeding, in this case you need to consult a nutritionist (pediatric nutritionist).

Artificial feeding

You may prefer formula, but if your baby’s needs are fully met by breastfeeding, formula can be given in addition to, but not instead of, breast milk.Whatever the reason, you can talk with your nutritionist about the best feeding plan for your baby.

Weight gain and fortified foods

The best assessment of a child’s development is gain in weight, height and increase in head circumference. Weight needs to be measured regularly to make sure the baby is growing. This means weighing in the hospital or at home on a weekly basis. Ideally, if this happens at the same time, on the same scales, in the same or similar clothes.

If your baby is gaining weight a little slower than normal, nutritionists may suggest adding nutrients or using fortified infant formula such as Infatrini (Nutricia).Alternatively, you can compensate for insufficient feeding by adding 1 spoon of milk powder, diluting it in a jar of water to 30 ml. This will provide a richer nutrition in all nutrients, but in the same amount as before. This is called enriched feeding.

It is safest to make all dietary changes under the supervision of a dietitian or medical staff.

If your baby needs more calories, this can be done with specially formulated carbohydrate and / or fat supplements in baby milk.The most commonly used carbohydrate supplements are in the form of glucose polymers (Nutrien series (Nestlé), Polycal (Nutricia)

The combination of polymer of glucose and fat is available abroad in two forms Duocal (powder) and liquid Duocal (Nutricia), in the Russian Federation – liquid Liquid (Nutricia).

Fruit juices and drinks

Babies generally do not need fluids other than breast milk or formula or bottled water to quench their thirst. Fruit juices and herbal teas are not a vital part of any diet for babies, and sugary liquids can suppress appetite when feeding.Babies often cry due to thirst, as well as hunger, chilled bottled water can be offered between feedings, especially in hot weather. If a child is thirsty, water is the perfect drink.
Too little liquid can cause and worsen constipation. If you feel that your child needs more fluids, but refuses water, offer the child juice with an equivalent amount of water or 1 teaspoon of freshly squeezed juice in 100 ml of chilled bottled water.

Stopping breastfeeding

This is the process by which children gradually learn to chew food and swallow more solid foods. In the UK, the recommended age is 6 months.

Some babies require solid food at an earlier age, but no earlier than 17 weeks. If you plan to give a solid food to a baby under 6 months, exclude foods containing gluten, eggs, cheese, dairy products, fish, shellfish. Wait until the risk of developing adverse reactions is minimal.Signs that your child is ready to eat solid food:
– holding the head, stable upright position with support
– curiosity and interest in parental nutrition and chewing
– collecting food and putting it in the mouth
– having 1 or 2 teeth
– hunger despite feeding enough milk for several days.

First, solid food should complement milk feeding, not replace it. If your child is eating a more concentrated diet, it is most likely that he will not be interested in solid foods like his peers, so do not be discouraged if his peers grow faster than your baby – he will soon catch up with them.Soreness in the mouth or tongue, fear of a product of unknown consistency are all common reasons why children are reluctant to eat solid foods. Fear is most common if the child has had episodes of vomiting or reflux, or if these problems still exist. Reflux is the return of acidic stomach contents into the esophagus and is a very unpleasant sensation. It is important for all children, and especially children with EB, to start treatment early because of the scalding effect of the acidic stomach contents on the thin layer of the esophageal mucosa.Possibility of antireflux medication, as well as dietitian advice to feed the baby thicker foods that are less likely to return to the esophagus during reflux. It is important not to rush the child to switch to solid food, everything has its time. It is not necessary to ban food if you refuse solid food, this will lead to weight loss and more stress. As the child grows, he consumes more solid foods and drinks less milk. However, milk continues to supply him with various nutrients, and he should consume about 500 ml of milk per day.

Let your child slowly switch to solid foods.
The following tips can help you when switching to solid foods:

  • Choose the time when your baby is most hungry
  • Always spoon solids, do not add to the bottle
  • use special plastic spoon
  • Offer solid food before he gets too hungry the next time he feeds. Give some milk first when the baby cries
  • Don’t be discouraged if he refuses new food first.It takes time to get used to the new taste and texture.
  • Solid food can be prepared at home or purchased from the store
  • Do not add salt when cooking at home
  • If it is not possible to puree with a blender or mixer, do not use a sieve, as this will reduce the fiber content in food
  • From 6 to 9 months, the baby gradually learns to chew and the food should be thicker. You need to puree fruits or vegetables, cut the meat into small pieces
  • Children quickly lose confidence if they are afraid of having to control different consistencies at the same time, so it is better to offer the child food of the same consistency, rather than soft lumps in the liquid.
  • Introduce your baby to the cup
  • at 6-7 months

  • At 6-7 months, the baby needs to touch food with his hands, even if he has bandages on his hands. He needs to touch the food in order to mix it. Avoid sharp objects and foods that can scratch your mouth and gums.
  • Do not give honey until 1 year old, it may contain bacteria that produce toxins that can cause serious illness in young children.

Food that children can eat with their hands

Babies and young children with EB are often reluctant to try new foods.Holding the food and eating it himself gives the child more confidence and control. It is impossible to avoid the fact that the food will turn out to be a kind of mass, with which the child will play more than eat, but it will be worth it.
Foods that can be bitten and cut into pieces:
Biscuit, meringue (whites, whipped with sugar)
Soft biscuits with cream
Rice paper *
Ice cream with waffle *
Snacks, crackers **

Foods you can bite and chew – if necessary, cut into small pieces or strips:
– nectarine, mango, banana, peach, pear
– baked apple without peel
– soft pitted plum, apricots, dry mango, dry pineapple, soufflé
– jelly
– ripe avocado without peel, cooked potatoes, soft crispy potatoes
– cooked carrots
– soft bread
– soft boneless fish, chicken
– canned Frankfurt sausages **
– processed cheese
– just cooked soft pasta , lavash
– pancakes, omelette

* use with caution, especially if the child pulls food to the lips and licks
** very salty, do not give until 9 months, no more than once a day until 1 year

By the end of the first year

By the age of 9-12 months, family meals are generally suitable for babies with EB as long as they are of a suitable consistency and are not very spicy or salty.Citrus fruits, tomatoes, or freshly squeezed fruit juices can cause oral discomfort. Avoid foods that can cut or scratch the mucous membranes of the mouth and throat, crispy chips, toast, crackers, raw carrots and celery. Fish is very nutritious, but always check to see if you have removed all the bones. Carefully feed the baby hard pieces of fruit (apples), as well as sausages with skin, small round foods such as tomatoes, grapes, which the baby can swallow and choke, it is safer to cut them in half.
A well balanced diet with an emphasis on protein and energy is recommended. If your child has a poor appetite, divide the meal 3 times and offer a nutritious snack to the baby in between. Milk is an important source of nutrients, so try to give your baby at least 500 ml of formula a day. Some babies find it difficult to go from bottle to cup. Although it takes longer to get used to it, this is necessary because prolonged bottle feeding can damage the teeth, especially if the baby drinks from the bottle at night when there is little saliva.

When can you drink cow’s milk?

Although it is recommended that all babies receive either breast milk or formula (or a combination) before 1 year, many give a baby cow’s milk for about 6 months. Infants with EB with increased nutritional requirements should continue to receive formula or breast milk, fortified if necessary, for at least the first year and for as long as possible. Milk modification – formula milk, as a bridge between breastfeeding and cow’s milk, is possible after 6 months.
Skimmed and semi-skimmed milk is generally unsuitable for nutrition as it is low in fat and therefore low in energy. Yogurt and cottage cheese made from pasteurized milk can be fed to a child from 9 months old. Choose foods that contain fats and sugars, as their energy component is higher.

Can’t eat, won’t eat

Natural events such as teething, minor illnesses, and about 2 years of age undoubtedly intersect with feeding. While these are all part of normal development, such periods can be very stressful times.Parents are very worried about feeding their babies during this time, try not to force the baby to eat on such days and reduce your anxiety.

If the child has a poor appetite, it is important to maintain the nutritional content of the diet without increasing its volume. If a child is accustomed to trying to feed him when he is healthy, then when he feels worse, most likely, he can also be fed. Such food can be used regularly without waiting for the child to eat. With good nutrition, babies cope better with short episodes of poor nutrition, and you will be less anxious because you know there is a supply.To create such a stock, you need to do the following:
– add 2-3 teaspoons of cream or condensed milk to cooked potatoes, sauces, yoghurts, sweet cream, mousse, jelly
– add butter, margarine, olive oil or mayonnaise to hot vegetables
– spread butter, cheese cream, margarine on bread, toast, sweets and biscuits
– add grated cheese, cheese cream, mayonnaise to cooked potatoes, beans, spaghetti, boiled eggs
– serve white or cheese sauce with fish and vegetables
– add avocado, because it has a high calorie content
– add 1-2 tablespoons of jam, honey, cottage cheese, sweet cream to rice pudding
– add 1-2 teaspoons of sugar to morning porridge, yoghurts, fruits
– put jam on the top layer of bread or biscuit , honey, a piece of cheese or chocolate.You can mix these ingredients with pudding or yogurt.
– If your child prefers puree, make soups, use milk, white sauce, heavy coconut milk rather than water to achieve the correct consistency, dilution with water makes the taste worse and leaves less nutrients. Avoiding the use of a sieve retains the fibers.
– for lesions of the mouth, it is better to give the child chilled food
If the weight gain fluctuates, you can use another type of milk – more concentrated, for example, Nutrini (Nutricia).


Constipation is often the result of too little fluid due to reduced food intake or increased demands on hot weather. A child with EB with severe blistering needs more fluids. Constipation may be due to or exacerbated by iron supplementation.
In children with EB, even strong peristalsis can cause pain and blistering on the thin skin around the anus. Fear of pain as food passes through the intestines can lead to inhibitory actions.A vicious circle is established, the child suffers more and more constipation, and his appetite decreases. Regular bowel movements are also dependent on regular food intake, irregular feeding and poor appetite lead to heavier movements. Try to increase the fluid intake to 150 ml per kg over 24 hours for young children who do not get fluids through food. Offer your child bottled water, diluted freshly squeezed juice (1 teaspoon of juice per 100 ml of water).

If increased fluid intake does not help with constipation, you can use a mild laxative, you need to consult a specialist, it is important to see a doctor early.

From the moment your child starts eating solid foods, try to give him puree of fruits and vegetables every day. From 9 months, you can give cereals from unprocessed grains, from 10-12 months, beans (and sweet corn if the child can chew it). Plum is very useful and is usually liked by babies if it is seedless or together with yogurt, cottage cheese, sweet cream.The fibers in these products, combined with a sufficient amount of liquid (about 100 ml / kg), help the food move more smoothly through the intestines and help it pass comfortably.

Sugar and dental care

In some types of EB, the structure of the teeth is disturbed; in other children, the teeth do not suffer.
The most common causes of tooth damage are:
– Blistering and scarring limits the tongue’s ability to remove food particles from the gums
– Bacteria near the teeth combine with sugar and release acid.The acid softens the enamel of the teeth by affecting the sensory nerves
– Teeth cleaning is usually difficult if the mouth is sore and the jaws are tightly clenched.

Tooth damage causes pain and decreases food intake. Removing damaged teeth is an unpleasant procedure and if multiple teeth need to be removed, anesthesia may be required. Extraction of teeth causes scarring in some forms of EB, leading to lack of tooth growth and problems with oral hygiene. Thus, it is important to protect your teeth as much as possible.

Due to the fact that children with the most severe forms of EB require more calories, and this is achieved by consuming sugar and eating frequently, it is important to maintain balance. Sugar consumption is just as important as frequent meals. Sugar together with other foods is less harmful than alone. Chocolate sponge cake immediately after the main meal is less harmful than in between meals if it is nibbled in small pieces over several hours. Drinks with sugar should be drunk quickly, or immediately after a meal with water.

Prevention is always more important than cure. If sugar is consumed in reasonable amounts, the benefit of this diet is that it uses more energy while minimizing tooth damage. The following are important points related to this topic:
– children should not normally consume sugar, it is better to add fruit sugar to the bottle
– no need to dip it in jam,
doll honey is lemonade, Coca-Cola should not be consumed by children due to high sugar and acid content.It is better to use water or milk instead.
– You can use cheese for snacks, for example, put it on sandwiches or make delicious sandwiches that melt in your mouth
– Avoid sweets and foods high in carbohydrates for up to 1 year, such as chocolate, by using more nutritious dishes.
– it is better to finish food with spices than sweets
– even children with 1 and 2 teeth should visit a dentist, preferably familiar with EB, to clarify the technique of brushing teeth and washing the mouth.

Stopping breastfeeding

Use this table as a guide, not a rigid schedule.


Early morning




Late evening

Not earlier than 17 weeks

Breastfeeding / infant formula

1-2 teaspoons of rice for babies with breast milk or formula

Breastfeeding / infant formula

Breastfeeding / milk formula

1-2 teaspoons fruit / vegetable puree

Breastfeeding / infant formula

Breastfeeding / infant formula

6-7 months

Breastfeeding / infant formula

Increase in cereals with breast milk or formula

Breastfeeding / infant formula

Increase in fruit or vegetable puree for appetite yoghurt / cottage cheese

Breastfeeding / formula milk / cup drinking

Meat, cut into pieces / puree of meat and gravy / vegetables that can be eaten by hand / baby food

Breastfeeding / infant formula

Breastfeeding / infant formula

7-9 months

Breastfeeding / formula milk / cup drinking

Crackers /

porridge mixed with breast or artificial milk for appetite

Breastfeeding / formula milk / cup drinking

Beans / cheese / boiled eggs / pasta with sauce, butter with bread, fresh fruit / yogurt /

Breastfeeding / formula milk / cup drinking

Increase the number of cuts of meat / puree of meat with gravy, pureed vegetables / vegetables that you can eat with your hands / baby food for appetite

Breastfeeding / formula / cup drinking

Breastfeeding / formula milk / cup drinking

9-12 months

Breastfeeding / formula milk / cup drinking

Oatmeal / breast milk or formula for appetite

Breastfeeding / formula milk / cup drinking

Increase in beans / cheese / boiled eggs / pasta with appetite sauce, bread and butter, fresh fruit

Breastfeeding / formula milk / cup drinking

Meat, cut into pieces and gravy / fish with sauce / potatoes / rice / pureed vegetables / vegetables that can be eaten by hand

Fresh fruit

Breastfeeding / formula milk / cup drinking

Breastfeeding / formula milk / cup drinking

12-18 months

Breastfeeding / formula milk / cup drinking

Oatmeal with cow’s milk

Bread and butter

Drink from a cup

Increase in the amount of food as before for appetite

Drink from a cup

Increase in the amount of food as before for appetite

Drink from a cup

Breastfeeding / formula milk / drinking from a cup

Nutritional Problems in Children with Severe BE

Damage to the mouth and esophagus, poor tongue mobility, teeth damage, sensitive gums, reflux, esophageal narrowness, pain ———–> inadequate food intake ———> constipation, anorexia , apathy ———–> poor growth, developmental delay, weak immunity, poor wound healing ———–> nutritional deficiencies, anemia, osteoporosis —- ——–> Wound Nutrient Loss

Iron deficiency anemia and iron supplements.

Children with EB are often anemic (according to blood tests) due to the following reasons:
First, their skin is very fragile, they regularly lose blood through wounds in the mouth, esophagus, intestines or anus, on the skin. Secondly, it is difficult for these children to eat meat due to problems with swallowing or chewing. Chronic anemia causes fatigue and an early symptom of loss of attention and lethargy. Anemia also negatively affects wound healing.
Iron supplements cause or worsen constipation (less likely to cause diarrhea), especially when taken on an empty stomach.It is especially important that such undesirable consequences are associated with the need to continue medications with iron. Iron supplements are available in syrup and tablet form and are better absorbed when divided into 2 doses throughout the day (this also reduces side effects) and taken at the same time. To maximize the effect of the intake, it is necessary to separate the intake of drugs with iron and zinc.

Zinc deficiency and zinc additives

Meat is one of the best sources of zinc in the diet.However, for many children with EB, meat is difficult to chew and swallow, so meat consumption is low. Zinc supplements should not be given solely on the basis of low blood zinc levels because zinc may reflect malnutrition and should therefore be consulted with a dietitian for advice. Zinc supplements are usually given in effervescent tablet form for children with EB. Unfortunately, zinc often causes nausea and occasional vomiting, which does not require taking zinc supplements on an empty stomach to minimize them.

Selenium deficiency and selenium supplements

Selenium is required in very small quantities and a deficiency usually develops over several years. Selenium deficiency usually occurs in conjunction with other nutrient deficiencies, so a diet aimed at replenishing the deficiency of these nutrients, not just selenium, is necessary. It is only available in pill form, which must be crushed if there are problems with swallowing.

Translation from English. S.I.Bobko, ed.V.I.Albanova



Acid reflux, which occurs when acidic stomach contents seep into the esophagus, can prompt numerous lifestyle changes, not all of which are happy 1. For wine drinkers, discovering that their favorite vintage is causing their symptoms can make heartburn worse …Fortunately, there are remedies that can help moderate wine drinkers avoid the discomfort of acid reflux, but it’s best to check with your doctor to determine which is right for you.

Is this an emergency?

Seek emergency help immediately if you experience severe medical symptoms.

How wine affects acid reflux

Wine can cause or worsen acid reflux in several ways. First, the alcohol it contains can cause relaxation of the lower esophageal sphincter, or LES, a muscle valve that normally closes to prevent acidic stomach contents from entering the esophagus 1.Then the wine is sour, which can aggravate pre-existing inflammation or injury. to the lining of the esophagus and can stimulate the secretion of acid in the stomach 3. In addition, alcohol itself can also irritate the lining of the esophagus.

Low acid wines

One option to try for acid reflux caused by drinking wine is to see what happens when you choose less acidic wines. According to Wine Spectator, wines from warmer climates have less acidity than wines from cooler climates.Low acid grape varieties include Viognier, Merlot, Carmenere and Gewurztraminer. White wine has been shown to stimulate acid reflux more than red or rosé wine.

  • One option to try for acid reflux caused by drinking wine is to see what happens if you choose less acidic wines.
  • White wine has been shown to stimulate acid reflux more than red or rosé wine.


Over-the-counter antacids such as Tums or Rolaids are the fastest way to get short-term relief from a severe attack of wine-induced acid reflux, as they neutralize the acid in the esophagus and stomach on contact. 13. Liquid antacids usually work the fastest. … While quick relief can be helpful in some cases, antacids are not the solution when the problem is persistent and severe GERD.


Certain medications taken before drinking wine can help prevent acid reflux and soothe symptoms once they have started. Acid blockers, known as h3 inhibitors, are relatively fast acting and are effective within 30 to 90 minutes. They are available over the counter under the generic names famotidine (Pepcid), cimetidine (Tagamet), and ranitidine (Zantac).

Other considerations

In the past, wine and other alcoholic beverages were on most doctors’ lists to avoid for those suffering from acid reflux.However, clinical practice guidelines currently recommend allowing patients to independently determine which foods or drinks are causing acid reflux symptoms. Moderating wine consumption can be a medicine in itself. However, if acid reflux is more than an occasional problem, you should consult your doctor. It is also recommended that you talk to your doctor about your drinking behavior. In addition to exacerbating or causing acid reflux and damage to the lining of the esophagus, excessive alcohol consumption can lead to high blood pressure, cirrhosis of the liver, and other serious health problems.

  • In the past, wine and other alcoholic beverages were on most doctors’ lists to avoid for those suffering from acid reflux.
  • However, if acid reflux is more than an occasional problem, you should consult your doctor.

Leukoplakia – causes, symptoms and treatment of the disease

Leukoplakia of the oral cavity – a disease in which there is increased keratinization of the mucous membrane.The lesion can form on the surface of the tongue, the mucous membrane of the cheeks and corners of the mouth, in the palate. The disease begins with the formation of a small area of ​​inflammation, which remains unnoticed due to the absence of pronounced symptoms – only a whitish or gray coating may be present. But as the disease develops, the foci become larger, and other signs join the plaque. A distinctive feature is that it is impossible to remove plaque with improvised means. Over time, the affected area coarsens, which significantly increases the risk of developing a malignant tumor.

Causes of leukoplakia

The causes of leukoplakia usually lie in damage to the mucous membrane. This can happen as a result of the following factors:

  • Violation of the integrity of the mucous membranes. Scratches and wounds resulting from improper bite, cheek biting, sharp edges of teeth with chipped enamel or incorrectly installed dentures.

  • Irritation of the mucous membrane with food – acidic, spicy, too salty food, food of extreme temperatures can also provoke micro-damage to tissues.Alcohol, tobacco smoke and chewing tobacco also irritate tissues.

  • Irritation by galvanic currents – metal crowns increase the risk of developing leukoplakia.

  • Occupational hazard. Labor in the chemical industry, work with paints and varnishes, resins, etc. can have a negative effect on mucosal cells.

  • Exposure to stomach acid. Gastroesophageal reflux, bulimia, and other illnesses can reduce mucosal resistance and irritate them, making them more likely to develop.

  • Decrease in general protective forces. Avitaminosis, the use of antibiotics, previous operations and severe infections, hypothermia, hormonal diseases, menopause and many other factors that contribute to a decrease in immunity can be the main or aggravating factors in the development of the disease.

Heredity is also important – researchers have found that the disease more often affects people whose close relatives are sick with leukoplakia of the oral mucosa.

This disease is precancerous, therefore, at the slightest suspicion, it is important to consult a dentist.

Symptoms and manifestations

At the initial stage of development, the characteristic symptoms of leukoplakia may not be present. Gradually, small foci of white or gray color appear in the mouth – up to several millimeters. The surface of the altered areas is rough and hard. Mucous membranes around the lesion may appear unchanged and healthy.

The disease can spread almost anywhere in the mouth.When lesions appear on the gums, discomfort and slight pain when chewing and brushing teeth may be added to the external symptom.

Usually, a visit to a doctor occurs when the focus develops up to 2-4 cm and other manifestations of the disease join: a violation of taste, difficulty in chewing, pain, repeated inflammation of the mucous membrane.

Types of leukoplakia

The type of disease determines the tactics of treatment, as well as specific symptoms. There are several forms of the disease.


Flat leukoplakia is the most common variant. In most cases, the disease is discovered by chance, as part of a routine dental check-up or while treating other oral diseases. For a long time, this form of the disease does not make itself felt. Only a few weeks or months after the onset of the disease appear a slight burning sensation, a feeling of pressure and retraction of the affected area. If the tongue is affected, the disease is detected earlier.This is due to the loss of gustatory sensitivity.

With a flat shape, the focus of changes is a dry, rough surface of any shape and size. With damage to the inner surface of the cheeks, pathology often forms around the excretory ducts of the salivary glands. When it appears in the sky, tongue or under it, the focus often looks like white stripes with alternating dark areas. In half of patients with leukoplakia, the formation rises above the surface of healthy mucous membranes by 1-3 mm. The color of the plaques can be milky, white, or grayish.As a rule, the disease is not accompanied by inflammatory complications.


Verrucous leukoplakia can be a consequence of flat, if the provoking factor has not been eliminated. Hyperkeratosis becomes more pronounced, the focus rises above the surface of the mucous membranes by 3-5 mm. When probing, it has a hard surface and can be mobile. Usually this form is not accompanied by pain.

The color of the affected area gradually changes to yellowish. Other characteristic symptoms include severe burning sensation while eating and when exposed to water, a feeling of tightness, and discomfort in the mouth.This form has a high risk of malignancy.


This type of leukoplakia develops from verrucous in 1/3 of all cases. On the pathological area of ​​the mucous membrane, multiple small ulcers and cracks are formed. This leads to the attachment of sharp pain. The size of the lesions increases, and eating and even talking becomes difficult.

Violations of tissue integrity become the gateway to infection. Therefore, the erosive form is often accompanied by inflammatory complications, depending on the localization of the pathological focus – gingivitis, glossitis, stomatitis, etc.

Tupeiner’s Leukoplakia

This form of the disease is characteristic of smokers. Smoking 10 cigarettes a day increases the likelihood of developing the disease 50 times. Usually, areas of the soft and hard palate are affected, less often the gums. If you give up a bad habit, the disease can disappear without a trace on its own.

The mucous membranes of the palate become cyanotic or gray, acquire a folded structure. The narrowing of the ducts of the salivary glands leads to the accumulation of secretions in the tissues, stagnant processes and the development of inflammation.The disease looks like multiple red nodules, accompanied by inflammatory processes.


This species is a benign lesion. The focus is characterized by strong desquamation up to the loss of large areas of keratinized epithelium. Ulceration and cracks appear on the formation, bleeding is observed. The size of the tumor can reach five centimeters in diameter and rise above the healthy tissue by more than a centimeter. Such leukoplakia of the oral cavity can develop as a result of sudden hormonal changes, depression, stress.

Diagnostic features

Diagnosis of the disease begins with a visual examination by a dentist. The doctor will ask questions about the general state of health, clarify the prescription of complaints, identify risk factors for the development of the disease. The specialist can confirm the assumption using several methods:

  • Biopsy. One of the most accurate diagnostic methods, in which an area of ​​altered tissues is taken and further studied in the laboratory.

  • Smear for oncocytology. It is a scraping of the surface cells of the mucous membrane.

  • Schiller’s test. An iodine solution is applied to the mucous membrane, the changed areas are not stained.

  • Laboratory tests – general blood test, research for tumor markers, etc.

Other diagnostic methods may be required depending on the clinical picture.

Treatment methods

Treatment of leukoplakia may require a collegial approach: the participation of an oncologist in the development of an action plan.The basis of therapy is the elimination of provoking factors: quitting smoking, changing jobs in case of occupational harm, adherence to a soft diet with refusal of spices, etc. According to indications, correction of dentures, replacement of fillings, treatment of caries, removal of teeth that cannot be restored and other measures are carried out …

As part of a comprehensive treatment, the doctor may prescribe the following medicines:

  • Preparations for restoring the normal structure of the oral epithelium.It is usually applied in the form of applications to the affected areas.

  • Antiseptics. Used for the prevention and treatment of inflammatory complications of the disease.

  • Painkillers and symptomatic therapy. Systemic medications or local anesthetic applications used in dentistry may be used.

Self-medication for leukoplakia in the mouth is strongly discouraged. Many drugs, including some anti-inflammatory drugs, are irritating and increase the risk of cancer.

In case of severe disease, hospitalization may be required. The presence of ulcers and erosions is an indication for the use of hormonal anti-inflammatory drugs, proteolytic enzymes, etc. Surgery is indicated if conservative treatment is ineffective. Cryodestruction, excision with a scalpel are usually used.

Preventive measures

The basis for the prevention of leukoplakia is the rejection of bad habits, adherence to a gentle diet and oral hygiene.It is important to visit your dentist regularly and treat oral diseases in a timely manner. Particular attention should be paid to patients with a genetic tendency to leukoplakia.

90,000 Can Tomatoes Cause Bloating? – Health

Unsurprisingly, bloating is a fairly common indigestion problem. It can be caused by diet, lifestyle and certain chronic diseases, and often appears with total samples


Not surprisingly, bloating is a fairly common indigestion.It can be caused by diet, lifestyle and certain chronic medical conditions, and often appears along with general digestive problems such as constipation. Whether you experience this feeling of bloating and tightness regularly or infrequently, it is not always easy to pinpoint the cause. While some foods often cause bloating, other foods, including those that commonly promote digestive health, such as tomatoes, can cause bloating in some people.

Tomatoes and Digestion

Tomatoes are widely recognized as a healthy, low-calorie source of vitamin C, potassium and beneficial antioxidants. Thanks to their moderate amount of fiber and high water content – fruits provide about 2 grams of fiber per cup and are almost 95 percent water – tomatoes promote efficient digestion and regular bowel movements. However, these generally positive characteristics can cause bloating, especially if you eat a lot of tomatoes or your diet is low in fiber.Bloating caused by water is usually short-lived, while bloating caused by a sudden increase in fiber is often accompanied by intestinal gas.

Tomato sensitivity

Despite the high water content, tomatoes are relatively sour. If you have a sensitive stomach, eating tomatoes can irritate the stomach lining, causing inflammation and mild bloating. However, severe bloating after eating tomatoes can be a sign of intolerance – a chemical reaction that can only occur after eating a certain amount of problem food.Like dairy products, chocolate and citrus fruits, tomatoes are a common cause of food intolerances. Food intolerances, in turn, can cause bloating and bloating or a visible increase in abdominal girth.

Effects on IBS and GERD

Tomatoes may be more likely to cause bloating in the presence of common underlying digestive disorders, including irritable bowel syndrome and gastroesophageal reflux disease. Although IBS is a complex problem that is not well understood, food intolerances are believed to cause common symptoms of IBS in some patients, including bloating.Tomatoes and other acidic foods are known to cause GERD symptoms in some people. GERD, also known as acid reflux, occurs when a weak esophageal sphincter allows digestive juices from the stomach to travel up into the esophagus. While this usually leads to heartburn, it can also cause other gastrointestinal symptoms, including bloating, especially in a large proportion of GERD patients who also have dyspepsia or indigestion.

Other considerations

You don’t have to have a digestive disorder or food intolerance to bloat after eating tomatoes, especially if you usually eat tomatoes as a sauce.Like tomato juice and other concentrated tomato products, tomato sauce is very high in sodium – according to the USDA, an average serving of 1 cup contains over 1,100 milligrams of sodium. Foods high in sodium cause water retention, which can lead to temporary bloating, especially in people who are sensitive to sodium.