Do Tomatoes Cause Acid Reflux and Heartburn?

Do you have acid reflux and heartburn? Can you eat tomatoes with acid reflux and heartburn? Does eating tomatoes cause acid reflux and heartburn? If you’ve been on the fence about eating tomatoes because you have GERD and fear side effects such as acid reflux, heartburn, nausea, excessive burping, a sore throat or a bad taste in the mouth, then read on to find out all about tomatoes and if and how they cause acid reflux and heartburn.

What is acid reflux?

Acid reflux disease, formally known as gastroesophageal reflux disease (GERD), is a digestive condition characterized by the regurgitation of stomach juices and sometimes also food particles. Experiencing 2 to 3 acid reflux episodes per week is considered a sign of acid reflux disease. In addition to antacids and proton pump inhibitors, dietary changes are a pivotal part of acid reflux treatment. High-fat foods, fried foods, processed foods (e.g. chips), spicy foods and acidic foods from pickles to lemons, lemon juice, tomatoes and tomato sauce are common trigger foods that cause acid reflux.

Tomatoes acid reflux

What is heartburn?

Heartburn is a symptom of acid reflux disease. Stomach juice is naturally acidic, corrosive even, so as it raises up into the esophagus, it irritates the esophagus lining. This causes a burning sensation that can be felt in the middle of the chest where the heart is located, aka heartburn, and even higher up, in the back of the throat. In more severe cases, regurgitated stomach juices pour back into the mouth causing a bad, acidic, metallic or sour taste in the mouth. Aside from heartburn, other symptoms of acid reflux may include excessive burping, bloating, a sore throat and sore tongue, hoarseness and coughing, including coughing due to acid reflux at night.

Do tomatoes cause acid reflux?

Tomatoes themselves hardly cause acid reflux in a healthy person with good digestive health, but can trigger it if the person eating them already has acid reflux disease. If the acid reflux is severe, than plenty of foods can act as triggers, including tomato sauce, tomato paste, tomato juice, canned tomato products and even fresh tomatoes. Ingredients such as oil, onions, garlic, vinegar, lemon juice or hot spices added to tomato products are more likely to and often cause more severe acid reflux episodes versus plain tomatoes eaten by themselves. If the acid reflux is mild to moderate, fresh tomatoes may be tolerated well in limited amounts, as well as plain tomato sauces made from cooked fresh tomatoes (without the addition of onions, garlic, acidic or spicy ingredients).

Tomatoes heartburn

Why are tomatoes a trigger food for acid reflux?

In an established disease especially, tomatoes and tomato byproducts represent a trigger food for acid reflux. That is, eating tomatoes or tomato products can cause acid reflux and symptoms such as heartburn, excessive burping, a bad taste in the mouth or a sore throat in people that already have acid reflux. But why? Here are some potential reasons:

  • Tomatoes are naturally acidic and thus trigger-foods.

Some varieties more than others, but nonetheless still acidic. Acidic foods are triggers for acid reflux disease, whether it’s tomatoes, tomato concentrate, paste or sauce, tomato juice, vinegar, lemon, lemon juice, oranges, orange juice, sour yogurt, buttermilk, soured milk etc. In an established disease, these kinds of foods become even stronger triggers.

  • An existing disease creates susceptibility to acid reflux episodes.

Acid reflux disease is characterized by a state of hyperacidity. While stomach juices are far more acidic than tomatoes, tomatoes are sufficiently acidic naturally to work up an already upset stomach even more, encouraging the overproduction of stomach juices which then results in episodes of acid reflux, setting up a vicious circle of events that reinforce themselves in a loop-type pattern.

  • Some tomato products are worse for acid reflux than others.

Sometimes fresh tomatoes don’t cause acid reflux at all, but tomato byproducts likely will. At the top of the list we have tomato concentrate, tomato paste, tomato sauce, canned tomato products and tomato juice. And it’s not just store-bought tomato products, but also home-made ones. While store-bought tomato products often have additives such as dyes, acidity regulators, thickeners etc. and preservatives that are likely causes behind acid reflux episodes, home-made tomato products may cause acid reflux if they contain other ingredients that may be triggers for acid reflux.

  • Added ingredients may be the culprit.

Not all tomato products have just tomatoes in them. Added ingredients such as onions, chives, garlic, too much oil or butter, sweet or spicy peppers, sweet or spicy paprika, ginger, turmeric, pepper, mustard seeds or paste, vinegar, lemon juice, wine, heavy meats (beef, pork, sausage), citric acid, various preservatives etc. are often the causes behind acid reflux episodes.

  • It’s the amount.

How much of something you eat can determine if it’s good or bad for you. Even with acid reflux you may be able to enjoy fresh tomatoes once or twice a week and feel great, with no flareups. But if you start eating tomato sauce every day or every other day, and choose dishes that require quite a lot (e.g. pasta or chili), or have tomato sauce at night before bed, then your chances of experiencing acid reflux grow exponentially.

Are tomatoes good for acid reflux?

What benefits do tomatoes give you for acid reflux? Tomatoes do not do anything for acid reflux specifically, in terms of treating it, but they can definitely cause acid reflux or worsen it if it’s already there. In my experience, if your acid reflux is severe, it might be a good idea to just go on a strict diet for a month or so and exclude all trigger foods (see here what foods to eat and to avoid for acid reflux). After a good flush out period, you can start reintroducing some foods back into your diet slowly. Fresh tomatoes, for example. Once or twice a week you can have a couple of tomatoes raw (without skin), or stew them lightly, and just monitor how you feel.

This post was updated on Saturday / October 3rd, 2020 at 2:16 AM