Diet and Barrett’s Esophagus

Many of the dietary recommendations for Barrett’s esophagus are similar to the diet recommended for patients with GERD (gastroesophageal reflux disease).

Here are some recommendations for reducing GERD and decreasing the amount of acid and food exposure in the esophagus

Stay upright for 3 hours after eating – this will allow your food to digest more completely and reduce the amount of reflux you have when you lay down

  • Elevating the head of the bed – this can also decrease the amount of reflux that occurs when you lay down as gravity will help keep food in your stomach. Propping on pillows may not be as effective as putting blocks, books, or bricks under the upper posts of your bed. A big pile of pillows can cause you to hunch over, which may increase reflux
  • Eat a low-fat diet – lower fat meals will digest more quickly, so you’ll have less reflux
  • Don’t smoke – while smoking is more strongly associated with squamous cell cancer of the esophagus, it can also contribute to esophageal adenocarcinoma, which is the kind of esophageal cancer related to BE
  • Reduce caffeine intake – caffeine relaxes the lower esophageal sphincter, which is the muscle at the bottom of the esophagus. When this muscle is relaxed, you’re more likely to have reflux of stomach contents into the esophagus. A little caffeine is probably okay, but multiple cups of coffee a day is too much. Remember that a standard size cup of coffee is actually pretty small, so one giant cup of coffee is actually equal to 2 or 3 cups of coffee! Many carbonated sodas also contain caffeine and tea (hot and iced) also contain some caffeine. To find out the caffeine content of beverages, a quick internet search for ‘caffeine content’ will pull up several sources, such as this one:
  • Alcohol – drink in moderation. Alcohol relaxes the lower esophageal sphincter and can increase reflux. However, there are some studies that suggest moderate wine or alcohol intake can lower the risk of Barrett’s and esophageal adenocarcinoma (this will be addressed in a separate post)
  • Weight loss – weight loss will also help improve reflux symptoms. Obesity increases the risk of both Barrett’s esophagus and esophageal cancer

– posted by Kerry Dunbar, MD

19 thoughts to “Diet and Barrett’s Esophagus”

  1. Since January of 2009, I don’t have reflux symptoms at all anymore. I have a hiatal hernia and I lost about 25 pounds since January of 2009 (I was diagnosed in February 2009 with BE). My question is, do I need to avoid all of these things without having any reflux at all. I actually read a couple of articles saying that coffee and tomatoes actually decrease your chances of certain cancers including esophageal, so I started drinking coffee and eating tomatoes again but I need feedback on these issues.

  2. Dear Annie – That’s great that you’ve lost weight! Weight loss, even a few pounds, can significantly help reflux symptoms. Tomatoes are very healthy and I’ve also seen some articles saying that the vitamins and other compounds in them can reduce cancer risk as part of a healthy diet. The results for coffee are less clear. Some patients will still have ‘silent reflux’ even when their GI symptoms like heartburn and regurgitation improve. I still have patients minimize coffee when their symptoms improve, although some coffee is ok. So you should talk to your gastroenterologist and see what her/his opinion is also. K Dunbar, MD

  3. Annie, I have been suffering from acid reflux for years and I never realized it was because of the foods I ate! I used the phentramin for a few months and I’m not really sure how much it helped since I had to use willpower too! But I switched from 3 southern meals a day to 5-6 small um… california meals a day ~haha~ and I think my metabolism is healthier!

  4. Dr. Dunbar,

    Hello! Thank you for the information regarding Barrett’s. I’ve recently developed duodenal ulcers (3 in total) and on a recent follow up from a hospital admission, I’ve been diagnosed, via biopsy, with Barrett’s. As one might imagine, this has me concerned. I am a former smoker (quit 4 years ago), a very rare drinker (maybe four to five times/year), of average to below average weight (148lbs at 64″), and a I have a fairly good diet with little red meat intake and even less junk food. As such, I am concerned with this development at my age of 41.

    The internet is filled with varied and interesting sites regarding Barrett’s, so I thought you might clear up the info regarding food items I need to avoid and things I might increase in order to avoid complications – especially cancer, as this has me worried given my age.

    Many thanks for your time and consideration!


    Dan Sanford, M.Ed

  5. Moderate alcohol drinking is ok then? I have always been told that alcohol was a big no,no.

    I guess I´ll look for more info on that in the next post.

  6. I did not know that it’s bad to lay down after you’ve eaten. This is what most people do when they ate too much. The rest of the Don’t Do list are very true. I’m now going to take a walk after I’ve eaten something…

  7. Thank you for the advice, I have a question, though. If I know a person who is suffering from Barrett’s Esophagus, should I convince him or her to lose weight ? Are regular weight loss programs adjusted to the needs of people with Barret’s Esophagus ?

  8. Dr. Dunbar

    Many thanks for your advice. Moderate alcohol intake might be very difficult for some people.

    Some people are alcoholics & don’t know it. Some may have an allergy to alcohol & may not know that either. Others simply need to reduce the amount of alcohol they are consuming for many different reasons, i.e. reducing the risk of Barrett’s and esophageal adenocarcinoma

    However, for some it may be necessary to stop drinking completely either in the short term or for the long term.

  9. Great site with stimulating comments. I recently read that there is a capsule sponge that can be swallowed for 5mins and recovered by an attached cord after collecting a cell sample that can be analysed to check for Barrett’s Esophogus.
    This will allow many more people to easily get an accurate diagnosis of any precancerous cells at an early stage and take action.
    It has been used succesfully on 500 patients and it is planned to be release soon.
    Hopefully this will significantly reduce the occurence of cancer developing in acid reflux victims.

  10. Hi Kerry,

    Letting gravity help with the refluxes is a good idea, I will try to stand up after my lunch today and see how that goes. I would love to be able to reduce my medicine intake to reduce this.

    My goal is to be able to drink Espresso Again – I love that stuff :-)

  11. Thanks for the information. I have already gone to 1/2 decaf and 1/2 caffeine in my coffee. Now I think I will go to decaf in the afternoon and the occasional cup in the evening.

  12. My old man smokes, drinks coffee and drinks beer heavily. He reached the age of 75 without getting any esophageal problems. You should also consider genetics and not just diet.

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  13. I’m 41 and just had an EGD, doc took some biopsies and told my husband he didn’t see any cancer and it was just a normal procedure (I was still groggy from the procedure so missed all of this). Then I saw on the paperwork the words “Barrett’s Esophagus”. Since finding this last night I have been a mess with worry. The internet is filled with all sorts of horror stories about Barrett’s and the high risk of cancer…chemo, removal of the esophagus, etc. I wish I had not found this on a Friday evening, now I have to wait all weekend to contact the doctor for more info. My question…is there indeed a very high risk of cancer for those who have Barrett’s? Is there a way to heal Barrett’s so that it doesn’t get worse or is it a matter of the damage is done and all one can do is “maintain”?

  14. Peggy – I was recently diagnosed with it also . . . don’t panic. From what I have been told and read, I think it’s under 5% of the people diagnosed with Barretts develop cancer in the throat. Those are low odds. I am trying to incorporate some dietary changes as well as not going to bed within 3 hours of eating . . . mydocs made it sound like it’s really nothing to worry about though I am like you and have been concerned. We know 2 people who have had it for over 20 years with no problems. Think the key is to get regular endoscopies every year or so to see if there are any changes.

  15. I’ve been dealing with acid reflux for couple years. It started when I gained about 30 pounds in a hear. I stopped drinking alcohol and lost about 20 pound. My acid reflux is almost nonexistent, with the exception of pizza night.

  16. Been dealing with acid reflux for 10 years…for some reason missed my last endo. Have it scheduled in two weeks…hope all is good. Feeling a lot of discomfort lately though. I really need to cut back on alcohol, coffee and could lose a couple pounds too. You’ve all inspired me to follow the BE diet.

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