Portion Perspective Overeating is a surefire way to aggravate the symptoms of reflux. A full stomach applies pressure on your lower esophageal sphincter, says Roberta Anding, a registered dietitian and spokesperson for the American Dietetic Association. Yet most restaurants pile two or more servings onto one entrée-size plate. To help control GERD while eating out:

Ask the waiter for a half portion.Share a meal with your dining partner.Order two small appetizers for your main course.Take half your entrée home in a to-go bag.Eat slowly

Self-Knowledge You can read about the various causes of GERD and not clearly recognize yourself among the many descriptions. That’s because individuals are unique and different things - including foods - trigger GERD. Because people are not genetically identical, Anding says, you must learn which specific foods aggravate your reflux symptoms - and keep track of them. Anding suggests that when you dine out you ask the waiter how a dish is made. A menu might list pasta with cream sauce, but that could be a red cream sauce. If tomatoes trigger your symptoms, then you’ll wish you had ordered something else.

Some foods are notorious for causing GERD to flare up. While it’s important to know which foods specifically contribute to your reflux symptoms, here are a few general menu guidelines: Avoid acidic foods. For example:

Condiments like ketchup, mustard, and vinegarTomato-based sauces and soups

Steer clear of citrus fruits. For example:

Oranges, lemons, grapefruit, and limes - whole or in juice formAny seafood dish cooked or basted in lemon juice

Forgo fried foods. For example:

Anything sautéed in butter or oilFrench fries, onion rings, fried fish, potato chips

Forget about fatty foods. For example:

Fatty cuts of meat, such as prime rib, duck, and sausageMeals made with high-fat dairy, such as cheese, cream, and butter

Pass on spicy foods. For example:

Spicy peppers, red pepper flakes, wasabi, salsa, and hot sauceFinally, go easy on garlic, shallots, and onions.

Choose Cuisines Carefully

Going out for ethnic or fast food? The following are some smart and not-so-smart choices for people with GERD. At an Asian restaurant… Order:

Steamed dishes made with vegetables, chicken, tofu, beef, or porkNoodles in brothEgg drop, clear, or miso soupSushi with soy sauce (skip the wasabi)Steamed dumplingsEdamameFortune cookies

Avoid:

Fried eggrolls, dumplings, rice, and crab rangoonsWonton soup"Crispy" anythingGeneral Tso’s dishesTempuraThai spices

At a Mexican restaurant… Order:

Vegetarian refried beans (made without lard)Vegetable burrito or quesadilla without cheeseBrown riceGuacamoleGrilled fajitas

Avoid:

Mole (chocolate) sauceAnything labeled spicy or containing chiles or jalapeño peppersFried tortillas (chips, strips, or salad bowls)SalsaSour creamDeep-fried ice cream

At an Italian restaurant… Order:

Broth-based pasta sauces and soupsBread sticksSalad with light Italian dressing on the sideRoasted, grilled, or broiled meatsGrilled, poached, or steamed fish dishes (without cream sauce)

Avoid:

Cheesy dishes like lasagna, ravioli, and tortellini and anything with an Alfredo sauceTomato-based dishes like red pizza, pasta with red sauce, bruschetta, and tomato soupFried appetizers like zucchini and calamariChicken, veal, and eggplant Parmesan

At a fast-food restaurant… Order:

Grilled chicken sandwichSalad with light dressingPlain hamburgerTurkey or ham submarine sandwich with veggies

Avoid:

French friesFried fish or chicken sandwichesHeavy condimentsMilkshakes

Assess the Extras

Some extravagances go hand in hand with a fine restaurant meal - specifically, dessert and alcohol. But if you want to walk away with fond memories of your dining experience, it’s important to ask yourself if indulging is really worth it. If you do decide to dive into the “good stuff,” these tips will help guide you into safer waters:

Enjoy one glass of wine and stop there.Look for lighter desserts made with fresh fruit.Avoid anything made with chocolate or full-fat dairy, including dishes like crème brûlée, cheesecake, and pudding.Split a dessert with your dining partner.Choose decaf coffee or tea.Resist the chocolate mint candy on the way out; the mint and chocolate deliver a double whammy.

Eating out with GERD can be a challenge. But if you make smart choices and keep track of the foods that tend to aggravate your reflux, you can enjoy a restaurant meal without getting burned by GERD’s side effects. As Anding says: Moderation while eating out will provide reasonable symptom control. You may not walk away without any reflux symptoms, but if you enjoy one glass of wine, a few bites of dessert, and take half your meal home with you, you should be able to enjoy a restaurant meal without severe symptoms. And enjoyment is what a restaurant meal is all about!