Most of us get a little heartburn once in a while. Over-the-counter antacids usually take care of the discomfort in our chests or throats, and we feel instant relief.

For others, the problem is more serious: gastroesophageal reflux disease, or GERD. Also known as reflux, GERD is chronic heartburn that affects a person’s quality of life.

“About 20% of people have some form of reflux,” says UNC Health gastroenterologist Nannaya Jampala, MD.

Even infants can experience reflux, he says. Fortunately, most outgrow the problem in six to nine months.

Heartburn pain is caused by stomach acid backing up into the esophagus, which is the tube that takes food from your mouth to your stomach. There is a ring of muscle, called a sphincter, at the end of the esophagus that normally keeps acid from splashing up. If it relaxes at the wrong time, acid can irritate the esophagus, which doesn’t have the same protective lining that the stomach does.

If you are experiencing heartburn more than once a week that affects your quality of life—or if you have pain or difficulty swallowing, have an unexplained cough or are losing weight without trying—check with your doctor. “Silent reflux” (GERD without feeling the burn) is rare, but damage is still being done.

“There’s a danger if GERD is left untreated,” Dr. Jampala says. “Prolonged exposure to stomach acid could lead over time to esophageal cancer.”

Fortunately, he says, GERD is easy to diagnose and treat. A variety of over-the-counter and prescription medicines can help reduce acid production, and antacids can neutralize acid if you have breakthrough heartburn. Talk to your doctor about which medicine may be right for you.

What you should (and shouldn’t) eat with GERD

For many people, dietary changes—not only what they eat, but also when and how much—can solve their heartburn problems, says UNC Health dietitian Shelly Wegman.

Certain acidic or spicy foods can increase GERD symptoms. Wegman suggests avoiding carbonated beverages, alcohol, caffeine, peppers, peppermint and spearmint, citrus fruits (oranges, grapefruit, lemons and limes), tomatoes, garlic, onions, fried foods, and high-fat gravies and sauces.

“Everyone is different,” she says. “And how much effect these foods have depends on how much and how often you eat them.”

For example, stuffing yourself full of lasagna or enchiladas is probably going to cause some heartburn—especially if you follow that big meal with a nap or a cigarette, which can relax the esophageal sphincter.

To avoid the pain, Wegman says, better choices would be herbal teas, decaffeinated coffee, meats, fish, beans and rice. Grilling chicken and pork is better than frying them. And you may not even miss the garlic and onions once you start exploring herbs and spices—think cumin, coriander, basil, ginger, turmeric, rosemary and dill.

When and how to eat to avoid GERD symptoms

“When you can, eat in a more relaxed, stress-free setting,” Wegman says.

Try not to overeat. Your body produces more acid to digest a big meal. When your stomach is too full, the acid can back up into your esophagus, causing heartburn.

On the other hand, if your stomach gets too empty, your body produces more acid in preparation for the food it is growling for.

“You need to find your stomach’s happy place—not too full and not too empty,” Wegman says.

She recommends eating small meals throughout the day.

Wegman also suggests not lying down too soon after eating—wait two to three hours instead. For most of us, that means cutting out late-night snacks.

Some people also tout the benefits of intermittent fasting, but Wegman says that approach may exacerbate GERD.