What Foods Should I Avoid with Scleroderma? A Nutritional Guide

October 9, 2025 •

4 min read

According to the Scleroderma Foundation, around 90% of individuals with systemic sclerosis (scleroderma) experience gastrointestinal issues. Understanding what foods should I avoid with scleroderma is therefore a critical step toward managing these symptoms and improving your overall well-being. This guide will help you navigate common dietary pitfalls and identify trigger foods that can exacerbate your condition.

Quick Summary

This guide covers specific food categories and items to avoid with scleroderma, particularly those known to worsen digestive issues, inflammation, and other symptoms. It offers practical advice for managing acid reflux, bloating, and swallowing difficulties through informed dietary choices, emphasizing the importance of personalized nutrition.

Key Points

Avoid Reflux Triggers: Limit citrus, tomato products, fatty foods, caffeine, and spicy items to reduce heartburn.
Reduce FODMAPs for Bloating: Certain carbohydrates in foods like onions, garlic, and wheat can cause significant gastrointestinal discomfort.
Say No to Ultra-Processed Foods: High salt, sugar, and artificial ingredients can increase inflammation and harm gut health.
Modify for Swallowing Issues: Soften or puree foods that are difficult to chew or swallow, and avoid dry, hard, or sticky textures.
Manage Raynaud's: Minimize cold food and drinks, as they can constrict blood vessels and worsen symptoms.
Consult a Professional: Work with a registered dietitian to create a tailored dietary plan and ensure proper nutrition.

Understanding the Link Between Diet and Scleroderma Symptoms

Scleroderma is a complex autoimmune disease, and its impact on the gastrointestinal (GI) system is one of the most common challenges patients face. Thickening and scarring of tissue can lead to poor GI motility, making it difficult for food to move through the digestive tract. These issues can cause a range of symptoms, from severe acid reflux to malnutrition. A mindful approach to diet is not a cure, but it can significantly reduce discomfort and improve quality of life. The foods you choose can either soothe or irritate your GI tract, making it essential to know what to put on your plate—and what to leave off.

Foods to Avoid for Managing Acid Reflux and Heartburn

Acid reflux is a common issue for scleroderma patients due to weakened esophageal sphincter muscles. Certain foods are notorious for triggering or worsening these symptoms and should be minimized or eliminated.

Citrus and tomato-based products: High acidity can irritate the esophagus. This includes oranges, lemons, grapefruit, and tomato sauces.
Spicy foods: Chili peppers, strong spices, and hot sauce can aggravate the stomach lining and trigger heartburn.
Caffeine and alcohol: Both coffee and alcoholic beverages can relax the lower esophageal sphincter, allowing stomach acid to back up.
Fried and fatty foods: These foods are slow to digest and can increase pressure on the stomach, leading to reflux.
Onions and garlic: For many, these gas-producing foods can worsen GI discomfort.
Peppermint: While often thought of as soothing, peppermint can relax the sphincter muscle and should be avoided if you have reflux.

Avoiding Foods that Cause Bloating and GI Discomfort: The Low-FODMAP Approach

High-FODMAP foods contain certain carbohydrates that can be poorly absorbed in the small intestine, leading to significant gas, bloating, and pain. For scleroderma patients, whose GI motility is already compromised, this can be particularly problematic. Adopting a low-FODMAP diet under the guidance of a dietitian can be a useful tool to identify triggers and provide relief.

Foods to consider avoiding, at least initially, on a low-FODMAP protocol include:

Wheat-based grains: Bread, crackers, pasta, and cereals containing wheat.
Certain fruits: Apples, pears, peaches, watermelon, and cherries.
Specific vegetables: Onions, garlic, cabbage, and broccoli.
Dairy products: Milk, yogurt, and ice cream (lactose).
Legumes: Beans and lentils.
Sugar alcohols: Sorbitol, mannitol, and xylitol, often found in sugar-free products.

Dangers of Ultra-Processed Foods and Other Triggers

Beyond specific GI symptoms, ultra-processed foods can contribute to systemic inflammation, a key issue in autoimmune diseases. These items are often loaded with unhealthy fats, added sugars, and sodium, and should be limited.

Processed meats: Deli meats, bacon, and sausages contain high levels of sodium and preservatives.
Salty snacks: Chips, crackers, and other high-sodium packaged goods can exacerbate fluid retention.
Sugary drinks and sweets: Sodas, fruit juices with added sugar, and candy can contribute to inflammation and poor gut flora.

Managing Raynaud's Phenomenon and Swallowing Difficulties

Dietary choices can also impact other scleroderma symptoms. For Raynaud's, avoiding cold foods and drinks is often recommended, as they can constrict blood vessels and worsen symptoms. For those with dysphagia (difficulty swallowing), food consistency is more important than specific ingredients. Patients should avoid hard, dry, or sticky foods that pose a choking risk. Opting for soft, moist, or pureed options is safer.

Food Choices for Scleroderma Symptoms: Avoid vs. Soothe


Symptom	Foods to Minimize or Avoid	Foods to Favor	Reasoning
Acid Reflux	Citrus, tomatoes, spicy foods, caffeine, fatty meals	Bananas, melons, herbal teas, oatmeal, lean proteins	Reduces esophageal irritation and lowers stomach acid
Bloating	High-FODMAP foods (onions, garlic, wheat, certain fruits)	Low-FODMAP alternatives (white rice, carrots, spinach)	Minimizes fermentation in the gut, reducing gas and pain
Constipation	Processed, low-fiber foods	High-fiber whole grains, fruits (bananas, prunes), vegetables	Increases bulk and promotes GI motility
Swallowing Issues	Dry, tough, sticky, or hard foods	Soft, moist, pureed foods, smoothies, scrambled eggs	Prevents choking and makes consumption easier
Raynaud's	Cold drinks and icy foods	Warm beverages, soups, and foods at room temperature	Prevents blood vessel constriction triggered by cold

The Role of a Nutrition Professional

While this guide provides general advice, the best strategy is a personalized one. A registered dietitian can help you identify your specific triggers and create a dietary plan tailored to your needs. They can also help you navigate elimination diets like the low-FODMAP diet safely, ensuring you still receive adequate nutrients. In some cases, nutritional supplements may be necessary to address deficiencies caused by malabsorption.

Conclusion

For those living with scleroderma, managing symptoms often goes beyond medication. By carefully considering what foods should I avoid with scleroderma, you can gain a greater sense of control over your health. Focusing on whole, unprocessed foods, adjusting textures to aid swallowing, and steering clear of known triggers like high-FODMAP items and acidic foods can make a profound difference. Consulting a healthcare professional or a registered dietitian is crucial to develop an effective and safe nutritional strategy. While it may require significant lifestyle adjustments, making these changes is a powerful step toward minimizing discomfort and enhancing your quality of life. For more detailed dietary guidance, a reliable resource is the Scleroderma Foundation.

Frequently Asked Questions

Yes, a low-FODMAP diet can help manage severe gas, bloating, and GI discomfort for some scleroderma patients. It's recommended to do this under the guidance of a dietitian.

Spicy and greasy foods can trigger or worsen acid reflux and heartburn, which are common symptoms in individuals with scleroderma due to a weakened esophageal sphincter.

If you have dysphagia, try eating smaller bites, chewing thoroughly, and moistening food with sauces or gravies. Smoothies, pureed foods, scrambled eggs, and cottage cheese can also be helpful.

Some people with scleroderma find that avoiding lactose-containing dairy products can improve problematic GI symptoms like bloating. You can try a temporary elimination to see if it helps, ideally in consultation with a dietitian.

Ultra-processed foods are often high in salt, unhealthy fats, and additives that can increase systemic inflammation and contribute to poor gut health, both of which are concerns for scleroderma patients.

Strategies for constipation include staying well-hydrated by drinking plenty of water, consuming a high-fiber diet with whole grains and vegetables, getting regular exercise, and possibly using probiotics after consulting a healthcare provider.

Yes, caffeine can relax the esophageal sphincter, which allows stomach acid to enter the esophagus, worsening acid reflux and heartburn. Many scleroderma patients find it beneficial to reduce or eliminate coffee and other caffeinated beverages.

To support skin health, you can consume foods rich in Vitamin E, such as nuts (almonds, walnuts), seeds, extra-virgin olive oil, and avocado.

High sodium intake can contribute to fluid retention and may be a concern for individuals with scleroderma, especially if there is kidney involvement. Reducing processed meats and salty snacks is a good strategy.