What foods should you avoid if you have systemic sclerosis?

October 9, 2025 •

4 min read

Over 90% of individuals with systemic sclerosis (SSc), also known as scleroderma, experience some form of gastrointestinal (GI) tract involvement, making dietary adjustments a crucial part of managing the condition. Knowing what foods should you avoid if you have systemic sclerosis can significantly help minimize bothersome symptoms like acid reflux, bloating, and swallowing difficulties.

Quick Summary

This article outlines key food groups and specific items to avoid for managing systemic sclerosis symptoms, including those that trigger acid reflux, bloating, and swallowing problems. It also covers the importance of eliminating ultra-processed foods and identifies potential individual food intolerances.

Key Points

Acid Reflux Triggers: Avoid fatty and fried foods, caffeine, alcohol, chocolate, mint, and highly acidic items like citrus fruits and tomatoes to prevent heartburn.
Bloating and Gas Management: Consider a low FODMAP diet to reduce symptoms caused by intestinal fermentation, avoiding fermentable carbohydrates found in wheat, dairy, and certain fruits and vegetables.
Dysphagia Adaptation: Choose soft, moist, or puréed foods and avoid dry, tough, or sticky textures that are difficult to swallow due to slowed esophageal motility.
Reduce Inflammation: Limit consumption of ultra-processed foods, those high in added sugars, and high-sodium items to minimize systemic inflammation and support gut health.
Individualize Your Diet: Keep a food diary to identify your specific intolerances, which may include dairy or gluten, and work with a healthcare professional to ensure nutritional adequacy.
Beware of Drug Interactions: Be mindful of potential food-medication interactions, such as grapefruit's effect on calcium channel blockers, often prescribed for Raynaud's phenomenon.

Systemic sclerosis (SSc) is a complex autoimmune disease that can have a profound impact on the gastrointestinal (GI) tract. The fibrosis and vascular damage characteristic of SSc can affect any part of the GI system, from the esophagus to the rectum. This can lead to a range of challenging symptoms, including severe acid reflux, bloating, malabsorption, and difficulty swallowing (dysphagia). While there is no one-size-fits-all diet for SSc, avoiding certain foods and making strategic dietary changes can provide significant symptom relief and improve overall quality of life.

Trigger Foods for Acid Reflux

For many with SSc, acid reflux is a primary concern due to impaired esophageal motility and a weakened lower esophageal sphincter (LES). Certain foods and beverages can exacerbate this by increasing stomach acid or further relaxing the LES. Individuals should consider limiting or eliminating the following:

High-Fat Foods: Fried foods, greasy items, whole milk, and high-fat cheeses can delay stomach emptying and relax the LES, leading to increased reflux. Opt for lean proteins and healthy fats in moderation, such as those from olive oil or avocado.
Acidic Foods: Tomatoes and tomato-based products (sauces, ketchup), citrus fruits (oranges, lemons), and vinegar can irritate the esophagus and worsen heartburn.
Spicy Foods: Hot spices like chili, mustard, and pepper can cause burning sensations and abdominal pain, irritating the digestive tract.
Caffeine: Found in coffee, tea, and some sodas, caffeine can increase stomach acid production and relax the LES.
Alcohol and Carbonated Beverages: Alcohol, especially on an empty stomach, increases stomach acid. Carbonated drinks introduce gas into the stomach, which can worsen bloating and pressure.
Chocolate and Mint: Both chocolate and mint (including peppermint) are known to relax the LES, making it easier for stomach acid to flow back up.

Dietary Changes for Bloating, Gas, and Abdominal Discomfort

Bloating, gas, and cramping are often caused by altered intestinal motility and small intestinal bacterial overgrowth (SIBO), which can be common in SSc. A low FODMAP diet is a research-supported approach for identifying and reducing triggers. FODMAPs are types of carbohydrates that can be poorly absorbed and fermented by gut bacteria, causing gas and bloating.

High FODMAP foods to consider limiting include:

Dairy: Milk, yogurt, ice cream, and certain cheeses contain lactose, a FODMAP. Lactose-free or plant-based alternatives may be better tolerated.
Grains: Wheat and rye contain fructans, a type of FODMAP. Gluten-free alternatives like quinoa and rice may reduce discomfort.
Legumes: Beans, lentils, and chickpeas contain galacto-oligosaccharides and can cause significant gas and bloating.
Certain Vegetables: Onions, garlic, asparagus, broccoli, and cauliflower are high in FODMAPs and may need to be avoided or cooked thoroughly, as cooking can sometimes improve tolerance.
Certain Fruits: Fructose-rich fruits like apples, pears, peaches, and cherries are high in FODMAPs.

Modifying Diet for Dysphagia and Dry Mouth

Dysphagia, or difficulty swallowing, is another common symptom of SSc caused by slow esophageal muscle movement. Dry mouth, due to decreased saliva production, can further complicate swallowing.

Dry and Tough Foods: Tough cuts of meat, nuts, seeds, toast, and crackers can be difficult to chew and swallow. Soft, moist protein sources like fish, ground meats, or eggs are better choices.
Sticky Foods: Mashed potatoes, soft candy, and thick white bread can stick in the throat and are best avoided. Moistening food with sauces or gravy can help.
Hard-to-Chew Vegetables: Raw, fibrous, or tough vegetables can be challenging. Puréeing or blending vegetables into soups can make them easier to consume.

Foods to Limit Due to Overall Impact

Beyond symptom-specific triggers, certain food categories should be generally limited to reduce inflammation and support overall health in SSc.

Ultra-Processed Foods: Instant noodles, deli meats, frozen meals, and sugary snacks are often high in additives and low-quality fats that can harm gut bacteria and increase inflammation. Choosing fresh, whole foods is always the best option.
Added Sugars: High intake of added sugars can fuel inflammation. Check labels for ingredients like corn syrup, sucrose, and honey.
High Sodium Foods: High sodium intake can contribute to high blood pressure, which is a concern for many with SSc. Highly processed foods and cold-cuts are often high in sodium and should be limited.

Comparison of Foods: Avoid vs. Embrace


Issue	Foods to Avoid	Better Alternatives
Acid Reflux	Fatty/fried foods, coffee, chocolate, mint, acidic fruits/tomatoes, alcohol	Lean protein (fish, poultry), cooked vegetables, mild spices, herbal tea, water
Bloating/Gas	High-FODMAP foods (wheat, dairy, legumes, onions, garlic)	Low-FODMAP alternatives (oats, rice, lactose-free milk), well-cooked vegetables
Dysphagia	Dry foods (crackers, toast), tough meats, sticky textures	Soft and moist foods (soups, stews, purées), smoothies, well-cooked meats
Inflammation	Ultra-processed foods, added sugars, high sodium	Fresh, whole foods, antioxidant-rich fruits/vegetables, omega-3 fats

Navigating Dietary Needs with SSc

Managing diet with systemic sclerosis is an individual journey, and it’s important to work closely with your healthcare team. The severity and type of GI symptoms can vary widely. Keeping a food diary can help identify specific triggers, and a registered dietitian can provide personalized guidance to ensure you maintain adequate nutrition. In some cases, eliminating common culprits like gluten or dairy may be a necessary diagnostic tool to pinpoint intolerances. The ultimate goal is to find a diet that minimizes discomfort while providing the necessary nutrients.

For more detailed information and resources on managing scleroderma, you can visit the Scleroderma Research Foundation website at srfcure.org.

Conclusion

For individuals with systemic sclerosis, dietary management is a cornerstone of effective symptom control. Avoiding common acid reflux triggers like high-fat, spicy, and acidic foods is crucial. For bloating and gas, a low FODMAP approach can be highly effective. Adjusting food textures and consistency can dramatically improve swallowing for those with dysphagia. By limiting processed foods, added sugars, and excess sodium, and focusing on fresh, whole foods, patients can reduce inflammation and support their overall health. Personalized guidance and a systematic approach to dietary changes can make a significant positive impact on managing the complex GI challenges of SSc.

Frequently Asked Questions

Yes, some people with systemic sclerosis benefit from eliminating wheat (gluten) and dairy, especially if they have associated intolerances. Since celiac disease has a higher prevalence among SSc patients, an elimination diet under medical supervision can help identify if these foods worsen your GI symptoms.

Some fruits and vegetables, particularly raw or high-FODMAP ones, can worsen symptoms. For acid reflux, avoid citrus fruits and tomatoes. For bloating, limit high-FODMAP options like apples, pears, and garlic. Thoroughly cooking vegetables can improve tolerance.

To manage dry mouth and dysphagia, avoid dry, sticky, and tough foods. Eat soft or puréed foods, and moisten meals with sauces, gravies, or broth. Drinking small sips of water throughout the day also helps.

Ultra-processed foods are high in additives, added sugars, and unhealthy fats that can promote inflammation and disrupt gut health. Choosing fresh, whole foods helps to support your overall health and minimize potential triggers.

High sodium intake is linked to increased blood pressure, which can be a concern for SSc patients. While the link to autoimmune activity is still being researched, limiting high-sodium processed foods and meats is generally recommended for cardiovascular health.

FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. These short-chain carbohydrates can ferment in the gut, causing gas, bloating, and pain. A low FODMAP diet restricts these foods and can be a helpful short-term tool to identify specific triggers for your symptoms.

Staying warm and promoting circulation is key for Raynaud's. Drinking warm liquids and eating warm foods can help. Eating foods rich in Omega-3 fatty acids, like fatty fish, can also reduce inflammation.