Acid reflux from exercise

Exercise-Induced GERD: What to Do About It

The online fitness trainer and nutrition coach Ivana Chapman loves weight lifting, but weight lifting doesn’t always love her back. Even though Chapman competes in Masters National Physique competitions, the 41-year-old often struggles with exercise-induced GERD during training. A self-described natural athlete, Chapman switched to bodybuilding after competing internationally in karate for 14 years when GERD made martial arts maneuvers nearly unbearable.

“When my GERD is bad, I have to avoid any high-impact activities like running, jumping, or skipping rope,” says Chapman.

For athletes like Chapman who engage in high-intensity workouts, exercise-induced GERD is fairly common. Studies show elite runners often experience reflux. But you don’t have to be ultra competitive to experience reflux symptoms during exercise.

“There are certain activities that can trigger reflux, and exercise is one of them,” says Sumona Saha, MD, a gastroenterologist and an assistant professor of medicine at the University of Wisconsin School of Medicine and Public Health in Madison.

Like Chapman, who changed sports, it’s important for those with GERD not to give up exercising. And for the general GERD population, exercise can actually help reduce symptoms. If you’re overweight or obese, a 10 percent weight loss has been shown to reduce reflux and heartburn, says David Levinthal, MD, PhD, the director of the neurogastroenterology and motility center at the University of Pittsburgh Medical Center.

A study published in December 2016 in the journal Neurogastroenterology & Motility followed 15,295 generally obese patients and abdominally obese patients who self-reported GERD symptoms for several years and found that those who reduced their body mass index (BMI) by 2 kilograms (4.4 pounds) or more and their waist circumference by 5 centimeters or more improved their GERD symptoms.

What Happens When You Work Out With GERD?

During reflux, the lower esophageal sphincter (LES) muscle, which serves as a barrier between the stomach and the esophagus, opens, allowing stomach acid to travel up into the esophagus and cause heartburn. Any exercise that increases abdominal pressure, such as heavy lifting, stomach crunches, or high impact workouts, can trigger reflux.

“In reflux, whatever material is in the stomach will only come back through that barrier if the pressure in the stomach exceeds the pressure of the barrier,” says Dr. Levinthal.

If you have GERD and a hiatal hernia, that’s a double-whammy. Half of those with reflux have a hiatal hernia, even if they don’t know it, says Levinthal. “In that circumstance, the stomach may actually push up a little bit into the chest through a larger opening. It doesn’t make as close a seal.”

Pregnant women may also need to adjust their workout. At least 50 percent of women report some GERD in their pregnancy, usually in their third trimester when the fetus is almost fully formed, says Dr. Saha. “There’s mechanical pressure that’s applied to the stomach and there’s an upward motion of gastric content.” In early pregnancy, too, hormonal changes will cause weakening of the LES. “That doesn’t mean we don’t want women to exercise during pregnancy, they just need to find the exercises that suit them,” Saha adds.

While there are few rigorous studies on how exercise affects GERD, commonsense precautions can make a difference in keeping reflux down while you’re working out.

  • Reconsider eating before exercise. “The less material that’s in the stomach, the better. An empty stomach can’t reflux, essentially,” says Levinthal. Otherwise, wait one to two hours before exercising. “Not eating within two hours will give enough time for food to pass from the stomach to the small intestine. When food material has moved through the stomach, there’s less likelihood that someone is going to reflux while they’re exercising,” says Saha.
  • Choose food wisely. When eating before exercise, avoid foods that trigger GERD for you. Choose complex carbohydrates. Your stomach metabolizes these foods quicker, a process known as gastric emptying. People with diabetes may experience slower gastric emptying and should avoid high fat, high protein foods before exercise, which take longer to empty, says Saha. “Even two hours after eating a meal, their stomach may still not be clear of food and will reflux as a result.”
  • Eat slowly. Chapman says she needs to watch not only what she eats, but how, making sure she doesn’t eat too much or too fast. “I’m not always perfect with these things, so it can trigger symptoms.”
  • Avoid lying flat. Interventions to prevent reflux during sleep also apply to exercise. If you want to do crunches, do them on an incline bench. “When I’m experiencing moderate to severe acid reflux symptoms, I also need to avoid weight training while lying down,” says Chapman. “So I stick with seated or standing exercises at a slow pace. Too much jostling of the stomach makes the issue worse.”
  • Adjust your workout. “My general advice for clients who suffer with GERD is to listen to their bodies and start slowly,” says Chapman, who recommends walking and controlled weight training in a standing or sitting position. High impact, high intensity workouts, such as running, cycling, or rowing, can potentially cause reflux. Acrobat maneuvers and gymnastics may also jostle stomach contents. “The key thing would be avoiding exercises that would really taunt the lower esophageal sphincter’s barrier function. Things that put you in odd positions, upside down, or that defy gravity,” says Levinthal.
  • Skip the straw. Straws aren’t just bad for the environment, they’re bad for reflux, too. “When we drink through a straw, we actually swallow a lot more air. People find that they burp more because we’re taking in air with each sip of drink,” says Saha. Chewing gum causes aerophagia, too.
  • Dress in loose, comfortable clothing. Tight waistbands can put additional pressure on your abdomen.
  • Hydrate right. “You don’t want to get dehydrated, but take it easy on prehydration. If all that fluid is in your stomach, it’s the same rationale; it could potentially reflux up,” says Levinthal.
  • Take up yoga. “Yoga has actually been shown to improve digestion in some studies,” says Saha. One case report published in July 2013 in the International Journal of Yoga found that six months of yoga while on a proton pump inhibitor significantly reduced stomach acid and improved esophagitis. Just be sure to avoid positions that exacerbate GERD.

If lifestyle modifications don’t improve your GERD during exercise, ask your doctor about taking acid-suppressing medication, says Saha. “Exercise is so important not only for weight loss, which may improve their GERD, but also for general well-being.”

Stopping Bloating due to Acid Reflux

Posted by Glenn Ihde on March 28, 2012

Gastroesophageal Reflux Disease (GERD) is a medical condition where stomach acid backs up into the esophagus. It can cause a number of varying symptoms depending on the individual and the severity of the condition. Most commonly, a person suffering from GERD experiences heartburn, acid reflux and indigestion in Dallas. However, there are a variety of other symptoms that also frequently develop as a result of the disease, including chest pain, asthma and trouble swallowing.

One symptom that frustrates many GERD patients is bloating. Bloating is caused by a buildup of fluids in the abdomen that causes an individual to carry around excess weight. There are a number of ways to prevent bloating as a result of GERD:

• Create a food diary. Bloating frequently indicates intolerance to certain foods. Use a food diary to keep track of the times you feel bloated, including what you ate.

• Take digestive enzymes. By taking digestive enzymes approximately 30 minutes before eating you can help your stomach digest food more easily by reducing gas in your digestive tract.

• Avoid gas-producing foods. Foods, such as broccoli, cabbage, cauliflower, and beans produce gas, which may lead to excessive stomach bloating, particularly in people who have Gastroesophageal Reflux Disease (GERD).

• Chew slowly. Eating slowly will prevent you from inhaling excess air when swallowing your food.

• Avoid carbonated beverages. Instead, drink water alone or with your meals. Further, do not drink through a straw, which can cause you to swallow air as you drink.

• Take an over-the-counter (OTC) anti-bloating medication. Some OTC medications are specifically designed to reduce gas and bloating. Speak with your acid reflux physician about medications for your bloating that will not interfere with your acid reflux treatment plan.

Tags: Heartburn Solutions, Reflux Complications

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Does drinking from a straw cause excess air in the stomach?

Short answer: Yes, actually. I think. Maybe. It probably depends on the person.

I have no scientific studies to back me on this, but it’s entirely possible that that’s because there… are no scientific studies on this. I wasn’t able to find any, at least. (If anyone actually knows of any, please post them!) So I’m going to Albert Einstein this with a Gedankenexperiment, with a few additional websites thrown in that talk about gastrointestinal issues and gas and bloating, so take what you will from it.

Whenever one chews or drinks, one is inhaling air into the stomach. That’s just the way ingesting food works. That said, people really don’t inhale too much air in this fashion, but that ingested air is the primary reason we burp and, to a lesser extent, flatulate (possibly the best word ever). The amount of air we ingest can be increased in a variety of ways, basically any time one actively takes more in:

  • Gulping/sipping/slurping (sipping hot coffee, one can hear the air being ingested)
  • Chewing gum
  • Sucking on candy
  • Smoking
  • Drinking anything with carbonation
  • Air tasting (no, not really)
  • And, finally, drinking through a straw

I’d be inclined to say, however, that straws are probably not the biggest culprit on the list. Whenever one drinks from a straw, it seems like there’s really only a minimal amount of extra air being swallowed (whatever is present in the tube above the liquid line). (Extra air on top of that isn’t being swallowed, as the mechanism for drinking through a straw is actually due to the drinker relaxing the jaw, which increases the amount of volume in the mouth/throat, which decreases the interior air pressure. Outside atmospheric pressure then forces the liquid up and in.) A confounding factor for your friend might be that a common beverage taken in through a straw is soda, which will definitely add more air (carbon dioxide) to the stomach, possibly causing feelings of bloating. Or if she’s convinced of this, it might even be a placebo effect at this point.

So to sum up: yes, drinking through a straw causes “excess” air in the stomach. But probably not too much, as regular eating and drinking will do that as well, as will many other daily activities (as I noted, slurping hot coffee is probably a much bigger/more frequent culprit than anything else). So tell her she’s right that it’ll put air in, but it’s most likely not that big of a deal. Live a little! Use a bendy straw! Burp!

(I apologize for being unable to back any of this up with hard numbers.)

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Hiatal hernia is a condition in which a portion of the stomach slides up into the esophagus due to the diaphragm muscles being stretched or torn. It can cause discomfort and is often associated with acid reflux disease. In severe cases, surgery might be required, but often relief can be found in a few lifestyle changes including certain exercises.

Losing Weight

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Excess weight is one factor in developing a hiatal hernia. Fat in the abdominal cavity presses the stomach upward and into the diaphragm. Bad posture and lack of muscle tone are also factors. Changing your diet to include more fresh vegetables and fruits, whole grains and filtered water can go a long way toward relieving your symptoms, especially related to any acid reflux problems. This kind of diet coupled with increased exercise will help you lose the fat that may be pushing on your stomach.

Exercises

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Certain exercises will provide relief from your symptoms, possibly forever. One activity is simply walking. Walking at a brisk pace, using good posture and holding in your abdominal muscles, can really help relieve the pressure you feel in your chest. Because you are holding yourself upright and bouncing slightly, your stomach can slide down back into place. Walking also provides stress relief, which will lower your stomach acid production and keep your stomach from clenching. Stress is a contributor to hiatal hernia. Any abdominal exercise, like sit-ups, will help strengthen the muscles in the area if done in moderation. Don’t do the extreme-type crunches because too much force can actually worsen your condition. Take it slow and easy, looking for gradual results. Yoga and Pilates may be beneficial because they aim to strengthen the entire organism, especially the core muscles.

For immediate relief if you are having painful symptoms, you can try one of two things, according to Dr. Ben Kim (drbenking.com). The first remedy is to lie on your back and relax. Place your hand under your breastbone and lightly massage downward a few inches. Do this twice daily. Before rising and after retiring are good times because you are already lying down and relaxed. Another thing to try is a little more aggressive. Drink a glass of water and stand on a raised surface, like a bottom step or stepstool. Jump down. Since the water adds weight to your stomach, the impact of jumping off the step can help your stomach slide back into place.

Exercise to strengthen your abdominal area, practicing good posture and losing weight may help permanently relieve your painful symptoms.

I chalked the initial incident up to unfortunate weather conditions. It was 85 degrees, 80 percent humidity, with a UV index of 6—not ideal for running at all, let alone an attempt at being competitive in a 5K. In the last quarter mile, I suddenly became horribly nauseous, my stomach revolting, liquid surging and burning in my throat.

My photo finish was quite the sight as I gagged my way across the finish line and landed on a nearby patch of grass, dry heaving over and over. People rushed to my side, a cacophony of jumbled voices and hands outstretched with cups of water. But I waved them off, feeling embarrassed that I had an audience while my body was in some unexpected state of rebellion.

“I have low blood pressure,” I gasped. “The heat gets to me sometimes.” I hadn’t yet been diagnosed with gastroesophageal reflux disease, or GERD, and 5Ks were normally the equivalent of a medium workout for me. So my explanation was not grounded in anything other than me trying to excuse my poor showing.

For me, running had always been my most comfortable space. Something I loved and excelled at. I could power through cold weather, hot weather, rain or shine, and the majority of the time I felt great during a race. I had raced competitively as a kid all the way through high school, even medaling at the Penn Relays one year. So when I started consistently feeling sick towards the end of every race regardless of the weather, I began dreading doing the one thing that had always brought me the most stress relief and happiness.

Finally, I was sent by my primary-care doctor for an endoscopy and was officially diagnosed with acid reflux and mild gastritis.

I was thrilled to finally have an answer for what I was feeling, but that was only the beginning of being able to reclaim my body, and my old routine.

GERD is a condition where stomach acid frequently flows back into the esophagus, irritating the lining and causing symptoms like chest pain, trouble swallowing, feeling like there’s a lump in your throat, or icky burning burps. Eitan Rubinstein, M.D., a gastroenterologist affiliated with Harvard Medical School and Boston Children’s Hospital, tells SELF that while most people experience some level of gastroesophageal reflux (GER) over the course of a day, repeated issues (meaning multiple times a week) is when GERD is at play. As SELF reported previously, GERD can cause long-term damage to the esophagus or ulcers affecting the esophagus.

It made total sense that running, or moderate- to high- intensity exercise of any sort, would worsen my symptoms. “Anytime you do anything strenuous, your stomach can tighten up, making contents flow upward, anything can give you reflux if you strain yourself hard enough,” Dr. Rubinstein explains. And, “If you’re breathing hard enough, your lungs are expanding and you can actually draw reflux material into your esophagus.”

And since gravity is a factor in experiencing reflux (for instance, lying down after eating is a know reflux trigger, as the position allows acid to travel up the throat more easily), different athletic activities can exacerbate GERD more than others. Lori Zimmerman, M.D., a pediatric gastroenterologist at Boston Children’s Hospital, tells SELF that she has had teen athlete patients come in complaining of symptoms after practicing gymnastics and cross-country running. Like Dr. Rubinstein, Dr. Zimmerman agrees that, above all, it’s the level of exertion more so than the actual activity. But the general mechanics associated with running and that “bobbing up and down of the body,” as she describes, lends itself to the potential for issues with GERD.

So what are you supposed to do when the one activity that helps you deal with stress is suddenly causing it? You make the mildly annoying, but very necessary, changes to your routine.

Deborah A. Fisher, M.D., who specializes in gastroenterology at Duke University and the Duke Clinical Research Institute, tells SELF that figuring out a proper course of treatment for reflux can be a matter of trial and error and patience. Knowing your triggers, she says, is an essential part of getting relief. With acid reflux, everyone has different triggers; there’s no hard-and-fast list, although there are common ones, like certain types of food (citrusy or spicy foods tend to be culprits), body positioning like lying horizontal, and smoking.

Can exercise help you combat acid reflux and heartburn?

If you suffer from heartburn or acid reflux, it’s advised to avoid any exercise which requires you to lay flat or vigorously move around. These types of exercise can cause acid to rise up from the stomach and trigger heartburn.

Another common mistake when exercising is not breathing properly. It can be a good idea to undertake some coaching to ensure you are breathing correctly while you exercise and to establish some techniques so you can use breathing to bypass heartburn symptoms.

Drinking too much, too quickly will also have a negative impact on chronic acid reflux, although you should always drink enough to remain hydrated during exercise.

Additionally to this sports and energy drinks should also be avoided. The high sugar levels and added caffeine can worsen heartburn and cause acid reflux to occur.

However, if the symptoms do persist, then taking Rennie can help alleviate the symptoms of indigestion and heartburn, so you can continue exercising.

How to Avoid GERD Symptoms While Working Out

Whether you live life in the fast or slow lane, you’ll need some form of regular exercise. Besides reducing body fat, exercise can help relieve stress and anxiety, improve your overall sense of well-being, and, in certain cases, decrease Gastroesophageal reflux disease (GERD) symptoms. But that doesn’t mean that all exercises are beneficial for GERD sufferers. Strenuous exercises can actually worsen symptoms for some people. These include:

  • Exercises that put a lot of strain on your abdominal wall, such as heavy weight lifting (e.g. squatting), gymnastics, rock climbing, and competitive cycling.
  • Exercises in which you jump up and down or bounce around a lot, such as vigorous running, high-impact aerobics, jumping rope, or using a stair stepping machine.
  • Exercises such as marathon running that require bouncy movements for long periods of time, or sudden bursts of speed such as sprinting or cycling. These exercises also cause you to take in large gulps of air, which can put pressure on your lower esophageal sphincter, causing the valve to open, and acid to move back up into your esophagus.

Gut-friendly exercises

If high-impact exercises don’t aggravate your GERD symptoms, and if your physician approves, then by all means do them. Otherwise, consider lower-impact exercises such as swimming, fast-paced walking, or low-level jogging. Alternatively, try riding a stationary bicycle, doing light treadmill exercises, as well as yoga, or light weight lifting.

How much do you need?

Generally, thirty consecutive minutes of exercise nearly every day will provide the greatest benefit. If you can’t afford that block of time, it’s perfectly acceptable to exercise 10 to 15 minutes here and there throughout the day as long as the day’s cumulative exercise total adds up to at least thirty minutes.

One word of caution – if you’re not in great shape, then don’t rush things. Too much too soon can lead to injuries. When just starting out, check with your doctor about what type of exercise would be best for someone of your age and current physical condition.

Some Common Acid Related Problems

  • Heartburn: It usually feels like a burning sensation in your chest and can rise upwards to your neck and throat.
  • Regurgitation: It occurs when stomach contents back up from the esophagus into your throat, so food re-tastes or repeats in your mouth.
  • Acid Indigestion: It occurs when stomach acids reach the throat, resulting in a sour or acid taste in the mouth.
First published in the Inside Tract® newsletter issue – 162 July/August 2007

In many people, moderate exercise — and the accompanying healthy weight — can be a good way to keep GERD symptoms at bay. But, for some people, especially athletes with intense fitness regimens, a good workout can have an unpleasant side effect: acid reflux. Here are some tips on how to get fit without the heartburn.

  • Don’t exercise within two hours of eating. If you have a full stomach, the pressure on your sphincter — the ring of muscle between the esophagus and stomach — can lead to acid reflux.

  • Eat sensibly before you exercise. In general, avoid foods that increase the risk of acid reflux, like chocolate, citrus juices, caffeinated drinks, and spicy or fatty foods. The National Heartburn Alliance recommends that, before a workout, you opt for foods low in protein and fat and high in carbohydrates.

  • Drink water. During your workout, drink lots of water. It will keep you hydrated and help with digestion.

  • Take chest pain seriously. “Unfortunately, the pain of heartburn is absolutely indistinguishable from pain caused by heart problems,” says David Carr-Locke, MD, director of endoscopy at Brigham and Women’s Hospital in Boston. “The same nerves are affected.” So play it safe: get any chest pain checked out by your doctor.

  • Take your medicine. If you consistently have heartburn when you exercise, take medicine beforehand. J. Patrick Waring, MD, a gastroenterologist at Piedmont Hospital in Atlanta, recommends an over-the-counter H2 blocker, (such as Axid, Pepcid, Tagamet, or Zantac.) If your symptoms are more severe, you may need a prescription from your health care provider.

  • Consider less intense activities. “Any activity that causes a lot of bouncing or jiggling is likely to increase your risk of GERD symptoms,” says Lawrence J. Cheskin, MD, associate professor at Johns Hopkins School of Medicine. He says that calmer activities — like walking — are less likely to cause problems.

  • But most importantly — keep exercising. While exercise can bring on heartburn in some people, Cheskin makes clear that it’s better to exercise regularly and have acid reflux than to live a symptom-free life spent lazing on the couch.

    “Exercise has so many benefits,” Cheskin tells WebMD. “The last thing I’d want is for people to stop exercising. I’d rather that people have heartburn — which we can control with medicine — than a heart attack.”

So if you have heartburn when you exercise, talk to your doctor. While modifying your workout might make sense, Cheskin says you could be better off taking medicine for GERD and keeping your fitness regimen as is.

A food does not have to be obviously acidic to be troublesome. High-fat foods are problematic for many people because they take a long time to digest. Dr. Aviv points out that many commercially produced foods and drinks are treated with acid-containing substances to enhance flavor and shelf life. Accordingly, the 28-day “healing” diet he suggests consists almost entirely of natural, unprocessed foods, especially lean protein foods like light-meat poultry, fish, egg whites and low-fat dairy, beans (combined with whole grains), and nonacidic vegetables and fruits.

High-fiber foods are very helpful, “second only to eliminating acidic foods,” Dr. Aviv said. Fiber enhances digestion, reducing pressure on the lower esophageal sphincter, and can aid in weight loss and maintenance, among other benefits like reducing inflammation. Try to eat a pound of vegetables each day, half of which are cooked and the other half eaten raw, as well as half a pound of raw fruit. Good sources include broccoli, carrots, beets, green leafy vegetables, apples, berries, bananas, avocados and pears. Other helpful fiber-rich foods include almonds, walnuts, lentils, chickpeas and lima beans.

If adopting the above measures fails to fully control acid reflux, taking a proton pump inhibitor may also be needed. But a P.P.I. should be used in the lowest effective dose at the correct time and for the shortest possible period, experts say. “Studies have revealed that 80 percent of Americans may be taking these powerful meds incorrectly,” Dr. Aviv wrote. He said they should be taken 30 to 60 minutes before eating breakfast or dinner (or both), but not used as an “antidote” to consuming acidic foods.

Exercising to Reduce Reflux

By Patricia Raymond, Michelle Beaver

Exercise can be a big help to acid reflux sufferers. Which reflux sufferers can benefit most from exercise? Those who are overweight.

Exercise promotes a healthy weight, and a healthy weight is important for preventing heartburn and for reducing it in people who already have it. Excess weight puts too much pressure on the lower esophageal sphincter (LES), and that pressure can cause acid reflux.

People who are overweight are much more likely to suffer from acid reflux than people who are a healthy weight. To reach or maintain a healthy weight, it’s all about calories in versus calories out. Consume fewer calories and burn more calories, and you’ll lose weight (unless you have an extremely rare condition such as a thyroid disorder).

However, not all exercise forms are great for reflux sufferers.

The following types of exercise can be problematic:

  • Abdominal exercises, such as crunches

  • Aerobics

  • Jumping rope

  • High-activity dance, such as break dancing, Zumba, or anything that has you spinning around or operating at a very high heart rate

  • Martial arts, such as karate or judo

  • Running

  • Anything that puts you upside down, such as a headstand in yoga or touching your toes

If you notice increased reflux symptoms during or after these types of activity, modify the activity or substitute it. If these activities don’t give you problems, of course, you can keep doing them!

So, what is the perfect form of exercise for reflux sufferers? There isn’t one. It fully depends on your condition, and how in shape you are. However, the following routine will work for many of you. Adjust as needed considering your activity level.

Day 1: For 20 minutes, take a brisk walk.

Day 2: For 30 minutes, go for a light swim or do stretching or calisthenics (such as arm lifts or very gentle leg lifts).

Day 3: For 20 minutes, take a brisk walk.

Day 4: For 30 minutes, go for a light swim or do stretching or calisthenics.

Day 5: For 20 minutes, take a brisk walk.

Day 6: For 30 minutes, go for a light swim or do stretching or calisthenics.

Day 7: For 20 minutes, take a brisk walk.

A routine like this is worth making time for. It’ll help you feel better in general and help burn excess weight you may have. Excess weight increases pressure on the LES, and that pressure is a trigger for reflux. Exercise that risk away! If this plan seems intimidating to you, start modestly by cutting the times in half or by doing the exercises very slowly.

How Exercising Can Relieve Your Acid Reflux

Category: GERD, Heartburn Posted by Digestive Health Services April 23, 2019

If you frequently suffer from acid reflux, you already know all about the uncomfortable pains and burning sensations in your chest that come with this common condition. These symptoms normally occur when you consume something that you know will bring them on, yet you proceed to scarf down that delicious food, deciding you will deal with the consequences later.

As it turns out, there may be other triggers besides food that make acid reflux worse – or help to relieve its symptoms. One such activity is exercise. So what’s the connection between exercise and acid reflux?

To Exercise, or Not to Exercise?

The simple answer is that certain types of exercise can help to mitigate the symptoms of acid reflux, and other kinds will make them worse.

Usually if the workout includes stomach crunches, abdominal presses, or high impact exercise, this will make acid reflux worse. Anything that causes you to lift heavy things, bend a certain way, or hold positions can actually be a reflux trigger. Avoid running and sprinting, cycling, gymnastics, or weight lifting.

More moderate and low impact exercise can be quite beneficial for acid reflux sufferers. Activities like walking, very light jogging, yoga, riding a stationary bike, or swimming are all good choices. Mainly this can help you shed some pounds which will alleviate symptoms associated with both GERD and acid reflux.

Reducing Acid Reflux as You Exercise

Losing weight should be the goal of anyone who is overweight and frequently experiences heartburn and/or acid reflux. Exercise can be the tool to get you to your goal. Never stop exercising just because it seems to trigger acid reflux. Find other types of exercise, or discover what you might be doing to exacerbate the symptoms.

The following tips may help to relieve heartburn during exercise:

  • Don’t exercise within two hours of eating
  • Avoid your normal reflux food triggers
  • Eat a healthy meal before exercising
  • Drink water while you exercise to stay hydrated and help with digestion
  • Take your OTC medications like Zantac, Pepcid, or Tagamet before exercising

If you are aware of your food triggers, modify your workout routine, and take OTC medications to reduce acid, but you continue to have problems with acid reflux, it may be time to see Digestive Health Services for help.

Keep notes of how different types of workout routines affected your acid reflux. Record what you ate before exercising, and what medications you took. You may be able to see a pattern, and relay this information to your doctor in order to find a more suitable treatment option.

Consistent physical activity is key to staying fit and reducing symptoms of acid reflux. Contact one of our gastroenterologists for help with the symptoms of GERD or acid reflux, and to ask about a treatment plan that is specially suited for you.

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Why You Get Heartburn When You Exercise

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If you’ve ever experienced exercised-induced heartburn, “feel the burn” takes on a whole new meaning thanks to an awful low simmering burn of acid reflux in your chest and throat. Sure, you understand a little heartburn after a big, spicy meal, but during a workout? That just doesn’t seem fair.

While some people are more susceptible than others, and not everyone will experience heartburn during exercise, it can rear it’s ugly head at the most unexpected times (and there’s never a good time!), so here’s what you need to know about this pesky side-effect to your regular workout.

Jason Machowsky, MS, RD, is a board certified sports dietician as well as a registered clinical exercise physiologist who has worked with athletes and novice clients alike who have dealt with exercise-related heartburn. Machowsky says that the physiological mechanisms that occur are similar to the classic definitions of GERD and acid reflux, but the catalysts have changed from burrito to burpee. (Try these 4 Burpee Alternatives for an Amazing Home Workout.)

Pressure keeps the lower esophageal sphincter (LES), a valve located between the stomach and the esophagus, closed, making sure stomach acid stays where it should, but movement, jostling, some foods and certain body positions can reduce the pressure of the valve, causing some stomach acid to creep into the throat.

Physiological vs. Mechanical Causes

Machowsky says there is a multitude of things that can cause heartburn (exercise-induced or not), but that they all typically fall under one of two categories: physiological or mechanical.

Physiological influences include people who have regularly occurring acid reflux or GERD, as well bring significantly overweight, as that raises your risk of these GI symptoms in general. (Here are The 50 Best Snacks for Weight Loss.)

Bridging the biological and mechanical gap, says Machowsky, is when blood flows away from the gut during high-intensity training in order to provide larger working muscles with adequate energy. This redistribution of blood causes a number of GI distresses like reduced digestion, diarrhea, and nausea. (P.S. This could be the reason Why Some Workouts Make You Feel Like Throwing Up.)

Other mechanical causes are basically due to our exercise of choice. “Running and jostling your body up and down repeatedly, as well as impacted-based activity” can provoke heartburn says Machowsky. “The crouched position on a bike also puts additional stress on the LES,” he says.

Eating Habits and Food Choices

No shock here, but the kinds of food you eat, along with when you eat them can make a world of difference when it comes to heartburn (or nausea, constipation, diarrhea, the works.)

“Higher fat and higher fiber foods are more often associated with exercise-related heartburn,” says Machowsky. Although fiber is very good for you, it digests slowly, and if you eat a high-fiber meal too soon before a workout, you can become constipated, putting too much pressure on the LES. “Caffeine, chocolate, spicy foods, mint, or any other foods classically associated with GERD, could add to it as well,” he says.

His general eating strategy for a smooth and efficient workout? “Make sure you’re giving yourself adequate time to digest,” he says. “Try to avoid eating significant amounts of food at least two hours before training, especially if you’re susceptible to heartburn already.” Also, pay attention to carb intake, as unless you’re gearing up for a very long workout or an endurance race, you don’t need to carb-o-load. Doing so will only back up the flow of digestion. (Looking for long-lasting fuel? Try these 6 All-Natural, Energizing Foods for Endurance Training.)

What You Can Do to Prevent It

Know your body and your current level of training. While even the most highly trained athletes can experience heartburn on the court, field, or locker room, says Machowsky, pushing yourself too hard, too fast can be a recipe for disaster. “If you go too hard, too quick, and there’s a big jump in intensity, that can trigger it,” he says. “Be careful not to bite off more than you can chew.”

If you just can’t kick the heartburn, make a checklist. “Take these potential factors and identify if you fall into this bucket,” says Machowsky. “Does it happen during Tabata or during a bench press? Identify those things and modify them or adjust them to get it to stop.”

The one thing you never want to stop doing, however: exercising. Ironically, regular exercise actually minimizes the risk of getting GERD in the first place as it keeps weight under control, he says. “If you get heartburn, it doesn’t mean to stop exercising altogether. The key is making modifications.”

  • By Alyssa Sparacino @a_sparacino
DOCTOR’S VIEWS ARCHIVE


Topic: Irritable Bowel Syndrome (IBS), June 2000

Dr. Lee:
A viewer experiences heartburn and chest discomfort after exercise. This viewer wants to know whether his symptoms could be a warning for heart condition rather than GERD. What is your opinion on that?

Dr. Marks:
Vigorous exercise can aggravate acid reflux. However it is important to remember that exercise also causes heart pain (angina). All too often, pain in the chest following exertion is described as “heartburn” when it is really angina. Anyone with chest discomfort during or after exercising, even if it feels like heartburn, should be evaluated for heart problems.

Dr. Lee:
Yes, I have to second that point. Every year I will have 2 or 3 patients coming into my office seeking relieve from heartburn. I will refer them to a cardiologist first because I am concerned that their symptoms could be angina (warning signals for impending heart attacks). Some of them actually did turn out to have diseases in their coronary (heart) arteries, and their heartburn actually represented angina. It is gratifying to have have them come back years later, thanking me for sending them to the cardiologists rather than just treating them for GERD.

Thus not all “heartburn” is due to GERD. Again, accurate diagnosis is the key.

Dr. Marks:
I am sure that your experience is very similar to other gastroenterologists.

Dr. Lee:
Especially if the symptoms are related to exertion or the symptoms do not seem to go away with maximal acid suppressant therapy.

The published answers represent the opinions and perspectives of the doctors and pharmacists of MedicineNet.com and are for educational purposes only. They should not be used to replace or substitute for timely consultation with your doctor. Accuracy of information cannot be guaranteed.

Please remember, information can be subject to interpretation and can become obsolete.

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