Spend a lot of time on a surfboard and you're more than four times more likely than other athletes to have GERD. While that news might give wave runners on the West Coast pause, you may have discovered that even exercise much less daring can reshuffle the contents of your stomach and provoke a reflux revolt. It's tough to find a way to get in exercise without the heartburn, and yet exercise is crucial for your well-being - and, let's say it, your weight.
Chances are you've been told to get moving because excess weight seems to increase GERD symptoms. In fact, you can draw a straight line when connecting the dots between being physically active, losing weight, and reducing GERD. "Although there are no specific exercises for GERD, weight loss is helpful," observes gastroenterologist Maxwell M. Chait, MD, in practice at the Hartsdale Medical Group in Hartsdale, N.Y. What's more, being physically active might help you sleep better, which could also ease GERD symptoms.
Physical therapist Justin Smith, RN, DPT, of Physical Therapy Services in Elizabethton, Tenn., says his personal and professional experience confirms that exercise can provide some heartburn relief. "I've always been active, but a couple of years ago I started to get a little bit of heartburn and acid reflux," says Smith. He also started to have what he initially thought were asthma symptoms but later learned was reactive airway disease, as stomach acid spilled out of his esophagus into his trachea and lungs. The GERD symptoms were worst after big meals and when he lay down at night. But, he says, they improved with exercise.
Smith also started taking medication for heartburn relief and says that with the medicine, exercise, and a few lifestyle changes, he's feeling much better. And as a physical therapist, he appreciates the importance of staying active with no-heartburn exercise.
Tips for GERD Exercise
While it's true that some forms of exercise can trigger GERD, especially those that have you lying flat on your back or that jostle your stomach contents, you don't have to engage in vigorous exercise to get heartburn relief and a trimmer body. When doctors reviewed the activity and sleeping habits of 1,875 adults with acid reflux, they found that those who took a walk after dinner and didn't go to bed for at least three hours after eating had the fewest GERD symptoms overnight.
For heartburn relief and to shed weight, try these ideas for no-heartburn exercise:
- Go low - low-impact. "If you want to do cardio, choose a spinning bike or an elliptical machine," says Smith, adding that treadmill running might sit fine with your tummy but that you should avoid the pounding of true pavement because of the jarring and the risk of gastric contents coming up. Walking is a good option, as are social activities like ballroom dancing. As you lose weight and gain some heartburn relief, you can try higher-impact activities.
- Discover deep-breathing exercise. When 19 people with GERD were divided into two groups, the one that did four weeks of breathing exercises had improved GERD symptoms up to nine months later. Work with a trainer or a physical therapist to make sure your breathing is on track as you exercise. Pilates and yoga both offer breathing instruction, but, says Smith, if you're not careful, they can be potential GERD triggers as well. Talk with your instructor about modifications so that you're never completely flat on the floor or holding inverted yoga postures, like downward-facing dog. The research on surfers illustrates the point. Published in the Clinical Journal of Sports Medicine, it discovered that surfers are more than four times more likely to have acid reflux at least twice a week because of all the time spent lying down on their boards in high-impact situations.
- Time snacks and meals around workouts. "Avoid eating within one to two hours before strenuous exercise to let the stomach be empty to prevent reflux," advises Dr. Chait. If you need to refuel after a workout, just keep your snack small, healthy, and light.
- Pre-hydrate. If you let yourself become thirsty and then suddenly start gulping down a beverage, you can make your GERD worse during and after exercise. Stay hydrated throughout the day. "If you wait until you are thirsty to drink water, then you're already dehydrated," says Smith. And, he adds, avoid sports drinks and energy drinks, both of which can be triggers for GERD because of their sugar and (in some cases) caffeine contents.
- Pretreat reflux. If your GERD symptoms seem to be a significant problem when you are working out, take an antacid or time your heartburn medication so that you can get in a workout while it's working. Talk with your doctor about when and how to take these medications to control acid reflux.
Finally, emphasizes Smith, don't assume that any chest pain during exercise is "just" GERD or acid reflux. Persistent chest pain deserves a doctor's look. A recent analysis of 111 adults with chest pain revealed that a large number of them had heart disease risk factors such as angina but also showed overlap between GERD symptoms and heart disease.
So get moving - make that burn stem from tired, stronger muscles and not reflux.
Last Updated: 6/24/2013