What is acid reflux?
A burning feeling, a sour or bitter taste, chest pain and regurgitation.
Often made worse by exercise, acid reflux (officially gastro-oesophageal reflux disease, or GORD in British English; gastro-esophageal reflux disease, or GERD in American English) can be a painful problem whilst you’re running or working out.
Heartburn is perhaps the most common symptom of acid reflux. It is felt as a dull ache behind the breastbone and is so termed because some people may mistake this pain for pain coming from the heart (angina or a heart attack). Conversely, some people with these heart conditions may think that are simply suffering from indigestion when something more serious is taking place.
Acid reflux, or heartburn, happens in the digestive system when stomach acid leaks back up into the oesophagus, sometimes making it as far as the mouth.
Heartburn may occur if the lower oesophageal sphincter (LOS), the muscular ring at the top of the stomach, is too slack to keep the contents of the stomach where they should be, says the British Society of Gastroenterology. The LOS normally acts as a kind of valve and the high impact of some sports or exercise can encourage this leaking, meaning reflux can be triggered by working out.
You are more likely to experience, or be aware of, acid reflux when exercising if you’ve consumed particular kinds of food or drink. For example anything acid-forming (like caffeine, alcohol, and anything high in refined sugar and salt), or spicy food.
It is a common complaint: you are not alone if you have experienced heartburn when you exercise, but it can be painful and uncomfortable if the symptoms persist.
However, since a high BMI is one of the trigger causes for GORD (or GERD), moderate exercise is recommended as it will help with weight management, may actually protect against reflux (see this study), and is a key tool in improving mood, stress and anxiety.
What can I do?
1) Modify your workout.
Different activities carry a higher or lower risk of reflux. For example, because of the exertion whilst horizontal (where the LOS is far more likely to leak), surfers report high instances of exercise-induced heartburn and, due to the impact of your feet on the ground, running can also bring on painful and hard-to-manage reflux.
Low impact is better, so a good choice for a cardio workout would be spinning. If you love to run, try a treadmill or softer surfaces (like trails) instead of the hard pavement which is more likely to worsen your symptoms.
2) Choose your pre-workout meal with care
It is sensible to avoid foods which increase the risk of heartburn and acid reflux. Our founder, Alfred Vogel, advocated an alkaline-based diet for health, and it has been shown that low-acid foods can have beneficial effects on the symptoms of reflux.
As well as acidic and spicy foods (as mentioned above), chocolate, caffeine or foods which have a high fat content may be best avoided.
Adding more bitter flavours to your diet can be helpful in managing acid reflux. Have a look at our ‘Bitterness helps your digestion‘ video for more information.
3) Good posture can help
As you eat, stay aware of your posture. Things to focus on include keeping your shoulders right back which leaves lots of room for your stomach walls to move properly under your ribcage.
This is important to think about for at least an hour after food too, as well as while exercising, and if you start to experience reflux, check your posture immediately.
4) Keep your portions small and chew properly
Try to avoid overloading the stomach at any meal – reducing portion size can make it far easier for the stomach to cope and therefore less likely to leak its contents upwards whilst you work out.
If you chew your food very thoroughly then you may well find that you don’t need as much, as satiety messages get through to the brain more quickly.
What shouldn't I do?
1) Don’t exercise immediately after eating
Make sure you leave around two hours between eating and working out. The added pressure of a full stomach on the LOS while you’re active is far more likely to lead to heartburn or reflux.
2) Limit your fluid intake with meals
Whilst it’s very important to stay hydrated, be smart about when you choose to drink. Avoid drinking for half an hour before food, if possible, and then don’t consume liquid for at least an hour after you’ve finished eating.
If you drink a lot of liquid, the size of your stomach will increase and, as with large portion sizes, this is more likely to lead to acid reflux.
3) Don’t drink high-carbohydrate sports drinks
Because of the acidic nature of the sugar substitutes in these drinks, you are more likely to suffer heartburn after consuming them. Water is less likely to induce acid reflux and you can always find a natural alternative to replace electrolytes and potassium and avoid muscle cramps.
What remedies are there?
The first thing to consider when managing the effects of exercise-induced acid reflux and heartburn is what lifestyle changes you can make.
Eating smaller meals, avoiding the foods listed above (spicy, acidic, etc), timing your meals and workouts so that you don’t eat immediately before exercise and not consuming too many fluids with your food are basic practices you can adopt.
Choose your sports wisely. Select something low-impact which doesn’t require you to be horizontal for too much of the time.
It is important to note however that if you are experiencing severe heartburn or the symptoms of acid reflux persist, you should visit your GP.
There are traditional home remedies which you might find useful when managing your symptoms, including bicarbonate of soda and cider vinegar.
Silicic acid is a compound of silicon and oxygen which has been found to be very effective in treating acid reflux. It works by soothing and protecting the lining of the digestive tract, as well as adsorbing or binding harmful substances.
Silicol®gel contains silicic acid which is a compound of the mineral substance silicon and oxygen in a colloidal (highly dispersible) and hydrated form. It has the ability to bind to a variety of harmful and toxic substances, including pathogens.
Adding more “bitter” flavours to your diet can improve your digestion. Digestisan oral drops is a combination of digestive bitter herbs and is a licensed herbal remedy for symptoms of indigestion. You can take it 15 minutes before each meal and it works best if you don’t disguise the bitter taste!
Digestisan Oral Drops
Digestisan is a licensed herbal remedy for the relief of indigestion, feelings of fullness and flatulence.
It contains extracts of freshly harvested Cynara (Artichoke), Dandelion, Peppermint and dried Boldo leaves.