Can exercise trigger heartburn?

Can your workout leave you suffering?

Nutritional Practitioner, BA (Hons), DN, DNT (Distinction)
Ask Ali

12 September 2016

How does heartburn arise?

Acid reflux is a result of the contents of your stomach, rich in potent hydrochloric acid, making contact with your oesophagus. The lining of your stomach features a protective mucosal barrier which acts as a shield against the strong acidic environment of the contents found there, however, your poor oesophagus isn’t so lucky. If the contents of your stomach defy the laws of gravity, travel backwards and make contact with the oesophagus, you are likely to feel the intense burning feeling we call heartburn.

There is a circular muscle connecting your oesophagus and stomach called the lower oesophageal sphincter (LOS). This plays an important role in preventing heartburn. However, as I will go on to discuss, dietary factors, lifestyle factors, activities (including exercise!) and medication can affect the functions of this important muscle, and you can suffer as a result.

Heartburn is extremely uncomfortable and can be quite distracting, especially if you are in the middle of a team event! It can be so agonising people often mistake it for a problem with their heart (hence the name). This, understandably, can be quite alarming – be sure to check with your doctor if you are in any doubt.

How does exercise have an impact?

So, as you now know, the correct functioning of the LOS has an important role in the incidence of heartburn.

Many factors can influence the opening of the LOS, exercise being one of them. High impact sports are an important consideration. During sports with lots of jolting motions such as, football or basketball and, some more obscure example including karate or water skiing, the contents of your stomach will be tossed around and can leak through the LOS if it isn’t particularly robust.

It is a fairly common complaint! You are not alone if you have experienced heartburn whilst exercising, but it can be a real nuisance if the symptoms persist.

However, the same movements and sports don’t cause the same problems across different people, so, it is important to understand that other circumstances and actions have a part to play.

So, what can you do?

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; opt for spinning which is a heartburn-friendly cardio workout. 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.

Choose your pre-workout meal with care

You are often more likely to experience acid reflux and heartburn when exercising if you’ve opted for certain types of food or drink beforehand. For example; acid-forming food and drinks such as caffeine, alcohol, spicy food and anything high in refined sugar or salt could be problematic. Foods which have a high fat content are also best avoided before exercise as they promote acid secretion and delay gastric emptying.

Our founder, Alfred Vogel, shouted from the rooftops that we should stick to an alkaline-based diet for good health, and it has been shown that low-acid foods can have beneficial effects on the symptoms of reflux.

Adding more bitter flavours to your diet can be helpful in managing acid reflux too. Have a look at our ‘Bitterness helps your digestion’ video for some inspiration.

Try out a small bitter salad before your meals incorporating different leaves such as endive or chicory. Alternatively take a few drops of a good quality bitter herbal tincture in a small amount of water 5 minutes before a meal which can spur your digestive juices into and protect your oesophagus.

Good posture can help

As you eat, stay aware of your posture. Keep your shoulders back and leave plenty of room for your stomach walls to move properly under your ribcage and those all-important secretions to flow freely.

This is important to consider for at least an hour after food too, as well as while exercising. Posture control is important to consider during exercise to prevent injury in many cases anyway. Stand up tall now!

Keep your portions small and chew properly

Try to avoid overloading the stomach at any meal – reducing portion size makes it far easier for the stomach to cope and it’s less likely your LOS will be put under pressure (literally). A full tummy increases the internal pressure which can cause your LOS to creep open. The more food you eat, the more acid required to tackle it all – this adds to the risk of heartburn.

Chewing your food very thoroughly and slowly is important too. Chewing properly means that the digestion process can start as early as your mouth and your stomach has less of a task ahead of it. Eating slowly also means you are less likely to overeat. This is always a bonus (for your waistline) and if you are exercising soon after.

Manage your weight

Yes, a healthy weight is important for many reasons but did you know the higher your BMI, the greater the risk of heartburn you face?

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. Result!

What shouldn’t you do?

Don’t exercise immediately after eating

Regardless of how good your eating habits are, you should try to leave around two hours between eating and working out. The added pressure of a full stomach on the LOS while you’re active is a recipe for disaster in terms of heartburn or acid reflux.

Limit your fluid intake with meals

Whilst it’s crucial to stay hydrated, especially when exercising, be smart as to when you choose to drink.

Avoid drinking for half an hour before food and then don’t consume liquid for at least an hour after you’ve finished eating. If you drink lots during a meal, you risk diluting your digestive juices, making them less potent which can give rise to indigestion and heartburn.

Don’t drink high-carbohydrate sports drinks

Because of the acidic nature of the sugar and sugar substitutes in these drinks, you are more likely to suffer heartburn after consuming them.

Water is much less likely to induce acid reflux and you can always find a natural alternative to replace electrolytes and potassium and avoid muscle cramps.

Can any home or herbal remedies help?

As mentioned above, there are important dietary and lifestyle factors to take into account to above heartburn while exercising.

If your symptoms are particularly troublesome you may need to add in some natural remedies into your regime in addition to these.

Often people assume acid reflux and heartburn are a result of too much stomach acid. However, this is not always the case and often people actually don’t have enough stomach acid. Having too little acid can give rise to similar symptoms as having too much, which is often why it is harder to detect. If this is the case many antacids medications can make the situation worse.  Try some of my simple home tests which can give you a better idea of the type of imbalance, if any, you are experiencing.

If an imbalance in stomach acid is apparent, try taking some digestive bitters 5 minutes before your meals. Digestisan is a synergistic combination of bitter herbs including artichoke, dandelion, peppermint and boldo which work together to help support your stomach acid production and overall digestion.

Finally, in the case of severe flare ups which risk affecting your sporting performance, try Silicol®gel.

Silicol® gel contains silicic acid which works by soothing and protecting the lining of the digestive tract, as well as adsorbing or binding any harmful substances for excretion.

Have Silicol® gel on stand-by to soothe the oesophagus quickly and offer you some relief from that uncomfortably burning sensation if it crops up – with our top tips under your belt that shouldn’t be too often though. Happy exercising!

A.Vogel Digestisan Oral Drops


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Here's what I recommend

As the A. Vogel Digestion advisor, I recommend Digestisan with extracts of Artichoke and Peppermint, to help ease symptoms of acid reflux.

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Did you know?

Acid reflux at night is an all-too-common problem, contributing to an estimated 7% of sleepless nights, which can lead to fatigue, increased anxiety or concentration lapses the following day.

The physical symptoms our emotions cause

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