Exercise to Reduce Heartburn
One of the main reasons people exercise is to lose weight, but fitness can also play a role in treating heartburn and acid reflux disease. "It's one of the lifestyle modifications that we stress," says David A. Peura, MD, Professor of Medicine, University of Virginia Health Sciences Center, Charlottesville. "Even just a few pounds of weight loss can help with reducing the symptoms of acid reflux disease.
Steven Lamm, MD, author of No Guts, No Glory (Basic Health Publications) agrees: "Any exercise that promotes weight loss will be great for your digestive tract." But, before you lace up your sneakers or slip on your swimsuit, here's what to do, and what not to do when it comes to working out.
Don't: Stop taking your medication
Exercise is not a magic pill that will cure a weak or faulty sphincter muscle in the esophagus, says Peura. It will, however, aid digestion and promote weight loss so it's great for acid reflux disease in general.
Walking is a great cardiovascular exercise, and running can be good—just don't run on a full stomach, cautions Peura. You may swallow air, causing belching which brings stuff up in to the esophagus.
Don't: Bend low over the handlebars
Biking is a great activity that targets large muscle groups to torch calories. When heading out for a ride (or a spin at the gym), Peura suggests you maintain an upright position. Lowering your chest may encourage reflux.
Don't: Go head over heels
Inversions—from downward dog to headstand—can cause food to travel the wrong way. Make gravity work for you instead by focusing on standing and seated poses that keep your torso upright.
"The big problem with heartburn and reflux is not so much acid, it's actually that acid is going into the wrong place," says Peura. "When acid stays in the stomach, it's fine, but if acid goes back up into the esophagus, it causes symptoms." Any time your head is lower than your waist (like in downward dog pose) you may experience heartburn.
That's not to say it happens all the time. "Any of these movements in moderation is okay," says Lamm. You just don't want to spend the entire class upside down.
Don't: Jump in the pool immediately after eating
"Your mother told you not to swim after you eat for good reason," says Peura. Not only will blood be diverted to active muscles, but if you're diving or going under the water it can increase abdominal pressure which can force things up, he explains.
"It takes a bit of time to move the food from your stomach to your intestines," adds Lamm. "By exercising immediately after a meal, you're shifting the focus from your gut to your muscles."
Do: Strength train
Don't: Hold your breath
Try to avoid exercises that require you to do what is called the val salva maneuver, causing you to grunt as you lift weights. By increasing abdominal pressure—through holding your breath and grunting—you push more acid into your esophagus.
Also, try to target the abs with less strenuous upright exercises (such as sitting on an exercise ball instead of a desk chair) rather than doing a set of crunches in a supine position.
The bottom line, says Lamm: "Anything you can do to promote a healthy gut will help reduce esophageal reflux or GERD. Exercise is one strategy, but so is cutting culprits like smoking, stress, and extensive use of drugs like asprin, ibuprofen, and naproxen—they're very irritating to the stomach, especially when used frequently."
If you're taking low dose aspirin for heart health, talk with your doctor about your symptoms before stopping the regime.
And always talk to your doctor before starting any exercise regimen.
David A. Peura, M.D., Professor of Medicine, University of Virginia Health Sciences Center, Charlottesville.
Steven Lamm, M.D., "house doctor" on ABC's The View and author of No Guts, No Glory (Basic Health Publications, 2012)
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