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.
No matter what you eat, you worry that chronic heartburn will always be there. You've tried all the antacids, followed a bland diet, given up on certain foods completely. But still you wake up in the middle of the night, sometimes with pain deep in your throat, other times with a sore throat and trouble breathing, as if you were having an asthma attack. You try to sleep sitting up in a chair, and realize with dismay: This has been going on for years.
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.
SOURCES: David Carr-Locke, MD, director of endoscopy, Brigham and Women's Hospital, Boston. Lawrence J. Cheskin, MD, FACP, co-author, Healing Heartburn (2002); director and founder, Johns Hopkins Weight Management Center. National Heartburn Alliance web site: "Tips to Combat Exercise-Induced Heartburn." J. Patrick Waring, MD, gastroenterologist, Piedmont Hospital, Atlanta.