Exercise has so many positive health benefits! But it’s not easy on your digestive tract. In fact, some people who exercise, especially high-impact exercise like running, complain of a variety of digestive symptoms, including nausea and heartburn.
How can something so good for your health cause heartburn? Heartburn is caused by acid reflux. Most people experience acid reflux at one time or another, often after eating a large meal. However, some people have acid reflux regularly. If you have that old familiar nausea and burning in your chest more than a few times per week, you may have the more chronic condition GERD (gastroesophageal reflux disease). The symptoms of acid reflux and GERD are similar, but GERD is a chronic, ongoing problem.
GERD happens when the muscular sphincter that separates the esophagus and stomach, called the LES, weakens. When the flap doesn’t work properly, acid and partially digested food can backtrack from the stomach into the esophagus and cause irritation. When this happens, you can experience heartburn and backflow of acid and food into your throat or mouth. Needless to say, that’s an unpleasant sensation, especially when you’re in the midst of a workout. People who experience acid reflux during exercise don’t necessarily have GERD, the more chronic variant of acid reflux. The symptoms may instead be related to the exercise itself.
High-Impact Exercise and Heartburn
For example, runners are at high risk of digestive symptoms in general, including heartburn and reflux. That’s because running is a high-impact activity. The constant impact and pounding increase pressure within the abdominal cavity and pushes up on the esophageal sphincter. The backward pressure lets acid escape into the esophagus. This irritates the lining of the esophagus and causes acid reflux symptoms.
Running isn’t the only activity that can bring on acid reflux; plyometric moves, like jumping and sprinting can too. Also, some abdominal exercises, like crunches, can aggravate acid reflux due to the increase in abdominal pressure. Even weight training can trigger acid reflux, especially heavy lifting, as it increases pressure in the abdominal cavity when you lift.
To make matters worse, exercise slows digestion, allowing food to stay in the stomach longer. During exercise, especially intense exercise, your body shifts blood supply to exercising muscles and the skin to help eliminate heat. Therefore, blood is diverted away from digestive organs. If you ate a meal before a workout, it’ll stay in your stomach longer. This, too, can cause or worsen acid reflux symptoms.
No doubt, heartburn, and reflux is an inconvenience! However, longer-term regular physical activity may help you tame the symptoms. Research shows losing as little as 10% of body weight, if you’re overweight, can reduce the symptoms. A study in Neurogastroenterology and Motility showed that losing belly fat helps tame acid reflux symptoms, at least in those who suffer from abdominal obesity.
Preventing Acid Reflux When You Exercise
If you suffer from acid reflux occasionally during exercise or if you have GERD, there are precautions you can take to lower your risk of having symptoms during a workout. First, plan your meals and snacks. It’s best to avoid eating anything within 2 hours of a workout. If you do, you’ll enter a sweat session with food in your stomach. Once you increase the pressure in your abdomen by lifting a weight or by jumping around, you’re at risk of a flare-up.
Watch what you eat, too. Certain foods are well-known for trigger a flare-up. Avoid fatty foods, as fat slows the movement of food through the digestive tract. The longer food hangs around, the more opportunity there is for acid reflux to flare up. Other foods that can worsen the symptoms include spicy foods, tomatoes, and tomato-based products, citrus fruits, chocolate, peppermint, and coffee. Alcohol and smoking are other common triggers.
If you’re prone toward acid reflux when you exercise, you can always modify your ab workouts by doing planks rather than crunches for your abs. Also, learn how to breathe properly when you lift. Some people swallow too much air when they exercise, and the trapped air pushes up on the esophageal sphincter and worsens the reflux.
What if high-impact exercise brings on the symptoms? First, try avoiding all trigger foods and wait at least 2 hours after a meal to work out. If it’s still a problem, substitute low-impact exercise for a portion of the high-impact exercise you do. Low impact doesn’t mean low intensity. You can do low-impact movement vigorously too.
What do you wear when you work out? Ideally, dress in light, loose clothing that doesn’t constrict your waist and tummy. Tight clothing pushes in on the abdomen and increases pressure in your gut.
What if You Have Acid Reflux Frequently?
If you have acid reflux more than two times per week, see your physician. You may have GERD and need treatment. Untreated GERD is more than an inconvenience. Acid reflux can irritate the lining of the esophagus to the point it becomes chronically inflamed. In addition, cells that line the esophagus can undergo changes that increase the risk of developing cancer of the esophagus. So, it’s important to monitor the condition.
Up to half of all people with GERD have a hiatal hernia, where the stomach pushes upward through the wall that separates the stomach from the chest cavity. Strangely enough, one of the more common causes of a hiatal hernia is lifting heavy weights, especially lifting with bad form. Try to avoid bending from the waist when you lift, since it strains the lower chest and diaphragm. Don’t work with weights that you have to struggle to lift.
The only way to “cure” a hiatal hernia is with surgery, but many people have one and don’t know it. Small hiatal hernias often don’t cause symptoms. If the hernia isn’t large, most doctors don’t recommend surgery. The problem with large hernias is they can get caught in the opening and twist. This can cut off blood supply to that portion of the stomach. If you suspect you have a hiatal hernia or if you have frequent acid reflux, talk to your physician about treatment options.
References:
· Medscape.com. “Gastroesophageal Reflux Disease”
· Neurogastroenterology and Motility. Volume29, Issue5. May 2017. e13009.
· GI Society. “How to Avoid GERD Symptoms While Working Out”
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5 of the Most Common Digestive Issues Related to Exercise
5 Foods to Avoid Before a Workout
5 Inconvenient Things That Can Happen During a Workout & What to Do About Them