Gastro-oesophageal reflux disease (GERD/GORD) is a common concern that can cause discomfort and impact daily life. Many wonder about the role exercise plays in this condition.

Research has been exploring the connection between exercise, and findings have led to diverse perspectives. Some believe that intense activity might contribute to reflux, while others suggest exercise could offer relief from symptoms.

Let’s explore the evidence and gain insights into managing exercise-induced reflux.

Link between exercise and stomach health

A study published in the American Journal of Gastroenterology in 2004 investigated the link between vigorous exercise and gastroesophageal reflux. The study aimed to understand why intense exercise can cause reflux and how it relates to the integrity of the esophagogastric junction (EGJ).

The EGJ is a specialised area where the oesophagus, the tube that carries food and liquids from the mouth to the stomach, meets the stomach. It serves as a barrier that helps prevent the contents of the stomach, including stomach acid and digestive juices, from flowing back up into the oesophagus.

Ten individuals with GERD and 10 without were part of a two-day study. They exercised for 60 minutes on either day, following the same diet. Exercise included running and resistance exercises.

Results showed a more than threefold increase in acid exposure during exercise for both groups. Notably, the degree of exercise-induced reflux was strongly connected to the shape of the EGJ, suggesting EGJ integrity is crucial in preventing strain-induced reflux during exercise.

Exercise and reflux symptoms

In 1984, researchers investigated the impact of exercise on gastroesophageal function in seven children with gastroesophageal reflux concerns. Among them, three experienced exercise-related gastrointestinal symptoms.

Notably, one patient exhibited significant GERD symptoms during intense exercise and recovery. While pathologic reflux was present in multiple patients, exercise did not consistently induce GER symptoms.

Exercise intensity and its influence on reflux occurrence

A 2014 study looked at how exercise intensity might relate to the occurrence of gastroesophageal reflux episodes in people with GERD. The researchers wanted to understand if there was a connection between how hard someone exercised and whether they experienced reflux symptoms.

They found that when exercise was more intense, with a high level of effort, people with erosive GERD were more likely to have episodes of reflux. On the other hand, when exercise was less intense, there wasn’t a significant link to reflux. This suggests that the level of effort in exercise can influence whether GERD symptoms occur.

The study also explored other factors like the pressure of the muscle that separates the stomach and oesophagus (lower oesophageal sphincter), weight status, and body mass index (BMI). While some factors showed a correlation with reflux, it’s important to remember that the relationship between the two is complex and can depend on various factors.

Tips for managing exercise-induced reflux

Exercise and GERD have a nuanced connection. While vigorous exercise can trigger reflux in some cases, research also indicates that exercise might be an avenue for symptom relief.

If you experience symptoms during or after exercise, there are several steps you can take to help manage and alleviate discomfort:

  • Adjust your timing: Consider the timing of your meals and exercise. Avoid consuming large meals right before a workout. Allow some time for digestion before engaging in physical activity.
  • Choose gentle activities: Opt for exercises that are less likely to trigger symptoms. Low-impact activities like walking, cycling, or swimming may be more suitable than high-intensity workouts.
  • Stay hydrated: Proper hydration is essential to minimise the risk of reflux. Drink water throughout your exercise routine to help dilute stomach acid.
  • Mind your clothing: Wear loose-fitting workout attire that doesn’t put pressure on your stomach. Tight clothing can exacerbate reflux symptoms.
  • Posture matters: Pay attention to your posture during exercise. Avoid positions that compress the abdomen, which can contribute to reflux. For example, try to maintain an upright posture while walking or running.
  • Avoid certain foods: Some foods and beverages are known to trigger reflux. Limit your intake of caffeine, citrus fruits, spicy foods, fatty foods, and carbonated drinks before exercise.
  • Practice breathing techniques: Incorporating breathing exercises into your routine can help improve the function of the lower oesophageal sphincter and potentially reduce reflux symptoms.

Researchers have showed that breathing exercises can relieve the symptoms of patients with GERD. A 2020 study evaluated the effect of breathing exercises on patients with gastroesophageal reflux disease (GERD). By analysing seven studies involving 194 patients, it was found that breathing exercises can enhance the pressure of the lower oesophageal sphincter (LOS). This improvement in LOS pressure, particularly in the crural diaphragm, suggests that breathing exercises have the potential to alleviate GERD symptoms.

The relationship between exercise and GERD is complex and can vary from person to person. Factors like exercise intensity, weight status, and overall health play a role. Listening to your body and making adjustments that work for you can help manage exercise-induced reflux.

Consider medication: Consult a healthcare professional about using over-the-counter antacids or prescribed medications to help manage reflux symptoms during exercise.

Listen to your body: Pay attention to your body’s signals. If you start to experience discomfort or symptoms, it’s okay to pause or modify your workout. Prioritise your wellbeing.

If exercise-induced reflux symptoms persist or worsen, it’s advisable to seek guidance from a medical professional. They can provide personalised advice and recommend appropriate strategies.

Remember that everyone’s body responds differently, so it may take some trial and error to find what works best for you.

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