Exercise-induced heartburn occurs when the burning sensation in the chest or throat is reliably triggered by physical activity. This discomfort, known as acid reflux, happens when stomach acid travels back up into the esophagus. The underlying cause is generally a momentary failure of the lower esophageal sphincter (LES), the muscle ring separating the stomach and the esophagus. Physical exertion, especially high-intensity activity, increases pressure within the abdomen, forcing stomach contents past a relaxed or weakened LES.
Strategic Eating and Drinking Before Exercise
Managing what and when you eat is an effective way to prevent exercise-related reflux. The timing of a meal relative to a workout is important because a full stomach places greater pressure on the LES. Allow a substantial period for digestion, ideally waiting two to three hours after consuming a full meal before beginning a workout.
If you need fuel closer to exercise, choose a light, easily digestible snack, such as a banana or a small portion of whole-grain toast. Avoiding certain food types immediately before activity can significantly reduce the risk of reflux. High-fat meals take longer to empty from the stomach, increasing the time window for potential reflux.
Specific dietary triggers should be avoided, as they can relax the LES or increase stomach acid production. These include acidic items like citrus fruits and tomato products, caffeine, and chocolate. Carbonated beverages are also problematic because the gas they contain creates pressure, causing the sphincter to open.
Adjusting Exercise Mechanics and Intensity
Certain types of exercise are more likely to aggravate reflux symptoms due to mechanical stress. High-impact activities involving significant jarring, such as running, jumping, or intense aerobics, can repeatedly jostle stomach contents. Opting for low-impact alternatives like walking, cycling, or swimming helps maintain a stable abdominal environment.
Body position during exercise also influences the flow of stomach acid. Exercises that require bending forward or lying flat, such as traditional crunches, leg raises, or inverted yoga poses, should be modified or avoided. Maintaining an upright posture allows gravity to assist in keeping stomach acid contained.
Beyond the type of movement, workout intensity plays a role. Strenuous exercise increases intra-abdominal pressure, a key mechanism in triggering reflux. Avoid wearing clothing that is too tight around the waist or abdomen, as this external pressure can also contribute to acid being pushed up into the esophagus.
Using Over-the-Counter Relief Preventatively
For individuals whose heartburn is predictable during exercise, over-the-counter (OTC) medications can be a proactive tool. These options manage or reduce stomach acid in different ways. Antacids, such as those containing calcium carbonate, offer rapid relief by neutralizing the acid already present in the stomach.
Since antacids only last for a short time, they are best suited for immediate, on-demand use and may not cover a full workout. A more preventative option is the use of H2 blockers, which reduce the amount of acid the stomach produces. These medications need time to take effect and should be taken 30 to 60 minutes before a known trigger, such as a workout.
While these medications manage symptoms, they are not a substitute for addressing underlying lifestyle factors. They should be used judiciously. If symptoms persist or require daily use, it signals a need for a professional medical evaluation. Proton pump inhibitors (PPIs) strongly suppress acid production, but they are reserved for more frequent or severe symptoms and are best initiated under a doctor’s guidance.
When to Consult a Healthcare Professional
Occasional heartburn is manageable with lifestyle changes and OTC remedies, but frequent or severe symptoms should prompt a consultation with a healthcare provider. Heartburn occurring more than twice a week may indicate a chronic condition like Gastroesophageal Reflux Disease (GERD). Chronic acid exposure can lead to damage in the esophageal lining.
Specific “red flag” symptoms require prompt medical attention as they may signal a more serious underlying issue.
- Difficulty or pain when swallowing.
- Unexplained or unintended weight loss.
- Persistent vomiting.
- Severe chest pain, especially if it radiates to the arm, neck, or jaw, which should be treated as a medical emergency to rule out a cardiac event.