When it comes to acid reflux and GERD, is exercise a good thing or a bad thing? The answer is not black and white.

When the LES (lower esophageal sphincter) becomes weak, it allows contents in the stomach such as food, acid, or bile to flow back upward into the esophagus, resulting in burning and discomfort. This irritates the delicate lining of the esophagus, which makes repeated reflux all the more painful. If you experience chronic reflux, your doctor may diagnose you with GERD (gastroesophageal reflux disease). 

Despite drug store remedy claims, not all reflux is caused by spicy food. There are a variety of reasons why someone may experience reflux including stress, being overweight, smoking, diet, GI conditions such as SIBO, autoimmune disease, or infections such as H. pylori. Because the causes can vary and overlap, it’s important to identify your unique cause(s) and treat accordingly, rather than blindly suppress symptoms with over-the-counter antacids. 

But no matter what your medical regime, attending to lifestyle is foundational for all healing - making dietary changes, managing stress, and exercising. However, before running to the gym, consider that when it comes to acid reflux, the type and intensity of exercise matters depending on the individual.

Being overweight can cause acid reflux, so exercising may be especially important for those individuals. Excess weight puts pressure on the stomach, forcing the contents to move in the wrong direction and in some cases, the person may develop a hiatal hernia (part of the stomach pushes through the LES). Maintaining a healthy weight is an essential healing mechanism for acid reflux, and exercising is part of attaining this goal.

However, exercise can work for or against acid reflux in many other cases. Before adopting an “all exercise is good exercise” mentality, consider the following:

When exercising:

• Position yourself upright: If your reflux acts up more at night, you’re not imaging it. It’s because there’s a gravitational component to reflux. Lying flat with a loose and open LES allows stomach contents flow upward more easily. When choosing a type of exercise, use positions that keep you upright. This may mean propping your head up with pillows in certain yoga poses or avoiding planks.

• Don’t focus on the stomach: Avoid exercises that directly target stomach muscles, such as crunches or sit ups, which can put unnecessary stress on the GI tract and further aggravate reflux. 

• Don’t break a sweat: While everyone is different, it’s not uncommon for high intensity workouts to be problematic for reflux. Instead, opt for low intensity, where your heart is working at around 50% or your maximum heart rate (as opposed to roughly 90% with high intensity). Low intensity workouts include walking, jogging, yoga, light biking, or swimming.

• Don’t eat and run: In addition to being rude at a dinner party, eating and running has health consequences. The more food in the stomach, the more can flow up in a bout of reflux. Plan your meals and workouts accordingly. Try not to eat for two hours before exercising, and when you do eat, avoid reflux trigger foods such as chocolate, citrus, tomatoes, peppers, spicy foods, alcohol, onions, and coffee. 

• Loosen up: Avoid constricting clothing. This rule applies during and outside of workouts. Tight clothing can put pressure on your GI tract, especially due to the location of waste bands and sports bras - the elastic cuts across the upper stomach and lower abdomen. Wear comfortable, loose-fitting clothing, especially during workouts.

All in all, when it comes to healing of any kind, some exercise is better than none, so get off the couch if you want to improve your acid reflux! Exercise for weight loss is especially important for overweight individuals, as the excess weight is likely causing, or at least contributing to the reflux. However, be mindful of the type, intensity, and amount of exercise. Keep yourself upright, avoid constricting clothing, choose low intensity workouts, and leave plenty of time between meals and the gym.