Change your habits to manage heartburn/gastroesophageal reflux disease (GERD)

 

Lifestyle modifications are a safe and inexpensive approach to treating GERD and promoting general wellbeing. Of the many possible lifestyle recommendations, only a small portion will be relevant and effective in treating your GERD.   It is, therefore, important that you pay attention to your symptoms in order to make the necessary, uniquely yours, lifestyle adjustments.

Kaltenbach T., et al., Are Lifestyle Measures Effective in Patients With Gastroesophageal Reflux Disease? Arch Intern Med. 2006;166(9):965-71

Lose extra weight

Being overweight is a known risk factor for GERD. A large, long-term clinical study showed that GERD symptoms improved in overweight people who lost weight. Even modest weight reductions resulted in symptom relief, but the more weight the study participants lost the greater the benefit they experienced.  Additionally, therapy with the antireflux medication, protein pump inhibitors, was more successful in people who lost weight than in those whose weight remained the same or increased during the study.

Adjust your sleeping position

Some people experience heartburn predominantly at night.  For such population, sleeping in a position that allows head and shoulders to be above the stomach significantly minimizes the risk of reflux.  

Ness-Jensen E., et al., Weight Loss and Reduction in Gastroesophageal Refl ux. A Prospective Population-Based Cohort Study: The HUNT Study, Am J Gastroenterol 2013; 108:376–382
Weightloss improves GERD in overweight people

To achieve such sleeping position you can elevate the head of your bed by putting bed risers underneath the bed’s feet. Alternatively, you can use a wedge pillow that provides a similar slant and is as effective but more convenient to use than are the bed risers.  Aim for 6-8 inches of elevation. Using multiple pillows for this purpose is not recommended, as it can increase the abdominal pressure and lead to the worsening of the symptoms.

Hamilton J.W., et al., Sleeping on a Wedge Diminishes Exposure of the Esophagus to Refluxed Acid, Dig Dis Sci. 1988,33(5):518-22
Heartburn/GERD trigger foods infographic

Avoid trigger foods and drinks

 

Many people associate the onset of GERD symptoms with the intake of certain food items.  Citrus fruit and tomatoes, carbonated and caffeinated drinks, alcohol, chocolate, spicy, fatty and sweet foods, as well as products containing mint are food items that are most commonly reported to worsen reflux. Foods that trigger your symptoms might differ from the ones listed here.

Pay attention to your symptoms and avoid foods that aggravate them.

Avoid lying down after a meal

 

GERD symptoms commonly appear after meal consumption. To take advantage of gravity, which helps keep stomach contents in its place, avoid reclining or lying down (as well as bending) for several hours after a meal. Eating a light dinner early, at least 3 hours before bedtime, will considerably minimize the risk of acid reflux in people who experience GERD at night.

Avoid large and heavy meals

 

A large meal, high in fatty, sweet and processed food, will stretch out your stomach and delay its emptying, increasing the chance of reflux. To prevent overeating, eat smaller sized meals more frequently, and chew your food slowly.

 

Manage stress

 

Chronic stress is an established risk factor contributing to a variety of gastrointestinal disorders, including GERD. People under stress often perceive their GERD symptoms as very intense even when the measurements of the acid in the esophagus do not show increased levels. Explore different ways to relax and reduce stress - through meditation, connecting with friends, pursuing hobbies and exercising in nature.

 

Quit smoking

 

Adding to the list of reasons to rid yourself of this unhealthy habit is the fact that smokers have significantly higher rates of acid reflux than nonsmokers.  Smoking adversely contributes to the health of the upper gastrointestinal tract and exuberates GERD. Its most direct effect is that it aggravates coughing which, in turn, provokes reflux.

 

Avoid tight fitting clothes

 

Tight clothing can exert pressure on your abdomen and cause discomfort as well as obstruct the normal movement 

Konturek, P.C., et al., Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options, J Physiol Pharmacol. 2011, 62(6):591-9
Kahrilas p.k., Gupta R.R., Mechanisms of acid reflux associated with cigarette smoking, Gut, 1990,31,4-10

of food down the gastrointestinal tract.

 

Practice abdominal breathing

 

Abdominal breathing may improve reflux symptoms by strengthening the diaphragm which is part of the antireflux mechanism. A small study that investigated the benefits of breathing exercises in GERD relief found that abdominal breathing not only improved GERD, but in some cases dramatically reduced the use of antireflux medication - protein pump inhibitors.

Eheree A.J., et al., Positive Effect of Abdominal Breathing Exercise on Gastroesophageal Reflux Disease: A Randomized, Controlled Study, Am J Gastroenterol 2012; 107:372–378

Abdominal breathing entails using your abdomen instead of your chest. To better understand how to properly use this technique, place one hand on your abdomen and the other hand on your chest. While inhaling and exhaling, the hand on your abdomen should move outward and inward; the hand on your chest should remain still.

 

To practice abdominal breathing, sit comfortably with your shoulders relaxed. Start by inhaling through your nose in 5 short snuffles. Hold your breath for 3 seconds, then slowly exhale through pursed lips for about 10 counts, expelling all the air. Pause briefly, taking 2-3 normal breaths, then repeat the exhale/inhale routine. If you feel uncomfortable or start to feel dizzy at any point during the exercise, stop and try it some other time.​

Abdominal breathing for GERD relief

In the beginning, repeat this exercise 5 times. Over time, gradually increase inhalations to 10 snuffles, while holding your breath for 10 counts and exhaling for 20 counts.

Aim to practice this technique several times a day, ideally before a meal, for approximately 15 minutes.

Last updated: January 9, 2017