LIFESTYLE CHANGES TO REDUCE ACID REFLUX (GERD)  

Gastroesophageal Reflux Disease, or GERD, can cause many uncomfortable or life-altering symptoms. GERD results from a weakened lower esophageal sphincter (LES), one of the two mechanisms in your stomach. The LES is responsible for GERD because its primary responsibility is to prevent stomach contents, like stomach acid, from regurgitating up into your windpipe. When the LES is weakened, it cannot prevent this from happening. As a result, stomach contents can freely reenter your windpipe, causing uncomfortable symptoms like heartburn or chest pain.

There are many ways to reduce the symptoms of acid reflux. Your first option should include scheduling a visit with your primary care physician (PCP). Your PCP will be able to go over the causes of acid reflux and also discuss treatment options. At this appointment, you and your PCP will discuss your options and determine which method of treatment works best for you. One of the first options your PCP will discuss is using medications to control the acid reflux.

Your PCP may discuss medication options like one of the popular PPI medications (proton pump inhibitor). PPIs commonly prescribed include drugs like omeprazole (Prilosec or Prilosec OTC), lansoprazole (Prevacid), or pantoprazole (Protonix). PPIs are also typically prescribed first as they work much quicker than other drugs for acid reflux. PPIs work by blocking gastric acid secretion by binding to the hydrogen-potassium pump that resides in the cells that make up the parietal, or outer layer, of your stomach. It is worth nothing PPIs have been said to have adverse effects like malabsorption of vitamins and minerals, gastritis, and other gastrointestinal symptoms.

Instead of a PPI, your PCP may prescribe you a histamine H2-receptor antagonist, also called an H2 blocker. H2 blockers are prescribed by physicians to help reduce the amount of acid produced by the cells in the lining of your stomach. Though commonly associated with allergies, histamines are actually produced in the stomach by enterochromaffin-like (ECL) cells. When histamine is released by the ECL cells, it stimulates the cells responsible for making acid in the cell. The H2 blockers are known as antagonists because they interfere with this process by inhibiting the acid-producing cells from responding to the histamine released by the ECL cells. H2 blockers can sometimes work quickly to relieve the symptoms of acid reflux; however, if you are taking an H2 blocker to help heal a stomach ulcer, it may take longer to find relief while using the medication. 

The second option your PCP will discuss with you is lifestyle changes. Your plan of treatment may include a mix of both lifestyle changes and a medication regimen initially to help your acid reflux improve more quickly. Lifestyle changes are ways of modifying your everyday life to help improve the symptoms of acid reflux. The changes involve identifying the factors that can trigger your acid reflux or make it worse. Lifestyle changes can significantly improve your acid reflux symptoms, and they are often easy to implement. If you are looking to try more of a lifestyle modification approach before trying medication, here are a few strategies that you can implement today before scheduling your first appointment with your PCP to discuss your acid reflux symptoms.

Find the Right Position

One of the best ways to help control acid reflux is gravity. The LES is weakened in GERD, and when you lie down after a particularly large meal, it cannot prevent the contents of your stomach from flowing back into your esophagus and causing you significant discomfort. Think about the time of day you most frequently experience the symptoms of heartburn. If it happens more regularly at night, you may want to consider sleeping with your head raised to prevent stomach acid from backing up into your esophagus while you sleep. You can invest in a bed wedge to help you maintain the proper level of elevation to prevent this regurgitation at night. Many people do not even realize it is happening; they just wake up in the morning with a dull ache in their chest and throat area.

Gravity is not just an issue at night. Maintaining the proper upright position after eating also helps prevent reflux after a meal. This lifestyle change allows the stomach to digest more of your meal before you retire to bed, preventing fewer stomach contents from regurgitating up your esophagus while you sleep. Avoiding exertion after a meal may also to prevent reflux as it can contract the abdominal muscles, forcing food through the weakened LES and causing the symptoms of reflux. Physicians also recommend that you do not lay down within three hours of eating, as that is when acid production reaches its peak. 

Stop Smoking

Not only does smoking cause many different health conditions, but it can also be responsible for exacerbating GERD. If you are currently a smoker, quitting smoking can be another lifestyle change to prevent acid reflux. Smoking aggravates GERD in a few ways. Smoking reduces saliva production. Reduced saliva production is a concern because saliva is alkaline and helps to neutralize stomach acid. It also helps alleviate the discomfort from heartburn by saturating the esophagus and washing the stomach acid back where it belongs. 

Smoking is also capable of causing an increase in stomach acid. It is even thought that smoking increases backwards movement from the intestines to the stomach leading to more corrosive stomach acids. Smoking can also affect the function of the LES by weakening and relaxing the sphincter, causing the stomach contents to reflux back into the esophagus. Additionally, smoking causes irreversible damage to the esophagus, allowing stomach acid to damage it much more quickly.

Plan Your Meals

Eating larger meals have two negative impacts for people who have acid reflux. Larger meals empty from your stomach much slower than smaller meals, exerting more force on your weakened LES. This force increases the risk of regurgitation of stomach contents back into your esophagus, causing heartburn. By eating smaller meals, you give your digestive system ample time to digest what you have eaten and reduce acid reflux risk down the road. 

Changing when you eat during the day can also alleviate the risk of painful acid reflux. Since it is recommended that you not eat within three hours of going to bed, it is best to eat during the early evening to give your stomach enough time to digest food and prevent reflux properly. You should consume the main meal of your day around midday, with your dinner being a meal that is light enough to satiate you without causing heartburn later. Depending on your lifestyle, it is recommended to eat either six smaller meals throughout the day or three smaller meals with three snacks.

Find Ways to Eat Your Food Slower

Quickly eating your food may be commonplace in today’s fast-paced world, but it is not recommended if you have Acid Reflux (GERD). Even the rate at which you eat food can cause painful heartburn. Studies report that people who eat their food faster are more likely to experience acid reflux later. When you eat too quickly, it does not allow your gastrointestinal system to work at an optimum level and could lead to indigestion and later heartburn. 

There are ways to encourage yourself to eat slower. Putting your fork or spoon down between bites prompts you to take the time to enjoy your meal. Additionally, when you eat fast, you typically do not thoroughly chew your food. Chewing twenty times or counting to twenty before your next bite also helps slow your eating. By eating slower and thoroughly chewing each bite, you give your digestive system a fighting chance to not turn against you!

Avoid Known Reflux Triggers

There are many known triggers for acid reflux. There are two reasons specific foods cause acid reflux. The food either causes the LES to relax when it should not, or it causes an increase in acid production in the stomach. Everyone has their own trigger foods, but the following two groups of foods are some of the biggest culprits.

Foods that can relax the LES include:

• Fried, greasy, or high-fat foods

• Those that contain whole milk dairy products or creamy sauces

• Caffeinated beverages like soft drinks, coffee, and teas

• Peppermint

• Chocolate

Many of the foods that stimulate acid production do so because they are acidic themselves. Foods that can cause an increase in acid production include:

• Caffeinated or carbonated beverages

• Alcohol

• Spicy foods

• Food containing tomato-based products

• Citrus fruits and their juices

Naturally, many people love a glass of wine or beer, and even though it can easily cause a flair in acid reflux, people who suffer from GERD can still drink alcohol. People with GERD can enjoy alcohol in moderation, a few different ways. Alcohol can be watered down with club soda or water. People should also consider limiting their alcohol consumption to one or two mixed drinks, 16 ounces or less of wine, or three beers. White wine is better for people with GERD to consume than red wine. You can also keep track of the onset of acid reflux to determine which alcohol types are triggers for your GERD.

Picking the Right Foods

It can be discouraging when trying to sit down for a meal or prepare a meal at home when many of your favorites are known to cause acid reflux. Thankfully, many foods do not increase the risk of heartburn. These foods include:

• White meat like chicken or pork

• Lean cuts of meat

• Sandwiches made on whole-grain bread with turkey, chicken, or roast beef

• Grilled meat

• Salads with low-fat or no-fat salad dressing

• Steamed vegetables like broccoli, carrots,  or asparagus

• Baked potatoes 

• Light desserts (yes, you can even still have dessert!)

Avoid Tight Clothing

While this tip might seem a little humorous, tight clothing can impact your acid reflux. Clothing that is too tight, especially around the abdomen, can place too much force on the stomach. This squeezing causes food to push up against the weakened LES, which relaxes and regurgitates stomach contents into the esophagus. Try wearing looser clothing, especially around mealtimes, to avoid inducing heartburn. Consider that an excuse for an impromptu shopping trip!

Find a Healthy Weight

Being overweight, like smoking, can cause many health issues over time. In fact, being overweight is one of the most significant risk factors for developing GERD. It can even impact GERD and the incidences of acid reflux. Excess abdominal fat can place more strain on the stomach and the LES. Studies have shown that a weight gain of even 10 to 20 pounds can cause a significant increase in heartburn among women. While being thinner certainly does not make you immune to heartburn, decreasing the strain on the stomach and LES from excess abdominal fat can help reduce the incidence of heartburn. 

Just as gaining a few extra pounds increases the risk of acid reflux, losing a few founds has been shown to decrease it. Introducing exercise and a healthy diet could help prevent excess weight gain while also reducing the reflux of acid from the stomach contents leaking through the LES from the pressure of the weight of abdominal fat. 

Find Ways to Avoid Stress

Stress is not a known cause of heartburn. However, stress leads to behaviors that can eventually cause a flare-up of heartburn. When you become stressed, your routines become disrupted, causing you to possibly eat meals later than usual, consume more alcohol, skip your workout, or eat greasy, fatty foods. Finding ways to reduce your stress can indirectly reduce your acid reflux. Examples of stress reduction techniques include:

• Meditation

• Breathing exercises like deep breathing

• Music therapy

• Massage

• Exercises like yoga, tai chi, stretching, or just taking a walk

• Guided imagery

• Aromatherapy

As you can see from this list, each of these suggestions is easy to implement. You can also take one at a time to see what works best for you. Finding lifestyle changes that would best for your life is the easiest way to make them stick, ultimately reducing your acid reflux.