GERD and Exercise: Exercise-Induced Acid Reflux Is a Thing, and It Almost Made Me Stop Running

I chalked the initial incident up to unfortunate weather conditions. It was 85 degrees, 80 percent humidity, with a UV index of six—not ideal for running at all, let alone an attempt at being competitive in a 5K race. In the last quarter mile, I suddenly became horribly nauseous, my stomach revolting, liquid surging and burning in my throat.

My photo finish was quite the sight as I gagged my way across the finish line and landed on a nearby patch of grass dry-heaving over and over. People rushed to my side, a cacophony of jumbled voices and hands outstretched with cups of water. But I waved them off, feeling embarrassed that I had an audience while my body was in some unexpected state of rebellion.

“I have low blood pressure,” I gasped. “The heat gets to me sometimes.” I hadn’t yet been diagnosed with gastroesophageal reflux disease, or GERD, and 5Ks were normally the equivalent of a medium workout for me. So my explanation was not grounded in anything other than me trying to excuse my poor showing.

For me, running had always been my most comfortable space. Something I loved and excelled at. I could power through cold weather, hot weather, rain or shine, and the majority of the time I felt great during a race. I had raced competitively as a kid all the way through high school, even medaling at the Penn Relays one year. So when I started consistently feeling sick towards the end of every race regardless of the weather, I began dreading doing the one thing that had always brought me the most stress relief and happiness.

Finally, I was sent by my primary care doctor for an endoscopy and was officially diagnosed with acid reflux and mild gastritis.

I was thrilled to finally have an answer for what I was feeling, but that was only the beginning of being able to reclaim my body, and my old routine.

GERD is a condition where stomach acid frequently flows back into the esophagus, irritating the lining and causing symptoms like chest pain, trouble swallowing, feeling like there’s a lump in your throat, or icky burning burps. Eitan Rubinstein, M.D., a gastroenterologist affiliated with Harvard Medical School and Boston Children’s Hospital, tells SELF that while most people experience some level of gastroesophageal reflux (GER) over the course of a day, repeated issues (meaning multiple times a week) is when GERD is at play. As SELF reported previously, GERD can cause long-term damage to the esophagus or ulcers affecting the esophagus.

It made total sense that running, or moderate- to high- intensity exercise of any sort, would worsen my symptoms. “Anytime you do anything strenuous, your stomach can tighten up, making contents flow upward, [so] anything can give you reflux if you strain yourself hard enough,” Dr. Rubinstein explains. And, “If you’re breathing hard enough, your lungs are expanding and you can actually draw reflux material into your esophagus.”

And since gravity is a factor in experiencing reflux (for instance, lying down after eating is a know reflux trigger, as the position allows acid to travel up the throat more easily), different athletic activities can exacerbate GERD more than others. Lori Zimmerman, M.D., a pediatric gastroenterologist at Boston Children’s Hospital, tells SELF that she has had teen athlete patients come in complaining of symptoms after practicing gymnastics and cross-country running. Like Dr. Rubinstein, Dr. Zimmerman agrees that, above all, it’s the level of exertion more so than the actual activity. But the general mechanics associated with running and that “bobbing up and down of the body," as she describes, lends itself to the potential for issues with GERD.

So what are you supposed to do when the one activity that helps you deal with stress is suddenly causing it? You make the mildly annoying, but very necessary, changes to your routine.

Deborah A. Fisher, M.D., who specializes in gastroenterology at Duke University and the Duke Clinical Research Institute, tells SELF that figuring out a proper course of treatment for reflux can be a matter of trial and error and patience. Knowing your triggers, she says, is an essential part of getting relief. With acid reflux, everyone has different triggers; there’s no hard-and-fast list, although there are common ones, like certain types of food (citrusy or spicy foods tend to be culprits), body positioning like lying horizontal, and smoking.

I had to eliminate all kinds of food and drink from my diet, then slowly reintroduce them and pay attention to how they affected me in order to identify my triggers. (It was a devastating revelation to learn that coffee was a no-no for me.) And some of the foods I identified as triggers only affected me circumstantially as opposed to every single time I ate or drank them, so I could feel totally fine in one instance and then like my chest was on fire in another from the same food. But I began to notice the difference in how I felt running if I was consistent about avoiding my triggers at least 24 to 48 hours before a run.

Experimenting with medication on the advice of my doctor also helped. Luckily for my wallet, the most effective treatments were over-the-counter types like Prilosec or Zantac. Putting pressure on the abdomen can also exacerbate GERD symptoms, Dr. Fisher notes, so I now consciously avoid tight, constricting workout attire that presses on my diaphragm whenever I plan to run. “Anything that increases your intra-abdominal pressure, well the contents in there have to go somewhere,” Dr. Fisher points out.

With these lifestyle adjustments, the nausea and burning sensations slowly dissipated, and I worried less about dry-heaving in front of horrified pedestrians.

If GERD is an issue for you, check in with your doctor and try some of the tactics in this article to see if it helps. Dr. Fisher also suggests propping the top half of your bed up (by putting concrete blocks or bed risers under the top feet of the bed frame), which helps to put your body in a more ideal posture to keep stomach acid down while your sleep. Simply propping your torso up with pillows doesn’t always do the trick, she says, as this can still force your body to bend or crunch at the waist, possibly putting pressure on your stomach. Eating smaller meals rather than large ones can also help, as can avoiding eating a couple hours before lying down to help prevent issues at bedtime. And, of course, this is another reason to quit smoking, since the habit can worsen reflux issues.

Reflux symptoms can really interfere with your quality of life and your ability to engage in healthy activities, like it did for me with running, but it is usually very treatable, even though it’s not always the most convenient. Hey, sometimes I still throw caution to the wind and have that glass of red wine or drink the coffee that I know I’ll be somewhat sorry about later—but now, I just wait until after my run.


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Self – Health