Acid reflux affects almost one in five of us. Left untreated, regular bouts of acid reflux can result in everything from tooth erosion to chronic inflammation of the oesophagus, which can make swallowing painful. It has even been linked to oesophageal cancer.
One particular class of medicines that helps the symptoms of acid reflux and GORD are proton pump inhibitors (PPIs). These work by reducing the amount of acid your stomach produces and help the oesophagus heal from the damage caused by excessive exposure to acid.
Long-term use of PPIs has now been linked to an increased risk of bone fractures and gastric cancer but now research published in the peer-reviewed journal Neurology suggests an association between prolonged use of PPIs (for over four years) and developing dementia.
The good news is that there’s plenty you can do to ease symptoms of acid reflux and even aim to prevent it happening at all. Try our natural tips that could help ban that burning feeling.
STRENGTHEN YOUR DIAPHRAGM: There are two muscle layers that keep food in your stomach after you swallow it and stop stomach acid leaking upwards (refluxing) into the oesophagus: the lower oesophageal sphincter (LOS) – a ring of muscle at the bottom of the oesophagus – and the respiratory diaphragm, surrounding it. If these muscles are weakened, acid can “reflux” up into the oesophagus.
To strengthen these muscles and stop acid from leaking upwards, you can try things like:
Belly breathing: A clinical trial published in the American Journal of Gastroenterology found that deep abdominal breathing for 30 minutes daily helps strengthen the muscles surrounding the diaphragm, creating a more resilient barrier against acid. To do it, sit comfortably with one hand on your chest and the other on your belly. Breathe deeply with your diaphragm so the hand on your belly moves but the hand on your chest stays still. Imagine air filling your belly rather than your lungs. Contract your stomach muscles to exhale.
Strength training: In studies, a neuromuscular training medical device called the IQoro was found to help acid reflux symptoms. You simply place the “fins” of the device inside the lips (but outside the teeth) and pull the lever of the device straight out, at the same time as holding it with your lips. The resistance that’s created helps strengthen the entire muscle chain in the swallowing process – from the lips to the diaphragm and stomach. Available on prescription or privately for (£145, iqoro.com)
Holding your breath: Stretching the respiratory diaphragm so it is more flexible can help, says physiotherapist Nell Mead. “The diaphragm is at its longest at a full exhale, so that’s how you stretch it – breathe out as far as you can, mouth closed. “Then hold your nose, and hold the breath for as long as you can before you have to breathe in again. Repeat as soon as you can. You’re aiming to hold the exhale for 30 seconds.
LINE YOUR STOMACH: Antacids are medicines neutralise stomach acid, but some are combined with coating agents that also form a protective barrier to stop excess acid reaching your oesophagus. “Natural, colloidal silica gel is a coating agent which coats the stomach with a protective lining and adsorbs excess acidity and gas,” says Dr Richard Middleton, Registered Pharmacist and director of the British Herbal Medicine Association. “Try Silicolgel, which is particularly helpful for night-time reflux if taken before bedtime.”
CHECK YOUR MEDS “Some common medicines can cause or worsen acid indigestion symptoms including aspirin containing products and ibuprofen,” says Dr Middleton. They can irritate the oesophagus and stomach so aim to take them with food and plenty of water rather than on an empty stomach.
GET FLEXIBLE “If your ribcage is stiff when you breathe, it creates more resistance for the incoming air, so the diaphragm has to work harder,” says Nell. “Keeping your ribcage flexible can take some of the load off the diaphragm, letting it do its job better which could lower the risk of acid reflux.” Try this exercise: Hold on to your elbows above your head, your left hand holding the right elbow and vice versa. Reach your right elbow into the air (up towards the ceiling) as high as you can. You should feel a stretch down the right side of your ribcage. Hold the position then try to direct your breath into your right lung, so you’re stretching the right side of the ribcage from the inside as well as from the outside. Hold for 10 seconds, then repeat on the left side. Repeat three times on each side.
SLEEP STRATEGIES Lying down soon after eating makes it easier for stomach acid to flow up into the oesophagus. So eat your evening meal at least three hours before bedtime and aim to stay upright after it – sitting on the sofa is OK but use cushions to prop you up.
“Raise the head of your bed or use pillows to ensure your shoulders and chest are above your stomach,” says Dr Middleton. Sleeping on your left side may also help according to a study published in the The American Journal of Gastroenterology. It found acid cleared much faster in participants that slept on their left side compared to those on their backs or right sides.
WATCH YOUR POSTURE Upper cross syndrome (UCS) is a condition where muscles in the neck, shoulders and chest go out of balance and result in a forward-positioned head and curved shoulder posture – often as a result of slouching at a desk all day. According to some studies UCS can trigger acid reflux. So try to sit upright at your desk and stretch regularly.
CATCH THE FOOD CULPRITS Fatty foods not only relax the lower oesophageal sphincter but they also slow the rate at which food leaves the stomach – meaning there’s more pressure on it for longer, especially if you’ve had a big serving. Other foods can increase the production of stomach acid. These include caffeinated and fizzy drinks, alcohol, citrus foods and drinks, spicy foods, vinegar-based dressings and tomato-based foods. Experiment by cutting things out for a week to see if there’s any improvement in symptoms. And be sure to cook onion and garlic – both can be trigger foods for acid reflux, but even more so when eaten raw.
GET OUT OF PUFF(ING) Studies have found smokers are more likely to get GORD than non-smokers. That’s because nicotine relaxes the lower oesophageal sphincter, allowing acid to trickle upwards. Vaping will have the same effect.
GENTLY EXERCISE “Research shows that exercise can help with symptoms of acid reflux – but avoid anything that increases intra-abdominal pressure – pressure on the contents of your stomach and the sphincter at the top of it,” says Dr Esther Fox, clinical specialist physiotherapist. “That would include things like high-intensity Cross fit classes and intensive sit-ups, for example. Low intensity exercise that keeps you upright and moving is best – walking, cycling or gentle jogging, for example.”
PILATES PLEASE The slow, controlled movements of Pilates can help strengthen abdominal muscles and the diaphragm, which could help prevent episodes of acid reflux, plus ease stress, which can be a factor too. “Just choose your poses wisely,” says Esther. “Avoid positions where you have to bend at the waist and where your head is lower than your heart.”
YOU CAN’T BEAT BROCCOLI Some vegetables can have an alkalising effect on gastric acid. One study published in Complementary Therapies in Medicine showed that kale, radish and cucumber performed well. But the best was broccoli. It scored as well as bicarbonate of soda and a popular over-the-counter antacid formulation in their tests.
REDUCE THE PRESSURE “Tight-fitting clothes like muscle-fit T-shirts or high-waisted jeans can put pressure on the stomach, increasing the chance of acid reflux,” says GP Alexis Missick from UK Meds. “Looser clothing, especially around the stomach will help.” Also, try eating smaller, more frequent meals, rather than a couple of large meals a day – a full stomach puts more pressure on the low oesophageal sphincter