Best Ways to Beat Exercise-related Heartburn

By Karen Asp

You're trying to stick with a regular exercise program, but every time you work out, you get heartburn. The pain is so bad that it’s hard for you to stay physically active. In fact, you're tempted to kick the exercise habit completely. Not so fast. With a few tweaks to your lifestyle habits and exercise choices, you can work up a sweat without working up your heartburn.

Heartburn affects approximately 40 percent of Americans at least once a month, according to the National Heartburn Alliance. Even more telling, a survey of over 1,000 people found that roughly 40 percent of heartburn sufferers experience heartburn during exercise, and more than two out of every five have stopped being as physically active as a result. In fact, Dr. Steven R. Peikin, head of gastroenterology at the Robert Johnson Medical School and Cooper Hospital/University Medical Center in Camden, N.J., has a special name for this condition: exertion-associated gastroesophageal reflux, or EAGER.

How does EAGER occur? People who are prone to heartburn have a weak lower esophageal sphincter, the valve that separates the esophagus (or “food tube”) from the stomach. "It's supposed to be a one-way valve, but with certain activities or body positions, the pressure below the lower esophageal sphincter becomes so great that it forces the flow of stomach acids into the esophagus," says Peikin. That acid then causes symptoms like chest pain, a burning sensation in the chest or throat, or difficulty swallowing.

If EAGER has thrown a wrench into your workout routine, consider these six strategies to keep you moving:

1. Avoid high-impact activities.
Any activity that jostles you (think: running and step aerobics) can cause heartburn. That's why stationary cycling and swimming are two of the best activities for heartburn sufferers, says Peikin.

2. Be aware of your body position.
"Activities that require you to bend over or lie on the ground can cause heartburn," says Dr. Brian E. Lacy, director of the GI Motility Laboratory at the Dartmouth-Hitchcock Medical Center in Lebanon, N.H. That's why bowling and sit-ups might not be such a good idea.

3. Lift with care.
Weight lifting offers numerous benefits for your body, but because it can increase pressure inside your abdomen, it may also cause heartburn. This is especially true if you're doing heavy lifting, Lacy says. You can still lift weights; just lower the intensity.

4. Exercise on a relatively empty stomach.
If you've had a rich meal, wait at least four hours before exercising, says Peikin. If you've eaten a small meal, wait two hours. If you need a small snack before exercise, choose low-fat foods like a banana or half a bagel, suggests Lacy. Finally, certain foods -- like peppermint, chocolate, nuts, caffeinated beverages and fatty foods -- can trigger heartburn. These foods don’t affect everyone, but if they’re a problem for you, avoid them before working out.

5. Take preventive medicine.
If lifestyle adjustments aren’t enough, and you’re still getting heartburn every time you exercise, talk to your doctor about medication. Taking an H2 blocker 30 to 60 minutes prior to exercise can help reduce acid in the stomach for six to 12 hours. If heartburn is long-term and persistent, a proton pump inhibitor (PPI) can provide 24-hour relief. (Just keep in mind that a PPI needs to be taken daily and takes a day or two before it starts working.)

6. For immediate relief, try antacid and water.
If despite all your efforts, heartburn flares in the middle of your workout, pop an antacid, which will neutralize acid and provide immediate short-term relief. You should also drink plenty of water. "Water will dilute the acid and flush it back into the stomach," says Peikin.

While heartburn can make exercise a challenge, don’t quit working out. For one thing, excess weight makes you more susceptible to heartburn, and regular exercise can help keep extra pounds at bay. Instead of giving up, says Peikin, “find ways to overcome your heartburn, as exercise is too important to avoid.”

Karen Asp is a fitness/health writer who contributes to numerous publications, including Fitness, Natural Health, Men's Fitness, Prevention, Self, Shape and Women's Health. She's a contributing editor for Woman's Day and the Fit Travel blogger for AOL. Asp is also a certified personal trainer and group fitness instructor.

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