As with most things in life it comes down to mostly common sense. Before I tell you all the things you can’t have or do let me say this:
Your body is designed to heal itself.
Your cells are regenerating every moment of every day, striving for health. If you give the body what it needs (which sometimes means just getting out of its way, especially with pharmaceutical drugs) it can often find its way back to a healthful state. 99% of the time now I’m completely symptom free. Once you get to that state (which took me several months) you may not have to be so strict.
If you do nothing else, do this. Drink Slippery Elm “tea”. Ok, it’s not tea, it’s gruel. But it works!
Slippery Elm has been used for centuries as a digestive aid and it’s highly nutritious (rumor has it Washington’s Army lived on it and even had their gunshot wounds treated with it). Just like it sounds it’s literally tree bark, of the Slippery Elm Tree. When mixed with water it makes a thick gelatinous concoction that coats your entire digestive system. I have a cup before bed anytime I even think my heartburn is going to kick up. It’s not only good for acid reflux, but also for other digestive problems like Irritable Bowel Syndrome and diverticulitis and diverticulosis and can be made into a poultice to treat burns and wounds.
Slippery Elm “Tea”:
- Put all ingredients into your blender and blend until creamy.
- Let it cool a bit (it’ll really hold its heat, watch out!) and enjoy. You can also blend with less hot water and stir in some room temp water to cool it down but it will blend easier with very hot water.
Yes, it’s slimy, but you get used to it. I enjoy it even. More importantly it works! Before bed is the best time to have a cup of slippery elm “tea”. Reflux often happens when we lie down simply because gravity isn’t helping to keep things down where they belong. So have a cup right before bed (& remember to sleep on your left side, &/or propped up).
By the way, the Slippery Elm pills you’ll find at places like Whole Foods won’t do the trick. You need the Slippery Elm to coat your esophagus, not make the trip all the way to your tummy. Don’t know why, read ‘What is Acid Reflux Anyway?‘.
The biggest problem making slippery elm tea is lumps. I’ve tried everything. Whisking. Shaking. Stirring. Hot water. Cold. First cold to make a paste then adding hot. There’s only one way, in my experience, to make beautifully smooth slippery elm tea. You’ve got to use hot water and use a blender, or a chopper attachment on an immersion blender.
Let me restate for emphasis. If you do nothing else to naturally treat your reflux, drink slippery elm tea!
Other Lifestyle Changes:
- Lose those extra pounds. Studies have shown even moderate weight loss can reduce your symptoms.
- Chew your food. Your mouth is the beginning of your digestive system. Let those teeth and all that saliva do their job before sending it downstream.
- Use digestive enzymes. This is especially important if you’re getting older.
- Use probiotics. I really like the beadlet form, it survives the acidic environment of the stomach and gets the probiotics into your intestines, where they’re needed.
- Chew DGL (Deglycyrrhizinated Licorice). DGL stimulates mucus production, restoring the lining of the esophagus and stomach. Chew 2 tables between meals. Particularly useful if you suffer from ulcers.
- Read “Why Stomach Acid is Good for you” by Dr. Jonathan Wright and Lane Lenard, PhD for more info.
- Chew cinnamon gum. You’ll likely have to go to Whole Foods to find gum that doesn’t contain aspartame or sucralose. Look for gum sweetened with xylitol (good for your teeth, actually prevents cavities!) and/or stevia. I like the Between or Spry brands. Spearmint is often advised for tummy trouble but can weaken the sphincter between your esophagus and your stomach (the LES), and is NOT recommended. BEWARE! Most commercial gum is sweetened with aspartame, which is a whole other subject.
- Avoid bending over, particularly after eating (hinge at the hips and bend at the knees to load that dishwasher!).
- Sleep on your left side. Lying on your left side puts your stomach in a position less likely to send contents upwards. Sleeping on your back is the second best option, and on your right side is the worst option. Tummy sleeping is clearly out of the question!
- Quit smoking. Smoking may weaken the LES and you don’t produce as much saliva, one of the ways the body protects the esophagus.
- Sleep elevated. Prop the head of your bed up 4-6” with blocks (cheap first thing to try, although you might just slip to the end of the bed), use a wedge pillow (I never found one I really liked, I tried several and always slid down as the night wore on) or pile up some fairly firm pillows. If you use pillows like I did watch out for propping up the head and neck too much and letting your abdomen ‘sag’; make yourself a nice gradual incline.
- Avoid regular use of NSAIDs such as aspirin, ibuprofen (Motrin, Advil, Nuprin, Rufen), Naproxen (Aleve), and others. Studies show regular users of NSAIDs are twice as likely to develop acid reflux disease. Say it with me in your best Mr. Mackey voice: Drugs are Bad!
- Avoid unnecessary use of antibiotics. If you do have to take antibiotics, replenish your system with a good probiotic (yogurt isn’t enough to do the trick).
Hiatal Hernia Exercise
If, like me, your reflux is a result of a hiatal hernia (when the top of your stomach has popped through your diaphragm) there’s a simple but very effective exercise you can do to get your stomach to drop down back where it belongs.
First thing each morning drink a warm glass of water. Not hot. Not cold. Not coffee or tea. Warm water. On an empty stomach. Reach your arms out to the side. Let your stomach relax. Rise up on your toes. Then thump down onto your heels. Rise up. Thump. 10 times. Then take your arms overhead and pant – fast! – for 10 seconds. That’s it!
The warm water encourages your stomach to relax and gives it weight. Simple gravity helps the stomach drop down. Panting with your arms overhead encourages the diaphragm to tighten up and keep things in place.
Caution: Do not do this exercise if you have any disc issues in your spine as you’re putting a fair amount of force on your spine.
Don’t eat too much at one time. This has the biggest impact on my symptoms. Much more so than any particular food I eat. If I overindulge, even in the healthiest food, I’m gonna pay for it.
Give yourself time to digest (3 hours) before going to bed.
Avoid the following:
- Hot liquids and foods (temperature, that is). If you can’t hold it in your mouth, it’s too hot to go down your throat! Once you start doing the hold-in-your-mouth test you might be surprised how much piping hot stuff you’re sending down your esophagus!
- Greasy and fried foods. Fat makes food digest slower, so food remains in your stomach longer, giving it more opportunity to go up instead of down. However, healthy fats (fish oil, nuts, olive oil) are vitally important to health and in my experience a meal of healthy fats (oven roasted salmon, for instance) and one of unhealthy fats (french fries) have very different reactions.
- Chocolate (sorry, causes the LES to relax); I must admit this is the first place I indulge when I’m symptom free!
- Hard alcohol (beer is ok for most people, and red wine seems to have a protective effect – yay!)
- Peppermint and Spearmint. Peppermint is known for its tummy taming properties. But not when acid reflux is your problem, it relaxes the LES.
- Carbonated beverages
- Acidic foods: tomatoes, citrus
- Spicy food
- Raw onions and garlic – maybe. I’ve read both that onions and garlic are to be avoided, and because of the many health benefits, should not be avoided. Test it on yourself, see what happens.
Your triggers may be different than anyone else’s, and some of the foods above might be fine for you (for instance, I don’t seem to have a problem with spicy food). Pay attention to what aggravates you and what doesn’t. A food diary for a week or so is an excellent tool for determining what you should and shouldn’t eat.
Regular exercise is very important (for lots of reasons), but heavy weight lifting should be avoided as it can increase the pressure in the abdomen and force stomach acid up the esophagus. Bouncing (jogging, running, bouncing on a large exercise ball, jumping rope) is asking for trouble. Some say crunches or sit ups are also a bad idea. My personal experience doesn’t bear that out, but decide for yourself if it aggravates you. Basically any exercise that causes you to grunt or strain should cause you to say to yourself “hmm, I don’t think I should do that”.
No jogging? No weight lifting? Doesn’t that mean no exercise? Absolutely not!
Pilates! Pilates was certainly the answer for me when traditional weight training aggravated my condition. For almost two years Pilates was the only form of exercise I could do. Instead of spending five days a week in the gym killing myself with high intensity cardio and heavy weight training my reflux forced me to cut back to two days a week of Pilates (I didn’t know at the time that acid reflux was what was wrong with me, I only knew cardio and weight lifting caused me to have shortness of breath). Naturally I assumed I’d gain weight and lose muscle tone. Exactly the opposite happened. I lost weight (and have kept it off) and have gained muscle tone. Not without effort, certainly, but absolutely without grunting and straining.
You should avoid inverted positions (with your head below your stomach) but you can do most of the Pilates repertoire without aggravating reflux.
If yoga is your thing be sure to avoid anything inverted (“upside down”) like downward dog or headstands.
As for cardio, I highly recommend Nia, a non-impact form of aerobics, combining dance and martial arts kicks and blocks. It’s infinitely modifiable for your body and fitness level. But more than anything else, Nia is just plain fun! Or good old fashioned walking (the movement your body is most designed to do in my opinion).
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