If you’re tired of that sour taste in your mouth and the pain of heartburn is keeping you up at night, it’s time to take action against gastroesophageal reflux disease (GERD). While medication is often needed to treat more-severe cases of GERD, lifestyle changes are the first line of defense and an essential part of any treatment plan.
GERD occurs when contents of the stomach — stomach acid and food — back up into the esophagus. Follow these eight steps to help keep your acid reflux symptoms under control and prevent the potentially serious complications of GERD
1. Lose weight. “That’s probably the most important step that patients can take,” says John Clarke, MD, an assistant professor of medicine in the division of gastroenterology and director of esophageal motility at The Johns Hopkins Hospital in Baltimore. Excess weight increases pressure inside the belly, which can cause more reflux.
2. Limit or avoid alcohol and caffeine. Alcohol relaxes the lower esophageal sphincter (LES), the muscle that closes off the esophagus from the stomach after you swallow and keeps acids from backing up. Alcohol also can increase the production of stomach acid and slow stomach emptying. Beverages that contain caffeine can also worsen reflux symptoms.
3. Keep stress under control. A recent study found that people under stress, particularly from a demanding, fast-paced job, experienced worsened GERD symptoms. “Stress appears to affect perception of symptoms, but not actual acid production or number of reflux events,” says Dr. Clarke. That means “if you are stressed you will perceive reflux more than you otherwise would.” Meditating, exercising, and deep breathing are all good ways to manage stress and help prevent GERD symptoms triggered by stress.
4. Avoid foods that aggravate GERD. A number of foods are common triggers of GERD symptoms, says Clarke, including onions, garlic, fatty and greasy foods, chocolate, and peppermint. Clarke says that sticking to low-fat foods is important to minimize reflux symptoms, because fatty foods usually stay in your stomach longer. “Any foods that decrease gastric emptying tend to worsen GERD,” he says, and fat is one of the primary culprits for slowing down that process.
5. Don’t smoke. Cigarette smoking, like alcohol, weakens the LES and increases the likelihood of acid reflux. Smoking also decreases saliva production, and saliva buffers the acid in the stomach, Clarke says. Smoking also boosts acid production in the stomach, worsening reflux symptoms.
6. Wear loose clothing. Avoid wearing clothes that are tight around your abdomen. “If you have really tight clothes, you’re increasing the abdominal pressure,” Clark says. “The pressure will push fluid back up into the esophagus,” triggering reflux symptoms.
7. Talk to your doctor about your medications. A number of common medications can make acid reflux worse, including some medications used to treat high blood pressure, asthma, depression, and anxiety. Some birth control pills that contain progestin may also worsen GERD symptoms.
8. Stay upright after eating. When you lie down, it’s easier for gastric contents to flow into the esophagus and stay there, irritating the tissues. Eat your last meal or snack at least three hours before you go to bed, says Clarke. And don’t overeat at dinner. You can also raise the head of your bed between 4 and 6 inches, or sleep propped up with extra pillows to help ward off reflux symptoms.
Some habits may worsen your GERD symptoms more than others. By experimenting with these tips, you can make changes that will help keep you more comfortable.