While occasional heartburnwhich happens when stomach acid splashes up into the esophagusis unpleasant, persistent acid reflux can be serious.
"The acid chews away at the protective lining of the esophagus leading to inflammation, ulcer, and destruction of the lining," says Vivek Kaul, MD, associate professor of medicine and acting chief of gastroenterology and hepatology at the University of Rochester Medical Center.
Here are some lifestyle changes that can help.
Losing weight and maintaining a healthy body size is one of the surest ways to keep acid reflux at bay. One study of more than 10,000 women found that even a relatively small increase in body mass index could triple the odds of developing gastroesophageal reflux disease (GERD), which is persistent acid reflux.
If the average man or woman loses 10 pounds, he or she will notice an improvement in their reflux, says Robynne Chutkan, MD, assistant professor of gastroenterology at Georgetown University Medical Center in Washington, DC.
Eating the wrong foods can worsen acid reflux, either by increasing the acidic environment of the stomach or by relaxing the lower esophageal sphincter, a valve that acts as a barrier between the stomach and the esophagus. Fatty foods top the list of culprits, along with chocolate, citrus fruits, and juices.
But different people can react differently to the same foods. The trick is to figure out which foods bother you the most and avoid them, says Amar Deshpande, MD, assistant professor of medicine at the University of Miami School of Medicine.
Cut back on alcohol
Boozing is losing when it comes to acid reflux, because alcohol can increase the stomach's acidity. More acid means it's all the more likely it will spill upwards into the esophagus. Alcohol also contains numerous other chemicals that can be difficult to metabolize and irritate the stomach lining.
It's best to stay away from alcohol if you're prone to acid reflux.
Typical soda drinks like Pepsi or Coke contain citrus as well as sodium benzoate and other chemicals that can irritate the gastrointestinal tract, says Dr. Chutkan. They're best to be avoided if you have acid reflux. Carbonated water, on the other hand, shouldn't cause acid reflux.
"I tell people if you can tolerate San Pellegrino, that's fine," she says. "But if you drink carbonated water and you still have problems, it might be good to cut that out too."
Smoking can cause reflux not only because it increases acid production in the stomach, but also because it has a relaxing effect on the valve between the esophagus and the stomach.
"That valve normally stays shut and, once it opens up, it inappropriately allows acid and stomach contents to come up," explains Dr. Chutkan.
Like smoking, caffeine ups acid production in the stomach and opens the lower esophageal sphincter. That means coffeeeven decaffeinated coffee, which still contains small amounts of caffeineis off the menu for many people with reflux.
Look on the bright side. Cutting back on the morning cup of joe may also ease any jitters or heart palpitations you've been having.
Check your meds
Certain medications can raise the risk of acid reflux. These include bone-strengthening drugs such as bisphosphonates, certain blood pressure drugs, asthma medications containing theophylline, iron and potassium supplements, certain antibiotics (tetracycline is one), as well as aspirin and ibuprofen, and even fish oil supplements.
Taking a sleeping pill such as Ambien (zolpidem) may be a particular problem. One small study found that people taking Ambien were more likely to have nighttime acid reflux and more likely to be wakened by it. If one medication is giving you trouble, talk to your doctor about alternatives, says Dr. Deshpande.
Take a deep breath
The right kind of breathing, like the right kind of food, may also ease acid reflux symptoms. In a pilot study in the American Journal of Gastroenterology, researchers randomly assigned 19 patients who had acid reflux to either practice deep abdominal breathing or to a control group.
Those in the deep breathing group had better quality of life and lower stomach acidity four weeks and nine months after starting the practice.
Exercise the right way
Although exercise is critical for maintaining a healthy body weight, certain types of exercise may worsen acid reflux. Weight lifting and bench presses, for instance, can create extra pressure in the abdomen, forcing stomach contents up into the esophagus, says Dr. Deshpande.
But timing of exercise may be more important than the type of exercise, says Dr. Chutkan, who recommends that people work out on an empty stomach. "That will take care of symptoms in probably 95% of people," she says.