Heartburn? Lifestyle Changes to Reduce Acid Reflux Symptoms

Losing weight, eating leaner can provide relief

man with heartburn

We call it heartburn, even though it has nothing to do with the heart. It’s gastroesophageal reflux disease (GERD) and one in five Americans have had it at one time or another.

Although medications can help to control reflux, lifestyle changes often do the trick, says Scott Gabbard, MD, a gastroenterologist and hepatologist.

GERD affects people when the lower esophageal sphincter, which controls the opening between the esophagus and stomach, fails to close after food passes through, and stomach acids travel backward up the esophagus.

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Why reflux happens, how to prevent it

Dr. Gabbard lists excess stomach weight, fatty foods, large meals, and intake of alcohol, cigarettes, caffeine, chocolate and peppermint as risk factors for GERD. He says lifestyle changes are most important to help prevent that sphincter from opening in the first place.

Here are his top recommendations to help GERD sufferers:

  • Lose weight. There is no other single thing you can do that can have a greater impact on your reflux, Dr. Gabbard says. Losing weight is the most important, and often the hardest thing to do — but the effort is worth it.
  • Eat smaller, less fatty meals, especially late in the day. “Fat causes the sphincter to open, as do large meals,” he says. “No medicine can prevent you from getting reflux if you eat a pepperoni pizza and drink a full pitcher of beer.” 
  • Cut alcohol and smoking to start with, and see whether you need to make other dietary changes. “Many patients with reflux tolerate coffee just fine,” Dr. Gabbard says.
  • Don’t eat for three hours before bed if reflux hits you hardest at bedtime — and use a 6- to 8-inch incline wedge pillow. “Those can be purchased on the Internet for $30,” he says.
  • Wear looser clothes that doesn’t compress your abdomen. This sometimes helps, although that hasn’t been formally studied.
  • Take Prilosec® or Nexium® about a half hour before eating. Some patients mistakenly take them at bedtime, which doesn’t provide any benefit. The medications reduce the amount of stomach acid but they don’t help keep the sphincter closed; there is currently no FDA-approved medication that does.

Medications such as Prilosec and Nexium are basically safe over the long term, although studies show they contribute to a slightly increased risk of osteoporosis, pneumonia and colon infections, Dr. Gabbard says. He says GERD sufferers should discuss them with their doctor. He also says to talk to your doctor if reflux symptoms don’t respond to treatment or are severe and persistent.

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  • Fernando Domeniconi

    Not trying to promote my lifestyle, just as a feedback: I used to have heartburn on a daily basis. After I quit smoking and changed to a low-fat vegetarian diet, I never had it again.

  • Foofus P Kitty

    Nexium can cause you HUGE problems when trying to get off of it. It can actually intensify the acid. Worse medicine I ever took and the side effects are just as bad as the reflux.

    • Pat

      What are the side effects?

      • Mimi

        Acid rebound — worse than the original diagnosis.

    • Dee Marie in TN

      Your stomach uses acid to digest your food. When the acid is cut – ie. taking Nexium – it messes with the digestion of food. I had gastro issues so bad I thought I had IBS – diarrhea is quite common. While on Nexium I would have intense coughing fits coughing up phlegm – thought it was allergies but it seems farther down my throat than sinus would have been, and blowing my nose never helped. Seems my esophagus was coated with “goo”. I also agree with Mimi – acid rebound was a big problem – my stomach is hyper sensitive to even the smallest acids now. I started doing some research on Nexium and side effects – you will find a wealth of information on the Internet from actual people’s comments. Decide for yourself. I started to realize that what I thought were other ailments were actually side effects from the acid reducer. Acid reflux is a serious problem – you should not leave it untreated but do educate yourself when it comes to deciding how you want to be treated.

  • Ann

    Good article, but….I’ve heard acid reducers that are NOT Proton Pump Inhibiters are a little safer for people.i don’t know why doctors don’t consider them first. Things like Axid, for example.

    Other meds like Prilosec and Nexium seem to cause issues with B12, and even osteoporosis…as well as other problems. I DO like the idea of taking your med 30 minutes before your meal (if medication is absolutely necessary).

    Sleeping in an incline position…as well as the other pieces of natural advice are great ideas. Aloe drinks can be helpful. Avoiding junk food and sugar are great ideas.

    Best to avoid medication if possible, particularly PPI’s.

  • Marti Cozza Arnold

    Why do so many doctors recommend Prilosec and Nexium? Why not Protonix and Carafate or some other OTC remedies? What is the real difference??

    • Dee Marie in TN

      Here’s one consideration Marti – my doctor recommended a generic form of acid reducer – via prescription. She said that since medical insurance pays for part of the prescription, it would be more cost effective for me to purchase the meds this way rather than the over the counter option. As for the strength of the medicine, there was no difference between a prescription and it’s OTC equivalent.

    • Lee Thomas

      Carafate is a good medication, but it can lead to other digestive problems. I generally only take carafate when my acid is so bad that it gives me an ulcer. However, Nexium actually works for me. The only problem is after taking it for 3-years, I now have arthritis in several key joints…I’m only 32.

  • Claudia

    When I gave up gluten, my reflux and heartburn disappeared.

  • YtownBob

    Consider Dexilant over Nexium or OTC!
    It is a dual release drug…released over the day.
    I take the lowest dose available. ..best therapy ever! Fast onset of relief…
    I pay $20.00 for a 90 day script…With the manufacturer coupon!
    Can’t beat $7.00 a month!!

  • garnet

    I take tiny sips of water all day long. This really helps.

  • Theresa

    I’ve been having trouble with heartburn or acid reflux. Recently saw a great video on reflux remedy dot com that said eating an apple would cure it. Tried it last night and instant relief.

    • Lee Thomas

      That doesn’t work for me, as I also have eosinophilic esophagitus, and apples cause flare ups.

  • Laura

    Cheap fix I found to help is chewing gum. .. cinnamon or spearmint. Helps in most cases once Gerd acts up unless it was severe. Sleeping elevated also a plus. Limit food intake before bed. Every person’s tolerance level is different. I cut out everything and then slowly worked back in certain foods to see what I could tolerate.

    One Dr told me the gum was not significant. Try it for yourself. It’s cheaper and doesn’t have side affects! If I ate something before bedtime. .. chew the gum before you lay down. …9/10 it prevented a reaction. It diffuses the acid.