My Results - Self-care for Acid Reflux

Below are recommended lifestyle choices and behaviours that may help you improve and maintain your health.  Some you might already be doing.  Great, keep going!   Others might be new.  Perhaps you could give them a try?  The information is from trustworthy sources used by doctors and other health professionals.  The results are personalised to your sex, age, and health condition (acid reflux).

Section 1 - Recommendations with High Level of Evidence

These recommendations are from primary and secondary sources of health information, including clinical guidelines from national medical organisations and systematic reviews of well conducted research.
  • Eat healthily (NICE, 2019).
  • Reduce weight, if overweight or obese (NICE, 2019; ACG 2022).  Weight gain has been associated with a new onset of GERD symptoms.  Some studies show a dose-dependent improvement in GERD symptoms with weight loss, meaning symptoms improve at a similar rate to the weight being lost (ACG, 2022).
  • Stop smoking and avoidance of tobacco products (NICE, 2019; ACG, 2022).
  • Causes / "Triggers".  Avoid things that you believe can cause your symptoms (NICE, 2019; ACG, 2022).  These can include alcohol, coffee, chocolate, and fatty foods (NICE, 2019), carbonated drinks, spicy foods, acidic foods such as citrus and tomatoes, and peppermint (ACG, 2022).
  • Sleep.  Raising the head of the bed may help some people, or sleeping on a wedge.  Compared with lying left-side down, lying right-side down increases nighttime reflux and reflux after meals.  This may be because lying right-side down places the esophagogastric junction (where your oesophagus - food-pipe - joins your stomach) below the stomach and, therefore, more likely to "reflux" back into the oesophagus.  Therefore, people might be advised to avoid sleeping right-side down (ACG, 2022).  Having a main meal well before going to bed, at least 2-3 hours before bedtime, may help some people (NICE, 2019; ACG, 2022).
  • Psychological Therapies.  Psychological therapies, such as cognitive behavioural therapy (CBT; AGA, 2022) and psychotherapy, may reduce symptoms in the short term in individual people (NICE, 2019). Also, hypnotherapy, diaphragmatic breathing, and relaxation strategies (AGA, 2022).
  • Stress Reduction.  Stress-reducing activities such as mindfulness (AGA, 2022).

Section 2 -  Recommendations with Moderate Level of Evidence

These recommendations have some evidence of effectiveness, but may have insufficient quality or quantity of evidence to be in a clinical guideline. Therefore, these options are safe for you to explore but, ideally, in consultation with your healthcare provider.
  • A potential cause of acid reflux for some people is a weakened lower oesophageal valve called the Lower Oesophageal Sphincter (LES). The LES is located at the end of the food-pipe (oesophagus), just above the stomach. It is responsible for keeping stomach contents, including stomach acid, from flowing back into the oesophagus. If the LES becomes weak or damaged, acid reflux can occur, causing heartburn and other digestive discomfort. Some research suggests that breathing exercises can help to strengthen the LES. This research includes several randomised controlled trials (Eherer, et al., 2012; Halland, et al., 2021; Hosseini, et al., 2022; Sun, et al., 2016). A meta-analysis of 7 studies concluded that, "To some extent, breathing exercises can relieve the symptoms of patients with GERD" (Qiu, et al., 2020). A systematic review of 11 studies concluded, "Current knowledge suggests the potential of breathing exercises in the treatment of GERD" (Zdrhova, et al., 2023).

Section 3 - Information from Other Sources

This information is from other sources, such as websites from trusted health organisations. The information is usually good quality, but may be unreferenced, incomplete, or updated only periodically.
  • Eat smaller, more frequent meals (NHS, 2023).
  • Try to lose weight if you're overweight (NHS, 2023). Maintain a healthy weight. Excess pounds put pressure on the abdomen, pushing up the stomach and causing acid to reflux into the oesophagus (Mayo Clinic, 2024).
  • Try to find ways to relax (NHS, 2023).
  • Using wood, bricks or books to raise the head of your bed by around 10 to 20cm, so your chest and head are above your waist, may help relieve symptoms. This can help stop stomach acid travelling up towards your throat.  If you can't elevate your bed, you can insert a wedge between your mattress and box spring to elevate your body from the waist up.  But do not try to achieve the same effect by using additional pillows, as this can increase pressure on your belly and make your symptoms worse (NHS, 2023; Mayo Clinic, 2024).
  • Stop smoking. Smoking decreases the lower oesophageal sphincter's ability to function properly (Mayo Clinic, 2024).
  • Start on your left side. When you go to bed, start by lying on your left side to help make it less likely to have reflux (Mayo Clinic, 2024).
  • Don't lie down after a meal. Wait at least three hours after eating before lying down or going to bed (Mayo Clinic, 2024).
  • Eat food slowly and chew thoroughly. Put down your fork after every bite and pick it up again once you have chewed and swallowed that bite (Mayo Clinic, 2024).
  • Don't wear tight-fitting clothing. Clothes that fit tightly around the waist put pressure on the abdomen and the lower oesophageal sphincter (Mayo Clinic, 2024).
  • Some complementary and alternative therapies, such as ginger, chamomile and slippery elm, may be recommended to treat GERD. However, none have been proved to treat GERD or reverse damage to the oesophagus. Talk to a healthcare professional if you're considering taking alternative therapies to treat GERD (Mayo Clinic, 2024).

Section 4 - To Avoid

These 'To Avoid' recommendations are from other sources of information (Section 3). They highlight things to avoid as they might make your symptoms or condition worse.
  • Avoid food or drink that triggers your symptoms (NHS, 2023).
  • Avoid eating within 3 or 4 hours before bed (NHS, 2023).
  • Avoid wearing clothes that are tight around your waist (NHS, 2023).
  • Avoid smoke and smoking (NHS, 2023; Mayo Clinic, 2024).
  • Avoid drinking certain beverages, such as coffee or too much alcohol (NHS, 2023; Mayo Clinic, 2024).
  • Avoid taking any prescribed medicine without speaking to a doctor first (NHS, 2023).
  • Avoid eating large meals or eating late at night (Mayo Clinic, 2024).
  • Avoid eating certain foods, such as fatty or fried foods (Mayo Clinic, 2024).
  • Avoid taking certain medicines, such as aspirin (Mayo Clinic, 2024).

References

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