A:Bet you didn’t think this would come up in your fitness regimen, but your esophagus needs love during training, too.
Intense exercise can contribute to heartburn and gastroesophageal reflux disorder (GERD), and there's a good chance that ramping up your routine may be causing your symptoms, says Walter Coyle, M.D., head of gastroenterology at Scripps Clinic Torrey Pines in LaJolla, California. In fact, some studies suggest that up to 80 percent of marathon runners experience some type of gastroesophageal symptoms such as heart burn while running.
The reason why is multifaceted: First, intense exercise steals blood away from your stomach and diverts it to the muscles being used. This delays the emptying of your stomach, so any food that's sitting in there is more likely to slosh back up as you're running, bouncing, lifting, or otherwise moving around.
Then there's your breathing. A 2011 study published in Digestive Diseases and Sciences found that panting and "exaggerated ventilatory effort" during exercise puts pressure on (and can sometimes overcome) the valve that keeps gastric juices in the stomach from entering back up into the esophagus.
What you're eating and drinking before, during, and after your workout may have an effect, too. High-protein bars and shakes take longer to digest, so it's best to avoid them for at least an hour—maybe even two—before you exercise.
Sports drinks and gels can be very acidic, too, Coyle says, especially citrus flavors. "Water is always best for short workouts—and if you need electrolytes for longer training sessions, you might have to try different products until you find one that doesn't give you symptoms."
Even if you're only experiencing GERD after meals or at night, chances are your fitness activities are still playing a role. "During exercise, you've got a rhythm going and your endorphins are pumping and you're shutting off pain signals to your brain, so you may not realize you're actively refluxing," he says. "It may not be until later that you start to feel symptoms, like nausea, food sticking in your throat, or non-cardiac chest pain."
But there is one way that exercise helps relieve heartburn, and that's by keeping you fit. "Belly fat increases pressure in the abdomen, and anything you can do to keep pressure off that valve is a good thing," says Coyle. "Exercise itself won't make reflux better, but if you're overweight and it helps you lose five or 10 pounds, that can definitely make a difference."
Bottom line: Avoiding food (especially protein) before workouts and cutting back on sports drinks may help remedy your problem.
If not, try taking an over-the-counter medication like Tums, Xantac, or Pepcid Complete 30 minutes before your workout. If you're still experiencing symptoms—or if you consistently feel like food is stuck in your throat—see a doctor. You may need a prescription medication, and will want to rule out more serious conditions.