These nutritional strategies and medications can help prevent acid reflux.
Jan asks: I’m a marathoner who always get acid reflux during races. I need to eat and drink to keep my energy up, but doing so makes me feel so bad. Any advice?
Completing a marathon is a huge physical challenge, and mid-race acid reflux will certainly make that feat even more challenging.
Acid reflux usually occurs when the muscle sphincter (valve) between the stomach and the oesophagus relaxes or opens inappropriately, allowing stomach content to back flow into the oesophagus. The stomach content irritates and damages the tissues that aren’t designed to tolerate the acidic fluid.
When the stomach content pH (acidity measure) is around three, there is a burning sensation in the oesophagus that is likely the source of your discomfort. If the content is less acidic with a pH of five, there may be no pain, but the reflux fluid can enter the respiratory tree causing a hoarse voice (reflux laryngitis) or a chronic non-infectious cough.
Research shows that reflux can occur in people who are exercising on empty stomach. So it’s important to ingest some form of nutrition before your race. It’s likely you are already doing this, and so I’d advise you to consider the timing of your pre-race nutrition. Exercise-related reflux is worse shortly after eating.
You should experiment with different types of nutritional products to see what works for you. There are many forms of mid-race “food” on the market today. Perhaps switching to a different gel or bar or chew could provide relief. It will likely require some trial and error to develop a nutritional strategy. You may find that small, frequent feedings, possibly in liquid form, is best.
A persistent problem may warrant a visit with your GP to discuss pharmacologic interventions. There are basically three that are available over-the-counter: antacids (like calcium carbonate chewable tablets), H2 blockers (like cimetidine and ranitidine) and proton pump inhibitors, or PPI, (like omeprazole). You may find that taking a medication a day or two before your race could suppress your symptoms. There are risks that come with all medications, though, and the long-term use of PPIs has been linked with loss of bone mineral density.
Book an appointment with your GP if you experience reflux daily and it’s not just associated with your running.
