Don’t let acid reflux ruin your running

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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 experiencing 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 esophagus relaxes or opens inappropriately, allowing stomach content to back flow into the esophagus. The stomach content irritates and damages the tissues that are not designed to tolerate the acidic fluid.

When the stomach content pH (acidity measure) is around three, there is a burning sensation in the esophagus 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 noninfectious 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. Research shows that 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 medical 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. Be aware though that there are risks that come with all medications, and the long term use of PPIs has been associated with loss of bone mineral density.

If you experience reflux daily, and it's not just associated with your running, you should meet with your GP.

READ: What should I eat to help prevent heartburn?