January 3

How To Improve Your Posture to Improve Your GERD

13  comments

How To Improve Your Posture to Improve Your GERD

Introduction

More than half of the population experience heartburn on a regular basis. Twenty to thirty percent will experience it weekly. The most common advice is to change your eating habits and take medication such as OTC antacid tablets, proton pump inhibitors (PPI’s), or H2 Blockers. This may not be the best way to deal with this issue. Check your posture. In this article I will explain how to improve your posture to improve your GERD symptoms.

Surprisingly your posture has a huge impact on whether you will have GERD symptoms or not. Maintaining good posture while you are eating and for a few hours after eating can reduce symptoms drastically. I've found that if I start feeling heartburn coming on I can relieve it within a few minutes just by straightening my posture. 

What You Will Learn

  • Poor posture can change the orientation of your LES (lower esophageal sphincter) and the opening to your stomach making it easy for stomach acid to flow back into your esophagus causing heartburn symptoms
  • Ensuring that you maintain good posture while eating (and after eating) can drastically reduce the chances that you will get heartburn.

I Have “iHunch.” Do you?

In our advanced society where many people work at a computer daily and almost everyone has a smartphone or tablet, the incidence of forward head posture is on the rise. Bad posture changes the normal positions of our body and can disrupt the normal function of our vital organs.

This hunched over posture changes the position and orientation of our organs, especially the esophagus and its relationship to the stomach. This postural change can put the opening of the stomach either at the same level or slightly higher than the lower esophageal sphincter making it difficult to stop stomach acid from backing up into the esophagus.

I’m a researcher, and as part of my job, I spend a lot of time sitting at a desk slouched in front of a computer. Then I go home after work and spend a few more hours slouched in front of my home computer. Then I slouch on the couch for another few hours watching TV.

As a result, I have very bad posture and what is called forward head posture (FHP). Other not so nice names for this are "Scholar's Neck," "Wearsie Neck," "iHunch" or "Reading Neck.

I have been doing this for over 25 years. As a direct result, my posture while using a computer is horrid. Even though I work out at the gym for an hour, 5 days a week, it does not counteract this problem. 

I Had Acid Reflux For Over 40 Years

I also suffer from acid reflux; in fact, I have full on GERD. But I’m not so sure I can say this anymore. Over the past few years, I have been learning more and more about how to "fix" acid reflux and GERD. Instead, I can now say that I have not had anything more than mild heartburn maybe three times in the last 5 years. Believe it or not, I have gone back to my former eating or drinking habits. I can drink alcohol, eat spicy foods, pizza, fried foods, greasy hamburgers; basically, whatever I want.

The biggest breakthrough for me was coming to terms with the fact that Acid Reflux is not caused by too much stomach acid. It is caused by not having enough!

Once I finally believed this, and then did something about it, my symptoms have disappeared. I have not taken any acid reflux medication whatsoever since August 2015.

Fixing my posture was the final piece of the puzzle.


What Lifestyle Changes I have Made?

I did these 4 things to cure my Acid Reflux:

  • I started taking Betaine HCl with Pepsin before meals that contained a lot of protein.
  • I sleep as much as possible on my left side – never on my back.
  • I take Digestive Enzymes before meals.
  • I am conscious of my posture while eating and after I eat

That’s it.

After having Acid Reflux/GERD most of my life I rarely experience any symptoms anymore. 

Final Piece Of The Puzzle – Quit Slouching!!!

A slouched posture can restrict the passage between the stomach and the esophagus, causing the muscles of the esophagus to go into a spasm causing the LES to gape open enough to allow the escape of stomach contents into the esophagus, causing acid reflux symptoms. This simulates a hiatal hernia. (Add link to hiatal hernia article)

Over the past 8 months, I’ve tried to be more conscious of my posture especially while eating and after eating. I make sure my shoulders are back and down and that my head is as aligned as possible directly over my shoulder, not out in front of them (FHP). If that is too much to think about you may find it easier to just keep your solar plexus at a right angle to the floor.

If I feel heartburn coming on I immediately correct my posture and the feeling goes away almost immediately

It would be fantastic if I could maintain a proper, upright posture all the time but I’ve been like this for years, and it would probably take years to correct it. It probably will never happen. But I can maintain it at least while I am eating and for a period after. I feel it is important for avoiding GERD symptoms.

An upright position allows gas to pass up through the esophagus and release the pressure exerted by the stomach on the LES. It’s important to have a body position that minimizes the pressure a bloated stomach places on the LES and putting the esophagus at the correct angle, so as to allow easy passage of food on the way into the stomach and easy passage of gas on the way out.

In addition, a “straight” position allows gravity to more easily aid the LES and keep stomach acid where it belongs. 

Best Standing Posture If You Have GERD

Bad posture can cause heartburn

The image on the left shows poor posture while standing. In this position, the esophagus is in a disadvantaged position in comparison to the opening of the stomach. The esophagus is twisted in this position causing the LES to be forced partially open.  This causes stomach contents to reflux into the esophagus as pressure builds up in the stomach.

The image on the right shows correct standing posture in which the esophagus will be at right angles to the ground, allowing the LES to do its job which is to keep the stomach contents where they belong.

To maintain proper standing posture:

  • Stand with your feet shoulder-width apart, with your weight mostly on the balls of the feet.
  • Pull your shoulders back and down
  • Keep your solar plexus perpendicular to the floor
  • As much as possible keep your head directly above your spine, not pushed out forward or pulled backed behind 

Best Sitting Posture If You Have GERD

Bad Seated Posture vs Good Seated Posture

The image on the left shows poor sitting posture. The forward lean of the chest, shoulders, and head puts the esophagus in a disadvantaged position, twisting the esophagus causing the LES to be forced partially open increasing the chances that stomach contents will be more easily forced back up into the esophagus. 

The image on the right shows the correct posture while in a sitting position. This position minimizes pressure on the LES and keeps the esophagus perpendicular to the ground.

To maintain proper sitting posture:

  • Sit with your shoulders back and down. Keep your scapula's pinched together.
  • Keep your solar plexus perpendicular to the floor.
  • Consciously correct yourself when you begin slouching or leaning forward.
  • Do not twist to one side in your chair.
  • Keep your feet flat on the floor.

Try This Posture Test At Your Next Meal

At your next meal try to sit for the entire meal without resting you’re back against the back of the chair. Sit up straight, arch your back slightly, with your shoulders back and down, and without leaning against the back of the chair. If you cannot do this for 30 minutes, your posture is likely affecting your digestive process and causing acid reflux symptoms (heartburn). 

Best Sleeping Position If You Have GERD

The best sleeping position is on your left side. In this position, the LES is naturally higher than the opening to the stomach allowing gravity to help the LES contain stomach acids while lying. Sleeping on your left side puts the LES in an advantaged position, making it easier for the LES and gravity to keep the contents of the stomach from refluxing into the esophagus.

Sleeping on your right side puts the opening to the stomach above the LES so that it is constantly fighting to stay closed. Eventually, the muscles of the LES will tire and allow the stomach contents to flow into the esophagus.

Sleeping on your back puts the LES and opening to the stomach on the same level. The least bit of stomach pressure from bloating will easily push stomach contents into the esophagus.

Raising the head of the bed by 10 to 15 degrees will allow you to sleep on either side as well as your back. Just place some blocks under the head of the bed to raise it to the proper level. Be careful though as this may damage your bed.

If this is not possible, bed wedges are a simple, cost-effective solution to properly raise the body to advantageous position for sleeping.

Never sleep on your stomach.

One thing to be aware of: If you sleep on your left side all the time you will get tight hip flexors (psoas muscle). Tight hip flexors cause the release of cortisol. Excess cortisol affects your sleep - you may fall asleep easily but will awaken every few hours. This is from the excess cortisol. Here is a YouTube video you may find helpful: 7 Best Hip Flexor Stretches to Decrease Pain & For People Who Sit All Day

How to Correct Your Posture

There are a number of ways to correct your posture. It will take a great deal of time and effort but can be done. You will not be able to do this by conscious effort because as soon as your mind starts thinking about something else you will go back to old habits. 

It is beyond the scope of this article to go into enough detail to instruct you how to do this successfully improve your posture.

I would recommend going to see a good physiotherapist who can tailor the exercises to your exact needs. 

Other Ways To Correct Your Posture

There are some devices on the market that can help, but I feel that visiting a good physiotherapist is the best choice. If you would like to see some of the devices for improving posture here are few that I have tried with limited success:

Adrenalease

https://www.adrenalease.com/

This is a Toronto based company. The shirts have crisscrossing supports that go across the back and then around the shoulders to hold them in the proper position. You can wear them as is, to the gym or under your regular clothing.

The shirts were created by a University of Toronto Kinesiology graduate. I have no affiliation with this company.  They are fairly expensive at $120 for a t-shirt and $100 for a tanks top. Same prices for ladies; and they have a Posture Bra for $70.

POZE – The Ultimate Posture Coach

https://www.indiegogo.com/projects/poze-the-ultimate-posture-coach-health--2#/

I bought this from Indiegogo. It is fairly cheap at $49. Honestly, I have never given this a reasonable amount of time, only wearing it a few times. You are supposed to wear it daily, starting at 20 minutes and gradually increasing to a few hours per day.

It is a small round contraption that you tape to your upper chest by your collarbone. It vibrates if you slouch for more than 1 minute reminding you to straighten up. The literature says that after just three weeks your muscles will naturally maintain good posture standing and sitting. 

Summary

I have found that just correcting your posture when you feel heartburn symptoms coming on will most times fix the problem almost immediately.

If you have bad posture, this may have a dramatic effect on you as well. Please leave a comment below with your thoughts.


DISCLAIMER

The information contained in this article does not constitute medical advice and is not meant to diagnose, treat, prevent, or cure disease. Please contact your doctor. The information provided is for informational purposes only and are solely the views of the author.



Here are two short videos from Dr. Mandell on proper posture:
(Please visit Dr. Mandell's YouTube channel.)

Low Stomach Acid is the Main Cause of Heartburn, Acid Reflux, and GERD

Please Leave a Comment

  • David, I read your convincing article. I was diagnosed with mild/moderate GERD months back. I followed a strict diet and lost about 20 lbs. The bad part of it is that I lost some iron in me; however my blood pressure has been consistently good ever since. My main problem then was my hoarse voice here and then, without the other symptoms like heartburn, sore throat, pain …etc.My Doctor prescribed Famotidine
    which is helping me a lot but still continue to be in strict diet. Your posture suggestion has helped me after 2 days. My question to you is how to be weaned from strict diet and maintain a normal voice. please give me your thoughts. I am 85 yrs old and on fixed income and barely afford anything from medication to equipment. Thank you! Hope to hear your response soon.

    • Hello Adelina,
      I am not a medical doctor. I think you would get better advice from your doctor on this specific problem.
      Best Regards
      Dave

  • Hi, I too wondered if posture was causing my only recently onset symptoms, which is the question that I typed into Google which led me to find your article, which was very interesting to have read, along with others’ comments. I was encouraged to slouch a little by physiotherapists because of my very straight spine, which did assist me to use my core better and to sit at a desk and on a bus with greater shock absorption in the spine, but it did bring a couple of major negative issues with it, not just the recent reflux with associated nausea. Now to find the happy medium of posture & released thorax versus too much straightness! I too experienced my first day of major reflux after a long gardening day. Then nothing for a while, then after eating and working at my desk. You had another contact wondering about GORD /GERD after slouching over gardening so that has assisted me to realise why the nausea came that day (my issue is only just being recently diagnosed). Thank you.

  • I agree. I probably caused my LPD Reflux by lying down on the coach after a meal and not sitting upright.
    I eat an alkaline diet that helps but correct posture is the biggest help of all.
    I’ve just had a hot chocolate drink for the first time in 6 months and have maintained perfect posture and I have not had any symptoms.
    Great advise! Just a shame Doctors do not seem to know about the relationship of reflux with posture.

    • Hi Suzanne, I am glad this is working for you. Regarding doctors, I think they are too quick to prescribe medication without determining the underlying cause. They treat symptoms instead of the cause.
      Dave

  • Thanks for a very interesting article. I have suspected for some time that my slouchy posture has something to do with my reflux. I also sit for 10-12 hours a day at work as a 911 dispatcher (yeah, that can’t be good, I know). And like you mentioned, I come home tired and slouch on the couch for a few more hours watching TV and using my computer. I also crouch a lot while gardening and wonder if that might be messing something up. I’ve had my esophagus “stretched out” a couple of times, but after the last one it seems like the problem got worse. PPI’s don’t seem to help much. So I’m going to try to be more aware of my posture and see if I get better. Your article gives me hope!

  • Hi David – WOW, I am so glad I happened upon this article. As you started to incorporate the 4 remedies (enzymes, HCI, posture, sleeping, etc.), how long until you started to feel relief from acid reflux symptoms? Also, even coffee or water brings on burning symptoms for me. Was that the case for you as well or did you only have symptoms when you ate? Thank you for writing!!

    • Hi Jenn,

      Yes, I often got heartburn from drinking water and coffee.

      The most difficult transition is to stop taking any kind of medication, whether it’s H2 blockers, PPI’s or even antacid tablets. It took about 6 weeks to gradually reduce this down to nothing. During that time I avoided foods that caused bloating. I still had symptoms, sometimes severe. Don’t suffer during this time. If you experience symptoms take meds to get relief. Eventually you will  be able to get through a day with no symptoms.

      The next big challenge is adding HCl to your diet. I would wait about a week after being symptom free to start taking them. At first I was anxious about taking these, expecting to get severe symptoms, but I never had an issue. I started with taking 1 HCl cap before large protein meals. I gradually increased this to two or three before a large meal.  Now I rarely use them. My stomach is producing sufficient stomach acid on it’s own. I find just keeping good posture will relieve most symptoms within a few minutes. I don’t restrict anything from my diet anymore and consume whatever I want.

      All the best in your journey to good health
      David

  • Hi there,

    Thanks for the article, really insightful. May I ask which brand of enzymes and Betaine HCl with Pepsin you are actually taking? There are so many different types so just want to be sure.

    Looking forward to hearing from you.
    Thanks
    Alex

    • Hi Alex, thanks for your comment. I have tried a number of different brands of Betaine HCL. The brand that I think is the best is called Enzymatik Control by a company called ATP(Athletic Therapeutic Pharma). ATP is a Canadian company and all of their supplements are top notch. The only problem I find with them is the names of their products. I doubt Enzymatik Control would ever come back in a search for Bataine. I found it just by chance – I was on their website and was reviewing all of there product. They all have counter-intuitive names. This product is fantastic. Besides having 400g of Betaine HCL it has these enzymes: Cellulase, Amylase, Hemicellulase, Lactase, Pectinase, Protease, Invertase, and Alpha-Galactosidase. I highly recommend this brand. Also, beware of the price – they aren’t cheap. I have no affiliation with this company.

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