A client of mine has acid reflux, and the doctor told her to refrain from weights, but I feel that a light resistance will not harm her situation. What do you think and what exercises do you recommend?
Acid Reflux is an upper gastrointestinal condition in which acidic stomach fluids migrate to the upper part of the stomach and sometimes the esophageal tract. These symptoms are usually magnified while the patient is lying down. In that position, the GI tract is horizontally aligned with the esophageal tract without the aid of gravity holding acidic fluids.
Gastrointestinal disorders are be caused by gut ischemia (↓ blood flow), dehydration, use of tobacco and alcohol, medications (anti-inflammatory) and certain foods and fluids (especially those containing caffeine.) Acid reflux is most commonly related to caffeine, tobacco and alcohol use.
Does exercise in itself affect acid reflux? The medical community is unclear. A recent study showed that training at intensities of 70 percent max VO2 reduced blood flow to the gut by 60 to 70 percent. While training at higher intensities, the blood is located in the muscles performing the work. This lack of blood flow in the gut increases cellular death in the GI tract.
Antacids may provide some symptomatic relief. However, those containing magnesium hydroxide, like good ol’ Milk of Magnesia, may produce diarrhea, and those containing aluminum hydroxide can lead to constipation. Better to follow directions of physician in the matter of medications.
Proper hydration may limit the effects of acid reflux. The American College of Sports Medicine (ACSM) has published some updated guidelines. They suggest drinking two cups of water 20 minutes prior to exercise and then “the maximal amount tolerable” during exercise. Maintaining optimal levels of hydration allows all body systems to work synergistically at optimal levels of performance.
Basically, no exercises are contraindicated. Your client may be more sensitive when lying on her back performing abdominal exercises or with exercises in which she is slightly inverted. In these situations, you must rely on direct communication with her. To conservatively approach her condition, do not condition at training intensities or with exercises that increase her reflux symptoms.
- Green GA: Exercise-induced gastrointestinal symptoms. Phys Sportsmed 1993;21(10):60-70
- Persson PG, Leijonmarck CE, Bernell O, et al: Risk indicators for inflammatory bowel disease. Int J Epidemiol 1993;22(2):268-272
- Putukian M and Potera C: Don’t miss gastrointestinal disorders in athletes. Phys Sportsmed from www. physsportsmed.com. 1997:25(11)
- Worobetz LJ, Gerrard DF: Gastrointestinal symptoms during exercise in enduro athletes: prevalence and speculations on the aetiology. N Z Med J 1985;98(784):644-646